MONGOLIA Landlocked between the Russian Federation and China, Mongolia had an estimated population of 2.78 million in 2010, with 63.3% classified as urban. Large numbers of people continue to migrate to urban centres. Mongolia is included in a group of countries and areas with mid-level human development and average life expectancy. The main pillar of the economy continues to be the agriculture sector; however, recently the mining sector is increasingly contributing to the national economy. Mongolia has a severe continental climate which poses a great challenge to the delivery of health services especially to rural population. WHO's programme of technical collaboration is managed through a country office with professional staff in the areas of programme management, health systems development, environmental health, noncommunicable diseases, expanded programme on immunization, and communicable diseases surveillance and response. The Country Cooperation Strategy was updated in 2010 with five strategic priorities identified for 2010 2015. These strategic priorities are: (1) health systems strengthening through primary health care approach; (2) scaling up prevention and control of NCD s, injuries, violence and their determinants; (3) sustaining and accelerating the achievement of health-related millennium development goals; (4) strengthening health security, including control of communicable diseases and vaccine-preventable diseases and (5) strengthening environmental health management. These areas of collaboration will be reflected in the country programme budgets over the next two bienniums. In 2012-2013, WHO technical cooperation with the Government is expected to focus on the following WHO strategic objectives: 01 To reduce the health, social and economic burden of communicable diseases. 01.001.WP01 Member States supported to maximize equitable access of all people to vaccines of assured quality, including new immunization products and technologies, and to integrate other essential interventions with immunization and to control or eliminate targeted vaccine preventable diseases (VPDs). Office-specific expected result (OSER) OSER Indicator Baseline Target 01.001.WP01.MNG01 Support provided to improve routine immunization coverage at district level. 01.001.WP01.MNG01.01 Percentage of districts which reported routine vaccination coverage above 90%. 90% 95% 01.001.WP01.MNG03 Hospital-based sentinel surveillance for rotavirus diarrhaea and pneumoccocal pneumonia among children aged less than 5 years old. 01.001.WP01.MNG03.01 Number of quarterly surveillance reports on rotavirus diarrhae and pneumoccocal pneumonia submitted on time. 3 4 01.003.WP01 Effective coordination and support provided to Member States to provide access for all populations to interventions for the prevention, control, elimination and eradication of neglected tropical diseases, including zoonotic diseases. 01.003.WP01.MNG11 Collaboration between human and animal health sectors promoted and strengthened capacity in controlling zoonotic diseases. 01.003.WP01.MNG11.01 Number of coordinated risk assessment and joint responses to zoonotic events. 5 20
01.003.WP01.MNG12 National Action Plan for control and prevention of Neglected Tropical Diseases (NTD) and other parasitic diseases developed and implemented. 01.003.WP01.MNG12.01 Number of surveys conducted to establish the baseline of NTD/parasitic diseases. 01.004.WP01 Policy, strategy developed and technical advice provided to Member States and partners for ensuring collective regional health security. 01.004.WP01.MNG05 Strengthened functions and capacities of National IHR Focal Point and Point of Entry Entry (PoE)). 01.004.WP01.MNG06 Strengthened Indicator Based Surveillance, Event Based Surveillance and e-based surveillance data reporting system. 01.004.WP01.MNG05.01 Number of designated international airports/ports with public health emergency contingency plan. 01.004.WP01.MNG06.01 Number of aimags established E-based surveillance data reported system. 0 3 0 01.004.WP02 Policy and technical support provided to Member States to enhance their capacity to carry out vaccinepreventable diseases surveillance and monitoring and strengthen laboratory networks. 01.004.WP02.MNG04 Strengthened monitoring system for EPI performance and VPD lab capacity. 01.004.WP02.MNG04.01 Number of National Reference Laboratories for VPDs surveillance accredited by WPRO. 2 2 01.006.WP01 Advocacy for the International Health Regulations (IHR) (2005) carried out, and the functions and capacities of National IHR Focal Points and Points of Entry (POE) strengthened. 01.006.WP01.MNG07 Strengthened Mongolian Field Epidemiology Training Programme (MFETP). 01.006.WP01.MNG07.01 Number of MFETP fellows completed their training. 18 30 01.006.WP01.MNG08 Strengthened national capacity for risk assessment, risk management and risk communication. 01.006.WP01.MNG08.01 Number of sub-national level surveillance units conducted risk assessment. 5 21 01.006.WP01.MNG09 National and sub-national response capacity developed. 01.006.WP01.MNG09.01 Number of functional Rapid Response Teams established at sub-national level. 6 21
