BACKGROUNDThe quality management research of Mongolian health serve on basis analysis fromcurrent health service quality situation and its quality management, and comparison withthe Baldrige Health Care Criteria for Performance Excellence 2013-2014 which became theintegrated quality management standard developed by the National Institute of Standardand Technology, USA, and developed the relevant conclusions and recommendations.The Thesis is special due to the offer of the new standards particularly useful for thequality management improvement of the Mongolian health services. It should be noticedthat the Mongolian health sector quality monitoring system needs to be transformed tothe integrated quality management system.

Background. Cerebral palsy (CP), which is the most commonly encountered neuromuscular disorder of childhood, causes permanent physical deficits and sometimes intellectual deficits. Despite advances in the diagnosis and treatment of CP, the incidence of that disorder has not declined; it parallels the increased survival rates of premature infants. The children with CP may not have trunk control because they have spasticity and weakness in their trunk control. Goal. This study aimed to investigate the efficiency of functional electrical stimulation (FES) application on the abdomen-posterior back muscles in children with Cerebral palsy (CP). Materials and Methods. However 40 children with spastic CP, being treated in physical therapy, were selected by the way of random-sampling in the study, some of children were excluded by exclusion criteria and then 30 children have completed the study. The participants were randomly divided into two groups FES (n=15) and control groups (n=15). The control group received physical therapy 3 days a week in 45 minute for 6 weeks. The children in the FES group received physical therapy in addition to function electrical stimulation. FES was applied 5 days a week for 6 weeks to abdomen-posterior back muscles in 30 minute-long sessions. To evaluate the score of gross motor function measurement (GMFM) and to evaluate the trunk asymmetry in sitting, radiographic measurements were used. Result. The comparisons of the measurements of the two groups before and after the treatment showed that the GMFM standing score were statistical significantly (p<0.001) increased, and Cobb angles were decreased both groups, but the decrease in the control group was not statistically significant (p=0.128), and FES group was statistically significant (p=0.033). The comparison between groups GMFM standing score increased higher in the FES group than in the control group. Cobb angles after the treatment were statistically significant higher in the FES group than in the control group. Conclusion: To improve gross motor developing for children with CP, FES applied on abdomenposterior back muscles along with physical therapy is more effective than physical therapy alone.

ХУРААНГУЙ. Дутуу төрөлт нь анагаах ухаан төдийгүй нийгэм эдийн засгийн тулгамдсан асуудал юм. Дутуу болон жин багатай төрөх нь нярайн эндэгдэлийн тэргүүлэх шалтгааны нэг болж байна. Шүдний тулгуур эдийн үрэвсэлт өвчний үед зарим нянгийн бүрэлдэхүүн хэсгүүд нь жирэмсэлтийн явц ба ургийн хөгжилд нөлөөлж болдог гэдгийг харуулсан судалгааны үр дүнгүүд байдаг. Иймээс жирэмсэн эмэгтэйчүүдийн тулгуур эдийн өвчин нь нярайн дутуу болон жин багатай төрөх эрсдэлт хүчин зүйл болж байгаа эсэхийг судлахад энэхүү судалгааны зорилго оршино. Уг судалгааг эмнэлэгт суурилсан тохиолдол хяналтын загвараар Нийслэлийн Өргөө Амаржих Газар болон Эх Хүүхдийн Эрүүл Мэндийн Үндэсний Төв (ЭХЭМҮТ)-ийн нийт 90 оролцогчийг хамруулан хийж гүйцэтгэлээ. Тохиолдлын бүлэг 30 (37 долоо хоногоос бага тээлттэй, 2500 гр-aaс бага жинтэй нярай) оролцогч, хяналтын бүлэгт 60 (хэвийн тээлттэй) оролцогч хамрагдсан. Судалгаанд оролцогчдийн шүд цоорох өвчний (ШЦӨ) тархалт хяналтын бүлэгт 99%, эрчим 8.32 ЦЛА/ш, тохиолдолын бүлэгт ШЦӨ тархалт 100%, эрчим 11.33 ЦЛА/ш байв. Амны хөндийн эрүүл ахуйн (АХЭА) үзүүлэлтийг үнэлэхэд хяналтын бүлэгт 2.4 буюу ‘’дунд’’, тохиолдолын бүлэгт 3.2 буюу ‘’муу’’ үнэлгээтэй байлаа. Тулгуур эдийн өвчин, шүдний чулуу (***p<0.008), шүд буйлны эмгэг хөндийн гүн 4-6 мм байх нь (***p<0.006) жин багатай дутуу нярай (ЖБДН) төрөх эрсдэлт хүчин зүйл болж байгаа нь статистик ач холбогдол бүхий үр дүнг үзүүллээ. Буйлны үрэвсэл нь ЖБДН төрөх эрсдэлийг 5.5 дахин нэмэгдүүлж байна. Community Periodontal Index of Treatment Needs (CPITN) үзүүлэлт нь АХЭА үзүүлэлтээс хамааралтай болох нь статистикийн хувьд ач холбогдолтой байлаа (***р<0.000). Тулгуур эдийн өвчин шүдний чулуу, шүд буйлны эмгэг хөндийтэй байх нь ЖБДН төрөх эрсдэлт хүчин зүйл болж байгаа нь судалгааны үр дүнгээс ажиглагдлаа.

