WPRO NURSING DATABANK

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1 WPRO NURSING DATABANK COUNTRY: COUNTRY BACKGROUND INFORMATION Geography: Mongolia is a landlocked country located in North East Asia bordering with Russia and China. The total territory of the country is million Square kilometres. It is the nineteenth largest country in the world, but also it s the least densely populated with approximately 1.6 persons per 1 sq km. Mongolia consists of 21 provinces and the capital city. Provinces are subdivided into (districts) numbering 343, which are further subdivided into bags (1277). Ulaanbaatar (UB) is the capital city and divided into 9 districts and numerous subdivisions. Mongolia has some unique demographic and environmental characteristics which impact health significantly by distance between provinces and sub provinces. Population By the end of 2012, the population of Mongolia reached 2 million and thousand and it has increased by about 56.1 thousand people or by 2.0 percent, compared to the previous year. From the total population, 67.2 percent are living in cities, and the remaining 32.8 percent reside in the rural areas. Males comprise 48.6 percent of the population, while 51.4 percent are female. Currently, young people constitute the largest cohort in Mongolia. The goal of the state population policy for the period is to create conditions for maintaining the average annual population growth rate at no less than 1.8 per cent. This is to be supported by related MDG s goals such as reducing the mortality rates of infants and children under five years of age by one third and the maternal mortality rate by 50 per cent from the 1990 level and to increase life expectancy. In 2012, the average life expectancy at birth years; making Mongolia the 133 rd country in the world in terms of life expectancy, compared to other countries' average life expectancy. Climate: Mongolia has continental climate with four distinct seasons. Temperatures in winter time are as low as to 25 0 C and between 20 0 to 30 0 C during the warm season. Culture and religion: After the collapse of the Mongol Empire established by Chinggis Khaan in 1291, Mongolia reverted to a largely nomadic, pastoral country. Two distinctive features of the Mongolian culture are the nomadic way of life and Tibetan Buddhism, widespread as a major religion in Mongolia. Livestock herding, the main source of the nomadic lifestyle, is another important trait of Mongolian culture. Mongolians have a history of raising and caring for their livestock. Horses, cattle, sheep, goats, and camels are praised as the "five treasures Education: Educational achievement in Mongolia is high with a 97% adult population literacy rate. Government: Democratic political reform in 1990 began major transformations of all spheres of Mongolian life including management, financing and delivery of Health Date Printed: 30/10/2013

2 services. Mongolia has a parliamentary system of government, with a 76-seat legislature called the State Ikh Khural. The leader of the majority party serves as a Prime Minister. Women represent 62% of those with specialized, 50% of those in paid employment and 48% of municipal council seats. This is one of the factors which could assist in health promotion activities and community participation for successfully improving individuals and communities to seek healthy lives. Health care system The health care system in Mongolia is characterized by three levels of care and services and its prevailing principle is to deliver an equitable, accessible and quality health care and services for every person. - Primary care and services are mainly placed in family practice entities in UB city and sub province (soum) and inter-sub-provinces (inter soum) hospitals in local provinces named by aimags Secondary care and services are taken a place in district general hospitals in UB city and aimag general hospitals in local provinces, Tertiary care and services are placed in major hospitals and specialized professional centers in UB city. Maternal Mortality Statistics for the last two decades show a steady decline of infant and under-five mortality rates per 1000 live births. In 2012, the infant mortality and under-five mortality rates per 1000 live births declined 4.7 and 4.1 times respectively compared to the rates in Morbidity patterns of the total population in The following are the leading causes of population morbidity per population in 2012: - Diseases of the respiratory system ( ) - Diseases of the digestive system ( ) - Diseases of the genitourinary system (764.09) - Diseases of the circulatory system (817.03) - Poisoning and certain other consequences of external causes (502.8) Population Mortality in Diseases of the circulatory system, neoplasm s and injuries remain the 3 leading causes of population mortality since 1995, and the number of deaths due to these diseases has been increasing every year. The following were the leading causes mortality in 2012 per population: Diseases of the circulatory system (20.9), Neoplasm s (12.6), Injuries and poisoning (11.3), Diseases of the digestive system (5.3), Diseases of the respiratory system (2.3) Page 2