01.007.WP01 Support Member States to achieve minimum capacities for preparedness, detection, assessment of and response to emerging diseases and other public health emergencies, as required under IHR (2005), through implementing the updated APSED (2010). 01.007.WP01.MNG10 Improved compliance with recommended Infection Control and Prevention practice. 01.007.WP01.MNG13 Strengthened laboratory diagnostic capacity at district and province level. 01.007.WP01.MNG10.01 Number of health facilities implementing hospital acquired infection surveillance. 01.007.WP01.MNG13.01 Number of sub-national level laboratory staff trained. 0 5 02 To combat HIV/AIDS, tuberculosis and malaria. 02.001.WP01 Regional guidelines, policies, strategies and other tools developed for prevention, treatment and care for STI and HIV/AIDS, malaria and tuberculosis (including innovative approaches for increasing coverage of the poor, hard-to-reach and vulnerable populations). 02.001.WP01.MNG19 New WHO guidelines on ART (2010) adopted and implemented. 02.001.WP01.MNG19.01 Number of health care providers trained on revised national guidelines for HIV management. 0 50 02.002.WP01 Countries and areas implemented prevention, treatment and care interventions for STI, HIV/AIDS, malaria and TB and scaling-up to reach the most in need (including integrated training and service delivery; wider provider networks; strengthened lab capacities, etc). 02.002.WP01.MNG14 Active case finding strategies targeting populations at high risk of TB implemented. 02.002.WP01.MNG14.01 Number of strategies implemented. 1 2 02.002.WP01.MNG15 Strengthened national capacity on programmatic management of MDR-TB. 02.002.WP01.MNG15.01 Revision status of MDR-TB training module. 02.002.WP01.MNG16 Scaled up HIV/STI prevention interventions targeting MARPs. 02.002.WP01.MNG17 Strengthened linkages between HIV/STI and reproductive health services. 02.002.WP01.MNG18 Strengthened laboratory services for HIV, STIs and tuberculosis. 02.002.WP01.MNG16.01 Number of peer educators/outreach workers trained. 02.002.WP01.MNG17.01 Number of provinces/districts implementing one-stop services with focus on elimination of congenital syphilis. 02.002.WP01.MNG18.01 Number of laboratories participating in quality control system. 10 50 8/6 10/8 0
02.002.WP01.MNG20 Strengthened collaboration between TB and HIV national programmes. 02.002.WP01.MNG18.02 Laboratory network plan developed. 02.002.WP01.MNG20.01 Number of coordination meetings conducted. 02.004.WP01 Regional and national surveillance, evaluation and monitoring strengthened and expanded to monitor progress towards targets and resource allocations for STI and HIV/AIDS, malaria and TB control, including drug and insecticide resistance and impact of control efforts. 02.004.WP01.MNG21 Strengthened national capacity on strategic information for HIV/AIDS/STI and TB, including surveillance, monitoring and evaluation system. 02.004.WP01.MNG21.01 Number of reports on WHO framework for monitoring and reporting of health sector progress to universal access submitted on time. 02.004.WP01.MNG21.02 Number of national TB programme annual reports developed and distributed. 1 2 03 To prevent and reduce disease, disability and premature death from chronic noncommunicable diseases, mental disorders, violence and injuries and visual impairment. 03.001.WP01 Increased political, financial and technical commitment in Member States in order to tackle chronic noncommunicable conditions, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. 03.001.WP01.MNG30 Improved capacity, through training of health and other sector including NGO staff to manage, prevent and control NCDs including hearing, visual impairment and mental health. 03.001.WP01.MNG30.01 Number of health and other sector staff trained on NCD prevention and control. 1000 03.002.WP01 Enhanced capacity of Member States for the development and implementation of policies, strategies and regulations in respect of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities. 03.002.WP01.MNG34 Improved capacity, through Development of national strategic plans on disability and rehabilitation and improvement of skills of health and other sector workers on mental health including community based rehabilitation programmes. 03.002.WP01.MNG34.01 Number of national strategic plans on mental health, disability and rehabilitation. 1 2
