The children

Early years

Pre-School Years

Adolescence

 

Child survival

The trend for neonatal mortality rates in Mongolia is the same as in developed countries. From 2001 to 2003 the neonatal mortality rate was 14 deaths per 1,000 births. The major causes for neonatal mortality are asphyxia, respiratory distress and congenital defects, which require high tech tertiary level care and improved referral system.

The Infant and Under-Five Mortality Rates declined gradually in the last 5 years. Infant Mortality Rate per 1,000 live births was 31.2 in 2000 and declined to 22.8 in 2004. If this decline continues, it will be possible to achieve the MDG goal of a reduction of IMR by 60%. However, the peri-natal mortality rate of 28 per 1,000 live births poses a significant challenge to IMR reduction. The U5MR per 1,000 live births was 42.4 in 2000 and declined to 29.1 in 2004.

There are some positive changes in the mortality and morbidity pattern among children. The Under Five Mortality caused by pneumonia per 1,000 children was 3.9 in 2000 and decreased to 1.9 in 2003. The main causes of the U5MR are still acute respiratory infections (ARI), diarrhoeal diseases, and injuries. The total number of deaths between 0 and 1 year has decreased from 1,390 deaths in 2002 to 1,016 deaths (26% decrease) in 2004.

Of these, 400 die due to ARI and 170 due to diarrhoea every year and the rest due to other causes such as pre-maturity, low birth weight and congenital malformations. Infant mortality is higher in rural areas (32 per 1,000) than in urban areas (26 per 1,000). This may probably be due to long distances to health facilities as well as lack of access to antenatal and delivery care, including emergency services in rural areas. As in other countries, the mother’s educational level is inversely associated with neonatal, infant and under-five mortality and the child mortality rates are higher for male children than female children.

According to a survey on ‘Access to Water and Sanitation Services in Mongolia’ (2004), 44.6% of the population have access to improved water sources, and only 28.2% have access to improved sanitation. But there is a large disparity between rural and urban Mongolia. In regard to improved water sources, 62.1% of urban households have access, compared to 17.3% of rural households. In regard to improved sanitation provision, 42.6% of urban households have access, compared to only 4.8% of the rural households. Lack of access to safe water is one cause of the high incidence of diarrhoea, which is closely connected to child malnutrition and mortality. A survey on arsenic determination in drinking water conducted in 2004 showed that the country average of arsenic content in drinking well water is 0.014mg/l and 10% of all samples are arsenic positive and less than 14% of the surveyed population had any overt signs and symptoms of arsenicosis.

Most vaccine preventable diseases are under control. No cases of neonatal tetanus and no cases of death due to measles or maternal tetanus were reported in the last decade. The country has maintained a polio free status since 2001. The main causes for infant and maternal deaths are not related to diseases that are preventable by vaccine. However the morbidity rates due to measles and hepatitis B among vaccinated children were at the same level (1 per 1,000 children under five) in both 2000 and 2003. The vaccine coverage in all six antigens has increased from 92% in 2000 to 95% in 2004.

Childhood injuries
In last few years accidents and injuries among children and adolescent have become one of the public health problems in Mongolia. Nearly 14% of all deaths in the age group from 15-44 result from accidents and injuries, taking third place in the list of the five most common causes of mortality after circulatory system disorders and cancer. 22.6% of the deaths from accidents and injuries in the capital city of Ulaanbaatar affected children under 16.

 

 
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