Preterm birth is not only health problem but also one of major socioeconomic issues. Preterm Low Birth Weight (PLBW) is leading causative factor of neonatal mortality. Some researches results showed that during periodontal inflammatory disorder some bacterial components could affect pregnancy and fetal development. Therefore aim of our study is to assess and confirm periodontal disease of pregnant females whether or not risk factor of PLBW. We performed our study on the First Maternity Hospital and National Centre for Maternal and Child Health of Mongolia by clinical based case control method on 90 participants. Case group has 30 females (<37 weeks of gestation, and Neonates Birth Weight <2500), control group has 60 females (Normal birth) (ratio was 1:2). Dental caries prevalence on control group was 99%, the mean of DFM/t was 8.32 “average”, prevalence of case group was 100%, and mean of DFM/t was 11.33, which was also “average”. Oral hygiene examination assessment was poor. Study results showed that patients with periodontal disease such as dental calculus (***p<0.008) and periodontal pocket with depth of 4-6mm (***p<0.006) were risk factors for PLBW. Gingivitis is increased to have PLBW baby by 5.5 times. CPITN index was highly associated with dental hygiene index and it was statistically significant. (***p<0.000). Within the limits of this study poor periodontal health status of mothers may be a potential risk factor for a preterm low birth weight.

Backround: Hematology departments of health laboratories, over capital city and 21 provinces both of governmental and private sectors in this country, have to take responsibilities for providing hematology analysis. A wide range of technology and methods have been implemented among these laboratories. Harmonization of the hematology investigations of different laboratories with standard service all over the country is the major goal to reach. We organized the MEQAS (Mongolian External Quality Assessment Scheme) since 2008 on basis the Cooperation agreement between Ministry of Health and Sysmex Corporation in the establishment of Hematology external quality control and reference laboratory system in Mongolia. This is the report of our 8-year experience of MEQAS as the national project, covering increasing numbers of laboratory members. In 2008-2017 years we set up total 18 MEQAS in Mongolia. Materials and Methods:
Survey Materials
In each survey, the following three different of survey materials were used;
Sample A : Hematology Control Material 1*
Sample B : Hematology Control Material 2*
Sample C : Fresh Whole Blood Sample**
*Hematology Control Material provided by Sysmex Corporation
**Under cooperation of National Center for Transfusiology, a fresh whole blood sample was drawn from a healthy donor and prepared on the same day of sample delivery, according to the procedures reported by Kondo H et. all.
Standard Analyzers
3 units of fully-automated standard analyzers (KX-21, pocH-100i, XS-1000i), installed at the Shastin Central Hospital, were used to assign the target values for the survey materials. These standard analyzers have been calibrated with SCS-1000® before the survey, and monitored with hematology controls, e-CHECK(XS) ® and EIGHTCHECK-3WP® on daily basis.
Instructions & Sample Distribution
On every survey, the workshop was held to give guidance and distribute the survey samples to each participant.
Categorization of Peer Group
Participating data were divided into two peer groups, based on methodology; Group 1: laboratories used automated hematology analyzer (in further Auto’s), Group 2: manually examined group. Each laboratory was given ID number and was asked to analyze these samples 3 times and report the all data and average for CBC 8 parameters.
Statistical Evaluation Method
For individual reports, the results for each participant were evaluated and expressed according to peer group mean and standard deviation index (SDI), Precision index (PI), Absolute evaluation, Scoring system and Target-value evaluation methods (A B C D evaluation). Results:
The Auto’s inter-lab CV% of WBC for fresh whole blood showed decrease from 6.1 to 4.2 comparing with17^th and 18th MEQAS.
The Auto’s Inter-lab CV% of RBC for fresh whole blood showed decrease from 3.7 to 3.4 comparing with 17^th and 18^th MEQAS.
The Auto’s inter-lab CV% of HGB for fresh whole blood were very stable (2.9%, 3.0%), respectively from 17^th to 18^th MEQAS.
The Auto’s inter-lab CV% HCT for the fresh whole blood showed go down from 5.5% to 4.8% comparing with 17^th and 18^th MEQAS.
The Auto’s inter-lab CV% PLT for fresh blood showed go down from 10.2% to 8.2% comparing with 17^th and 18^th MEQAS.
The Auto’s inter-lab CV% of CBC parameter for fresh blood and control Material (Sample A) showed go down from 1^st to 18^th MEQAS.
The Auto’s inter-lab CV% of WBC, RBC, HGB, PLT for Control Material (Sample A) were big difference comparing with Japan’s CV%. Conclusion:
1. The Auto’s inter-lab CV% of WBC, RBC and PLT for fresh whole blood has been decrease respectively 4.2%, 3.4%, 8.2% in the 18^th MEQAS and there was difference in the CV% between manufacturers.
2. The Auto’s inter-lab CV% of WBC, RBC, HGB, PLT for Control Material (Sample A) showed go down from 1^st to 18^th MEQAS but were big difference comparing with Japan’s CV%. Acknowledgements We would like to express our appreciation to the Sysmex Corporation (Japan) for providing financial supports investigate this study.