03.003.WP01 Enhanced capacity of Member States to collect, analyse, disseminate and use data on magnitude, causes and consequences of chronic noncommunicable conditions, mental and neurological disorders, violence, injuries and disabilities, visual impairment and blindness. 03.003.WP01.MNG31 Strengthened systems for surveillance of NCD diseases and risk factors including mental health, hearing and visual impairment. 03.003.WP01.MNG31.01 Number of survey reports of Ministry of Health reporting on major NCDs and mental health problems. 2 4 03.004.WP01 Evidence and knowledge base available on cost-effectiveness of interventions to tackle chronic noncommunicable conditions, mental and neurological and substance-use disorders, violence, injuries and disabilities together with visual impairment, including blindness. 03.004.WP01.MNG33 NCD prevention and control at PHC levels established. 03.004.WP01.MNG33.01 Number of model centers established. 4 21 03.005.WP01 Enhanced capacity of Member States for preparing and implementing multisectoral population-wide programmes to promote mental health and to prevent mental and behavioural disorders, violence and injuries, together with hearing and visual impairment, including blindness. 03.005.WP01.MNG35 National programme on mental health implemented. 03.005.WP01.MNG35.01 Number of primary health care workers trained on early diagnosis and referral of patients with NCDs and mental health problem to aimag centers. 03.005.WP01.MNG35.02 Survey report on common mental health disorders including alcohol. 550 03.006.WP01 Enhanced capacity and ability of Member States' health and social systems to prevent and manage chronic noncommunicable diseases, mental and behavioural disorders, violence, injuries and disabilities together with visual impairment, including blindness. 03.006.WP01.MNG32 Millennium Challenge Account (MCA) funded Stroke and Heart attack Project planned, implemented and evaluated. 03.006.WP01.MNG32.01 Number of guidelines revised and approved. 03.006.WP01.MNG32.02 Newly established and reorganized units. 0 3 0 5
04 To reduce morbidity and mortality and improve health during key stages of life, including pregnancy, childbirth, the neonatal period, childhood and adolescence, and improve sexual and reproductive health and promote active and healthy ageing for all individuals. 04.001.WP01 Enhanced capacity of Member States to develop integrated policies, strategies, and plans towards universal access to effective interventions for improving maternal, newborn, child, adolescent and reproductive health. 04.001.WP01.MNG36 Strengthened partnership, coordination and resource mobilization for maternal, newborn, child health and reproductive health to reach MDG 4 and 5 and implementation of innovative strategies towards sustainability and reducing inequities. 04.001.WP01.MNG36.01 Number of partnerships' meetings conducted for joint program on maternal, child and reproductive health. 4 8 04.002.WP01 Research capacity strengthened and new evidence, technologies, interventions and approaches of global/national relevance available to improve maternal, newborn, child and adolescent health; promote active/healthy ageing, and improve sexual and reproductive health. 04.002.WP01.MNG37 Strengthened capacity through training of national, aimag and soum health workers on maternal, newborn, child, and adolescent health research. 04.002.WP01.MNG37.01 Number of health care workers trained. 1000 04.005.WP01 Strengthened technical capacity in Member States for accelerated action towards the achievement of universal access to the essential package of interventions for child survival, including improvement of quality of care. 04.005.WP01.MNG39 Implementation and evaluation of national child survival strategy. 04.005.WP01.MNG39.01 National child survival strategy developed. 04.006.WP01 Enhanced Member States' capacity for implementing evidence-based strategies, norms and standards for the prevention and care of diseases and health compromising behaviours in adolescents. 04.006.WP01.MNG40 Planning, implementation and evaluation of evidence-based adolescent-friendly health services carried out. 04.006.WP01.MNG40.01 Number of guidelines and standards for adolescent-friendly health services revised and updated per WHO guidance. 2 4