3 1. Historical events in nursing st nurse training: an assistant nurse training course for 3 months duration, with 26 people enrolled st National Medical Technical school established for 2 years training duration /official nurse training started/ 1962 Dornogobi Medical College founded. /For the south region/ 1968 Gobi-Altai Medical College founded. /For the western region/ 1969 Darkhan Medical College founded. /For the central region/ 1969 Nurse teachers training started. Send professional nurse teachers training in Poland The curriculum for nursing was revised and a new programme for basic training of paediatric nurse was established A separate Nursing School was established from the Medical Technical school in the Ulaanbaatar city For the first time, a 3 month Nursing management training course for nursing managers were conducted at the Nursing School in Ulaanbaatar Advanced Training Institute was established in Ulaanbaatar for postgraduate training of the Health workers Feldsher-nurse training at the 2 Medical Technical schools and 1 Medical College in rural areas was initiated Curriculum for Assistant Nurse was developed and implemented In considering an importance of the Nurse leaders, in 1993 the faculty of Nursing Manager was established at Medical Colleges. The nurses with at least one-year work experience were recruited to study to the faculty and in 1997 the first batch of graduates received their bachelor degrees. In 1998 two nurses gained masters degrees of nursing at the National Medical University (NMU) A three year Nurse Educator Programme was established at the Nursing School in Ulaanbaatar to prepare nurse educators in higher The new position of an officer responsible for nursing care and was established at the Ministry of Health. Page 3

4 1995 Kathleen Fritsch, Nursing adviser from the World Health Organization worked as a consultant at the MOH and took part in nursing service policy revision discussions, including nursing in Mongolia and made Recommendations for Nursing' from as an International Nursing Officer in Mongolia In 1996 the Mongolian Nurses Association was established, which was one more step forward in developing nursing care in Mongolia The International Nurses Day (IND) was celebrated for the first time at national level in Mongolia, on 12 May IND is celebrated every year from this time in the country The system of contracts with the National Medical University and Medical Colleges, the Regional Medical Colleges were re- launched under the National Medical University The Center of Health Education Methodology and Health Management and Information Center were united into a new "Center of Health Management, Information and Education" Center under the supervision of the MOHSW. The new Center is responsible the accreditation of health organizations and licensing of medical workers, including nurses/, as well as for postgraduate training of nurses and other health workers at all levels; as well as the conducting health to population Mongolian Nurses Association became an official member to the International Council Nurses and approved the Pledge of the Nurses and Code of Nurses," supported by ICN Policies First National Nursing Congress was organized with the support of the ICN and WHO/WPRO, under the theme of Nurses in the New Century. The opening speech, entitled "Current International Nursing development was made by Kathleen Fritsch, the WPRO Nursing advisor, and delivered to the nursing congress participants First policy documentation in nursing was approved by the Health Minister s order of 223 of 2005, titled Nursing Policy from in accordance with the WHO Strategic Directions of Nursing and Midwifery Services / / 2006 Review of midwifery services in Mongolia undertaken by WHO national standards in nursing procedures were revised and approved by the National standardization organization of Mongolia 2012 Approved Nursing development strategy by the Health Minister 2012 Initiated COPE quality improvement tool into nursing practice Page 4

5 2013 National Meeting of Nurses who are best in practice Organized 3 rd National Nursing congress on the theme of Equity and Access to Health care," organized by the Mongolian Nurses Association 2. Regulations and Laws 2.1 Type of regulation Regulation focus Definition of nurse and nursing, lisencure and accreditation Diploma and bachelor, master, doctoral level of nurse Nurse intake and planning for 4 years Job descriptions of the nurses Requirements of the newly graduators Nursing development strategy Nurse Title of Act or Law Year Regulatory categories authority All Mongolian Health law 2011 Government of Mongolia All level of Nurse preparation All All All All Law of Higher Education 2001 Ministry of Health human resourse development policy / / Frame of job descriptions of the Health professionals Requirements for some graduators in Health Nursing development strategy, Ministry of Health 2012 Ministry of Health 2012 Ministry of Health 2012 Ministry of Health 2.2 Regulatory authority contact Authority Address Phone number Fax number. address Ya. Amarjargal Head, Department of Policy Coordination and Implementation, Ministry of Health, Olympic Str-2, Ulaanbaatar-48, Mongolia Page 5

