Background: Over the past 20 years, world wide scale social and economic reforms, technological breakthroughs, and the population growth (increased by 1.64 billion), especially in urban areas, have had a negative impact on human health; changes in living and working conditions (environmental and air pollution), population density, traffic jam, unhealthy lifestyles, workload, and work stress – all contribute to non-communicable diseases – are increasing. According to researchers from Stanford University in the United States, “Stress plays a key role in the development of behavioral disorders such as poor diet, lack of exercise, alcohol and tobacco use, and addiction. Furthermore, these behavioral disorders play a major role in the development of metabolic disorders and cancer, such as hypertension, cardiovascular disease such as myocardial infarction, and diabetes and obesity. “Stress, in particular, depends on the type of workplace, work environment, and occupation in which the person spends most of their life. Materials and Methods: The study is covered 473 nurses from the specialized tertiary level hospitals in Mongolia. We determined their perceived work stress by the WPS (3 parts 57 questions) questionnaire of American scientist Rice. The work stress results were analytically analyzed with the cross-sectional method regarding the nurses’ arterial blood pressure. Results: Totally 473, or 121, 89, 146, and 117 nurses participated from NCTO (1), NCMH (3), NCID (4), and NCC (4). In present study, 34 or 7.2% of 18-24 year olds, 139 or 29.4% of 25-30 year olds, 99 or 20.9% of 31-40 year olds, 169 or 35.7% of 41-50, and 32 or 6.8% over 51 year olds. The study was conducted by collecting an age group similar to the age pyramid of nurses working in the hospital. The participants illustrated low levels of work stress in 7.6%, medium levels in 27.1%, and high levels of work stress in 65.3%, respectively. When we examine whether the level of stress exposure of nurses differs between the groups by high, medium, and low levels of workplace stress, the analysis of one factor variance confirms the statistical real difference (F = 3.071), (p = 0.028). The study results revealed that long lasted accumulated work stress trigger the hypertention. Conclusion The onset of stress in a nurse’s workplace depends on many different social factors, such as age, gender, organizational characteristics, organization, place of work, and years of experiences. In conclusion, we agreed with Spruil Tanya et al., that chroronic stress at work can be the reason for the high blood pressure.

Background: A midwifery services are recognized as one of essential health care and services. The amplification of trained midwives plays very important role to improve the quality of and access to health care services as highlighted in the global Human Development Report [1]. Obstetric care is the integrated specialized interventions aimed to detect, monitor, manage delivery, treat and prevent illnesses of mothers, fetus and newborns in pregnancy, childbirth and postnatal periods. Every year, 287,000 women die from complications related to pregnancy and childbirth, and 2.9 million newborns die before they reach the age of four weeks worldwide. The majority of the preventable maternal and newborn deaths occur in low-income countries [3]. Goal: This assessment was aimed to review the current situation and legal framework of midwifery services and comprehensive competencies of midwives, and to provide baseline data for the project as well as evidence based recommendations for further improvement of midwifery services in Mongolia. Materials and Methods: In order to assess the current status of midwifery services and integrated competencies of midwives, a range of quantitative and qualitative methods were used. A cross- sectional study for assessing the quality of obstetric care and practice was conducted by using observation checklists, questionnaires and interview guides. Midwives who are providing obstetric care in Mongolia were involved in the assessment. Results: A total of 321 midwives from NCMCH, and 2 maternity hospitals of Ulaanbaatar and 21 aimags were involved in the assessment. Out of them 97.2% were female and the mean age was 37.2±10.1 [95%CI: 36.03-38.21]. The mean of working years in health sector was 14.54±10.9 years and mean of working years with the current institution was 11.7±10.1 years. Minimum work experience was few months and maximum was 38 years. A majority of the assessed midwives hold some abilities sufficiently such as keeping medical documents during pregnancy [4.23; 95%CI: 4.15-4.32], educating and giving advice to the customers about after and before the pregnancy period [4.01; 95%CI: 3.91-4.11]. A majority of the assessed midwives answered holding some abilities as important, such as basic knowledge of mother and child public health care in the fertility system [4.11; 95%CI:4.00-4.21], implementing experiences [4.07; 95%CI:3.97-4.19], and very important documents for the Obstetricians Association to know about midwives’ practical and professional activity [4.05; 95%CI:3.92-4.17]. None of the midwives took “A” or point indicates highest level. 40.5 percent of assessed midwives took “D” or “Able to make a relatively easy content; Lack of general knowledge, skills and practices”. One third of participated midwives took “F” indicating lack of knowledge, skill and practice. Moreover, one fifth of the midwives took “C” indicating average level, understood most of the content, skilled moderately, and prepared enough to practice more in this field. Even though rural midwives got average level (22.0%) score 4.1 functions more than city midwives, it didn’t have any difference in the statistic correlation. 3.3 percent of all participant 7 midwives took “B” indicating above the average level in the knowledge test. The midwives have told training for them hadn’t organized frequently which is shown in the quality assessment. Conclusions Furthermore, it is necessary to increase the skill of midwives who would perform complex care based on clinical evidence to reveal the risks faced to maternal and infant health, prevent from degradation and manage safe birth.