04.007.WP01 Enhanced capacity and ability of Member States for accelerated action towards the achievement of universal access to reproductive health, including improvement of quality of care. 04.007.WP01.MNG41 Planning, implementation and evaluation of national reproductive health strategy including family planning and comprehensive abortion care. 04.007.WP01.MNG41.01 Number of guidelines and standards on comprehensive abortion care, reproductive and sexual health and family planning revised and adapted. 3 6 04.008.WP01 Capacity strengthened in the Region and Member States to develop policies and programmes to address population ageing. 04.008.WP01.MNG42 Support provided to strengthen capacity of national, aimag and soum health workers on healthy aging to support evidence based policies and plans. 04.008.WP01.MNG42.01 Number of models of age-friendly settings. 3 7 05 To reduce the health consequences of emergencies, disasters, crises and conflicts, and minimize their social and economic impact. 05.001.WP01 Establishment and implementation of national health emergency risk management plans and WHO readiness plans. 05.001.WP01.MNG43 Improved capabilities of aimag and soum health managers and other sectors in planning, implementation and evaluation of health emergency preparedness, response, communication strategy, safe hospitals initiatives through WHO assisted training. 05.001.WP01.MNG43.01 Number of trained health and other sectors' staff on emergency preparedness, response and recovery. 1000
06 To promote health and development, and prevent or reduce risk factors for health conditions associated with use of tobacco, alcohol, drugs and other psychoactive substances, unhealthy diets, physical inactivity and unsafe sex. 06.003.WP01 Training and advocacy to countries and areas with high and increasing disease burden associated with tobacco use to strengthen institutions to address public health problems concerned. Support to the Paris Conference to the WHO FCTC for its implementation. 06.003.WP01.MNG44 Technical assistance to address or prevent public health problems associated with tobacco use, enforcement and implementation of the WHO FCTC including MPOWER. 06.003.WP01.MNG44.01 Number of trained staff on MPOWER. 06.003.WP01.MNG44.02 Number of smoke-free settings. 06.003.WP01.MNG44.03 Number of resolutions/ordinance for comprehensive smoke-free city. 50 health and other sector staff 150 health and other sector staff 6 20 06.004.WP01 Improved capacity of Member States with a high or increasing burden of risk factors and disease in order to strengthen institutions to prevent public health problems associated with alcohol, drugs and other psychoactive substance use. 06.004.WP01.MNG45 Implementation and monitoring of the national/regional policies and programmes on alcohol and management of alcohol/drug abuse disorders by expanding Alcohol Use Disorders Identification Test (AUDIT) at the national level. 06.004.WP01.MNG45.01 Number of health and other sector staff trained on reduction of alcohol harm. 06.004.WP01.MNG45.02 Number of national programmes/plans on alcohol prevention and control. 06.004.WP01.MNG45.03 Number of meetings to introduce and implement the law on alcohol prevention and control. 1000 06.005.WP01 Improved evidence and knowledge base to inform policy development in countries and areas with a high or increasing burden of disease or death associated with unhealthy diets. 06.005.WP01.MNG46 Implementation and monitoring of the national/regional policies and programmes on risk reduction (salt, obesity and physical activity). 06.005.WP01.MNG46.01 Number of health and other sector staff trained on reduction of salt, obesity and physical inactivity. 06.005.WP01.MNG46.02 Number of intervention settings to reduce salt intake. 06.005.WP01.MNG46.03 Number of intervention settings to reduce salt intake. 550 0 3 settings 1 2 surveys
07 To address the underlying social and economic determinants of health through policies and programmes that enhance health equity and integrate pro-poor, gender-responsive, and human rights-based approaches. 07.001.WP01 Support provided to strengthen the capacity of the Organization and Member States to reduce health inequities, address socioeconomic determinants of health and promote more equitable and pro-poor policies, programmes and interventions. 07.001.WP01.MNG47 Support provided to reduce health inequities, address socioeconomic determinants, promote more equitable and pro-poor policies, programmes and interventions. 07.001.WP01.MNG47.01 Number of official policies or strategies that aim at reducing health inequities. 08 To promote a healthier environment, intensify primary prevention and influence public policies in all sectors so as to address the root causes of environmental threats to health. 