6 2.3 License, Registration and Renewal system By the Health Law /2011/ Nurses must renew the license every 5 years. Licensing body would be the Health Minister. 3. Nursing and Midwifery Associations Name of Association Address Phone No. Fax No. Mongolian Nurses Association 101. State 2 nd Hospital, Bayanzurkh District, Ulaanbaatar, Mongolia nyamaa@24@ya hoo.com President D. Nyamsuren Midwifery Association 2 nd Maternity Hospital, Sukhebaatar duureg, Ulaanbaatar Mongolia Ser_davaa888@ yahoo.com President S.Davaasuren 4. Nurse leaders and/or focal points Name and position title Organization and Address Phone number address S.Altanbagana Officer, Policy Implementation and coordination for Nursing Services D. Nyamsuren President Mongolian Nurses Association Ulaanbaatar , P.O.Box-78, Mongolia Ministry of Health Olympic Str. 2 Ulaanbaatar State 2 nd Hospital, Bayanzurkh District, Ulaanbaatar, Mongolia altanbagana@moh.mn altanbagana1@yahoo.com nyamaa@24@yahoo.com Page 6

7 President S. Davaasuren 2 nd Maternity Hospital, Sukhebaatar duureg, Ulaanbaatar 2 nd Maternity Hospital, Sukhebaatar duureg, Ulaanbaatar, Mongolia Ser_davaa888@yahoo.com 5. Categories and functions of nurses, midwives Category Entry requirement Length of training Level/Credential Description Nurse with Bachelor Degree diploma Nurse with Diploma Nurse of Trad.Med. with Diploma Paramedical Workers with Diploma Assistant Nurses 10 years basic or Nurses with Diploma 10 years basic 10 years basic 10 years basic 8-10 years basic 3 years over 1.5 years Bachelor Degree Diploma 120 credit Bachelor Degree Diploma over 30 credit Responsible for nursing administration and Work in senior positions as a nurse educators and manager of the Health Organizations 3 years Diploma Nurse Work in all level of hospitals and Health Organizations for nursing care 3 years Traditional medicine Diploma Nurse Over 3 years Paramedical Personal Diploma One year servise based training Work in secondary and level hospitals or traditional medical service unit at private based Health Organizationst Laboratory personnel, X-ray, Dental Technicians and Pharmacist in all health care settings. Assist the nurses at all health organizations Page 7

8 6. Nursing and Midwifery Education Page 8

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10 7. Resources available for other countries Subject/Title Nursing in the world Year published Description 2008 Nursing data of the country Contact (Name, Address, Telephone No., Fax No., , etc.) The international nursing foundation of Japan 8. Main nursing and midwifery issues/priorities 9. Important policies or strategies needed Consultant needed in Nursing for nurse reformation for: to revise nurse training program; to prepare national nurse teachers; to develop a national nurse training textbook included nursing basic theories' to support the development of powerful nursing faculty; and to reduce the gap between and practice. Nurse leaders must be trained at all national level, and study in developed countries. Partnering is crucial in order to develop nursing. Page 10

11 10. Does your country have National Health Plan and or Human resources for Health strategy? How have Nursing and Midwifery workforce policies been integrated into this plan/s? The Health sector human resource development policy is one of the strategic directions in Health human resource planning. This policy contains: o Introduction o Current situation of health sector human resources o Health sector human resourve development policy o Planning of medical specialists until This document analyses the current health human resourses in Mongolia, including nurses and midwifes, and plans for needs until The development policy includes a revised Nurses per doctors ratio with the goal of reducing the number of doctors and increasing the number of nurses. Page 11

Human Resources for Health Country Profiles. Mongolia

Human Resources for Health Country Profiles Mongolia WHO Library Cataloguing-in-Publication Data Human resources for health country profiles: Mongolia 1. Delivery of healthcare manpower. 2. Health manpower.