Mongolia celebrates World Health Day and launches “Maternal Mortality Reduction Strategy” and a new Child Growth Monitoring and Development Chart2005-04-07
Ulaanbaatar , Mongolia – The Ministry of Health of Mongolia launched the Government’s second Maternal Mortality Reduction Strategy on 7 April 2005. The launch coincides with the World Health Day which was also marked with the passing of a Health Minister order for a nationwide scaling up of a new child growth monitoring and development chart.
The new Maternal Mortality Reduction Strategy covers the period from 2005 and 2010 and its elements are based on the UNICEF East Asia and Pacific Regional “Strategy to reduce Maternal Deaths”.
The strategy proclaims its goal to reduce MMR from the current 98.8 per 100,000 live births down to 75 by the year 2010. This is a strategic call for change as mandated by the Millennium Development Goals that specifies a reduction by 75 per cent of 1990 maternal mortality ratios by 2015.
This is indeed a daunting challenge and according to the Government, this goal will be achieved through a multi-prong strategy by enhancing participation of governmental, non-governmental and donor organizations, as well as the civil society and individuals.
Some of the new features of the strategy include increasing accessibility, equity and availability of reproductive health and safe motherhood services for the remote, migrant, and disadvantaged groups of population, and enhancing participation of individuals, husbands, family and community members in preventing pregnancy, childbirth and postpartum complications, and ensuring prompt access to safe motherhood services. These strategic objectives will be obtained through, in part, by increasing usage of products enriched with supplements and vitamins essential for maternal and infant health.
The strategy is planned to be implemented through regular monitoring and evaluation to ensure a timely, effective, equitable and appropriate distribution of financial, material, information and human resources.
The Strategy indicates that the first MMR strategy (2001-2004) was successfully implemented and as a result MMR in was 2004 was 98 per 100,000 live births as compared to 157 in 2000 or a 40 per cent decline in just four years.
These achievements are basically attributed to advocacy efforts directed at decision makers to ensure favorable political environment, development and introduction of clinical guidelines to improve the quality of reproductive health services, early referral of high obstetric risk patients to specialist care, improved skills training of rural paramedics, and provision of essential drugs and equipment.
Mongolia has a population of 2.4 million. Children under 15 years of age constitute almost 33 per cent of the population, while women of age 15-49 years account for more than 28 per cent of the total population. Life expectancy is 63.5, including 66.7 for women and 60.8 for men. The fertility rate per 1,000 people is 18.05, net population growth is 11.9 and death rate is 6.1 according to the 2003 health indicators.
In Mongolia more than 95 per cent of all pregnant women receive antennal care. Early enrolment within the first three months of pregnancy in antenatal care is more than 74 percent. Among reproductive age women, 46 per cent have chronic health conditions, mainly anemia, urinary tract infections, cardiovascular and gastrointestinal tract diseases (RH Survey, 2003). More than 47 per cent of all pregnant women suffer from iron deficiency anemia, 37 per cent from vitamin D deficiency (Public Health Institute. 2004). And data shows that only just over 70 per cent of all pregnant women use iron supplements during their last month of pregnancy.
In Mongolia, the leading cause of maternal mortality include pre-eclampsia and eclampsia – almost 21 per cent of maternal deaths, bleeding – 20 per cent, and sepsis – almost 16 per cent, according to the surveys conducted by the Ministry of Health in 2003.
The country continues to face numerous challenges in improving the status of MMR. Among others, the challenges include poor infrastructure that impeded timely provision of emergency obstetric care and referral services, given the vastness of the territory and the sparsity of the population density. There is a shortage of doctors and midwives in the rural hospitals; the shortage of equipment for emergency and basic services for mothers and newborn babies; and unequitable access to quality safe motherhood services in the urban and rural areas.
The Maternal Mortality Reduction Strategy, 2005-2010, was developed and launched with the financial and technical support of UNICEF as well as WHO, UNFPA and the German Technical Assistance Organization – GTZ.
The growth chart used previously by family doctors and parents in Mongolia was designed to monitor the growth of children with respect to health and nutrition only.
The new and revised version of the child growth monitoring and development chart has been pre-tested in 2 rural soums (rural village) and 2 khoroos (sub-district) in Ulaanbaatar. The chart has a development checklist, which provides a tool for parents and health personnel to monitor children's development, according to a child’s physical, cognitive and psychosocial development milestone. It also provides parents and caregivers with information on positive behaviors such as exclusive breastfeeding, introducing proper solid food, micronutrient supplementation, identifying symptoms of certain diseases and taking the necessary action as well as HIV/AIDS/STI prevention.
It is a comprehensive method of empowering family, especially mothers.
The Minister of Health issued an order on 7 April 2005 which underlines the importance of scaling up the new growth chart at the national level as it will give parents and caregivers the responsibility of monitoring the growth of children, since the health of a child should begin from home.
The new chart was developed by experts from the Nutrition Research Center in the Mongolian capital with the technical support of UNICEF.
For more information and interviews, please contact
Chanrav Burenbayar, Communications Officer, UNICEF Mongolia
Mungun Tuya, Project Officer, Health & Nutrition, UNICEF Mongolia
Sundui Oyunchimeg, Communication Assistant, UNICEF Mongolia