08.001.WP01 Evidence-based assessments made, and norms and standards formulated and updated on major environmental hazards to health (e.g. poor air quality, chemical substances, electromagnetic force, radon, drinking water, waste water reuse). 08.001.WP01.MNG50 Development, implementation and monitoring of Water Safety Plan. 08.001.WP01.MNG52 Support provided to assess environmental risk factors, to implement interventions to reduce and mitigate them in the framework of National Environmental Health Programme. 08.001.WP01.MNG50.01 Number of policy documents and standards for drinking water quality revised and developed. 08.001.WP01.MNG52 Number of assessment reports, and developed norms and standards on indoor and outdoor air pollution, health impact assessment, chemical safety and child environment. 1 2 3 6 08.002.WP01 Enhanced capacity of countries and areas for the implementation of primary prevention interventions that reduce environmental hazards to health, enhance safety and promote public health, including in specific settings and among vulnerable population groups. 08.002.WP01.MNG49 Support provided for policy and program implementation on priority occupational health, chemical safety and healthy settings approach. 08.002.WP01.MNG49.01 Number of model healthy settings. 08.002.WP01.MNG49.02 Number of occupational and environmental health specialists trained on chemical safety and occupational health. 5 10 10 40
08.002.WP01.MNG51 Support provided for rural hospitals to improve water, sanitation, health care waste management and integrated primary health care. 08.002.WP01.MNG51.01 Number of hospitals equipped with facilities to improve water, sanitation and health care waste management. 08.002.WP01.MNG51.02 Number of community based environmental health and primary health care project implemented. 08.002.WP01.MNG51.03 Number of trained health volunteers on Public Health. 26 32 15 23 0 52 08.002.WP01.MNG53 Health care waste management in hospitals improved. 08.002.WP01.MNG53.01 Number of model hospitals on health care waste management. 08.002.WP01.MNG53.02 Number of trained health workers on health care waste management. 20 40 08.006.WP01 Evidence and knowledge base to inform policy available to enable Member States in identifying, preventing and tackling public health problems resulting from climate change. 08.006.WP01.MNG48 Implementation of National Programme on Climate Change and Health. 08.006.WP01.MNG48.01 Number of assessment reports and action plans on Climate Change and Health. 08.006.WP01.MNG48.02 Number of trained persons on mitigation and response of climate change and health effects. 1 3 4 20 09 To improve nutrition, food safety and food security, throughout the life-course, and in support of public health and sustainable development. 09.001.WP01 Partnerships formed and support provided to countries and areas to increase political, financial and technical commitment to addressing nutrition, food safety and food security through intersectoral action. 09.001.WP01.MNG54 Support provided for Food safety and education in food chain continuum and monitoring. 09.001.WP01.MNG54.01 Number of training curricula developed. 09.001.WP01.MNG54.02 Number of inspectors trained on food safety. 2 3 20 40
09.002.WP01 Evidence-based norms, assessments and guidance developed, adapted and disseminated to enable countries and areas to implement cost-effective interventions responding to all forms of malnutrition and foodborne diseases, and to promote healthy dietary practices. 09.002.WP01.MNG56 Strengthened risk based food inspection, Food Safety Emergency Response Plan and support National INFOSAN network and CODEX. 09.002.WP01.MNG56.01 Number of developed guidelines for risk based inspection. 09.002.WP01.MNG56.02 Food Safety Emergency Plan and National Strategy on Food safety. 09.002.WP01.MNG56.03 Adopted CODEX standards. 1 2 1222 09.003.WP01 Improved capacity in countries and areas to collect, analyse, disseminate and use data on the magnitude, causes and consequences of under-nutrition and nutrition-related chronic diseases, diet and physical inactivity. 09.003.WP01.MNG55 Support provided to planning, implementation and evaluation of nutrition programs/curriculum including infant and young child feeding and healthy diet and WHO Child Growth standards. 09.003.WP01.MNG55.01 Public Health Nutrition Curriculum developed. 10 To improve health services through better governance, financing, staffing and management, informed by reliable and accessible evidence and research. 10.001.WP01 Improved management and organization of health service delivery, through public and non-public providers and networks, reflecting principles of integrated primary health care (PHC) with increased coverage, equity, and quality of health services leading to better health outcomes. 10.001.WP01.MNG57 Technical support provided to the Ministry of Health and other partners on planning, implementation and evaluation of national health policies, plans and strategise for primary health care and overall national health systems development. 10.001.WP01.MNG58 Model PHC soum and district hospital established. 10.001.WP01.MNG57.01 Number of policies, plans and guidelines developed on primary health care that are supported by WHO. 10.001.WP01.MNG58.01 Number of trained health care workers on integrated PHC approach at soum and district level. 1 3 100 300
10.003.WP01 Improved coordination of the various mechanisms (including donor assistance) that support Member States in their efforts to achieve national targets for health system development and global health goals. 10.003.WP01.MNG59 Strengthened partnership and donor collaboration at national, aimag and soum level including support for SWAP. 10.003.WP01.MNG59.01 Number of health sector donor coordination meetings conducted. 5 10 10.004.WP01 Strengthened country health information systems that provide and use high-quality and timely information for health planning and for monitoring progress towards national and major international goals. 10.004.WP01.MNG60 Improved capacity of health and other sector staff on the use of information from routine health information system, operational health research and implementation of E-health strategy for health policy and programme development. 10.004.WP01.MNG60.01 Number of health managers trained on use of health information. 20 40 10.006.WP01 National health research for development of health systems strengthened in the context of regional and international research and engagement of civil society. 10.006.WP01.MNG79 Technical support provided to strengthen national research capacity. 10.006.WP01.MNG79.01 Number of web based database and registry. 10.009.WP01 Competent support provided to countries and areas to improve the production, distribution, skill mix, retention and the management of their health workforces. 10.009.WP01.MNG61 Improved production, distribution, skill mix, retention and management of the health workforce. 10.009.WP01.MNG61.01 Number of activities supported to implement the national human resource policy. 10
10.010.WP01 Health system financing improved in terms of the availability of funds, social and financial risk protection, equity, access to services and efficiency of resource use. 10.010.WP01.MNG62 Technical and policy support provided to assess, plan and implement policies on health financing to achieve universal access of essential health services for rural population and urban poor, to improve efficiency and equity of resource use. 10.010.WP01.MNG62.01 Number of policy briefs, assessments and guidelines developed to implement national health care financing strategy and SHI law. 10.010.WP01.MNG62.02 Number of health and other sector staff trained on using WHO tools and guidelines on HCF. 2 5 0 50 10.013.WP01 Implementation of norms, standards and measurement tools by Member States to quantify and decrease the level of unsafe health care provided and to improve the quality of the health care system. 10.013.WP01.MNG63 Capacity of health managers and health workers built and models of quality health care and patient safety initiatives developed. 10.013.WP01.MNG63.01 Number of health facilities implementing quality assurance and improvement program. 6 12 11 To ensure improved access, quality and use of medical products and technologies. 11.001.WP01 National policies to improve access, quality and use of essential medicines developed, implemented, monitored or revised. 11.001.WP01.MNG64 Development and implementation of standards and guidelines for quality, safety and efficacy of essential medicines and traditional medicines and strengthening of national regulatory and quality assurance system and system to control counterfeit. 11.001.WP01.MNG64.01 National drug regulatory authority established. 11.002.WP02 Improved regulatory and quality assurance systems for blood products, medical devices and laboratories. 11.002.WP02.MNG66 Strengthened rural diagnostic laboratories including specimen transport system and other medical equipment and technologies. 11.002.WP02.MNG66.01 Capacity of rural health care workers improved on laboratory diagnosis of common diseases through training. 500 laboratory workers and technicians