BackgroundThe prognosis of breast and cervical cancer is relatively good if they are diagnosed at early stages.In Mongolia, however the survival rate of these cancers has been lower than in developed countries. Prevalence of late diagnoses of breast and cervical cancer is one of the most significant factors of the low survival rate of cancer patients in Mongolia. In this study, we sought to determine (1) the delay in diagnosing related with patient and (2) delay in treatment related with medical care including possible risk factors.GoalTo study the diagnosis delay of breast and cervical cancers related to medical care system.MethodsBreast and cervical cancer patients treated in the inpatient wards of National Cancer Center completed a study questionnaire on the first symptoms, timeline of medical care, and socio-demographic information. Diagnostic delay related with patient is indicated by extension of time interval of 30 days between the first symptoms and the first medical consultation. Diagnostic delay related with medical care system is indicated by extension of time interval of 30 days between the first medical the consultation and the first diagnosis. The delays of time were analyzed using the Mantel-Haenszel test.ResultsThe mean value of cervical cancer patient delay was 1.7 months. 40% of the patients were diagnosed later than 1 month failing to seek medical assistance as soon as the first symptom has been found (p=0.03). But the mean value of breast cancer patient delay was 2.1 months and 57% of patients were diagnosed later than 1 month. Diagnostic delay was associated with lack of diagnostic capacity of general practitioners and of province and district hospitals (p=0.001).ConclusionsDelays occur in all stages of the diagnostic process. Our results may represent an important tool in guiding the actions for an early diagnosis of cervical and breast cancers. There is a need for improving breast and cervical cancer awareness and training of general practitioners to reduce breast and cervical cancers mortality by promoting early detection.

Introduction. Cervical cancer is one of the most common cancers among women worldwide. Its mortality exemplifies health inequity, as its rates are higher in low & middle income countries (LMICs ), and in low socio-economic groups within countries. Around 80% of global cervical cancer cases are in LMICs. (WHO, 2008 ) Goal. To determine the prevalence, incidence and mortality for cervical cancer among Mongolian population Objectives: 1. To determine the trends of incidence and mortality for cervical cancer by regions among Mongolian population during 2000-2009 2. To estimate DALYs for cervical cancer in 2009 Materials and Methods: Data for this study were abstracted from Annual Reports of the National Cancer Registry for 2000-2009.I ncidence and mortality rates were calculated as mean annual numbers per 100,000 residents. Age-standardized incidence rates (ASRs) and age-standardized mortality rates (ASMRs) were calculated by the direct method by weighting age-specific incidence and mortality rates to the World Population. The DALY combines in one measure the time lived with disability and the time lost due to premature mortality: DALY = YLL + YLD YLL – years of life lost due to premature mortality YLD – years lived with disability. Results: last ten years, the trends have been increasing of the prevalence, incidence and mortality rate for cervical cancer in Mongolia. The cervical cancer incidence rates are the highest in Central and Eastern regions than other regions. The average burden of cervical cancer across all regions in 2009 was 2868 DALYs per 100000 population, of which about 30,9% was due to premature death and 69% non-fatal health outcomes. Conclusion: The incidence of cervical cancer is generally low in China, moderate in Japan and somewhat higher in Korea and Mongolia [11]. Need to estimate the DALYs for common cancers in Mongolia.

Acceleration of emissions reductions in household coal stoves and modest improvements in other sectors, however, have the potential to considerably lower outdoor pollution and reduce total exposures to about 70% of those today (Scenario 1). Reducing total exposures closer to these international benchmark levels will require moving away from coal and wood as household fuels and even more control on other sources (Scenario 2). The first package of moderate control measures (Scenario 1) considered in this assessment will result in a slow decline in impacts(Figure) and a cumulative health savings over trends in 2013, but leave annual per capita health impacts only about 25% lower than today after ten years. A more aggressive set of control measures (Scenario 2), however, will result in more health protection over the period and reduce annual impacts by approximately 60% from current levels in 2025 . In terms of impact per capita,this would represent nearly a 70% reduction over the period taking population growth into account.

Machinery Repair Plant (MRP) of Erdenet Mining Corporation (EMC) is the subject of this research in order to determine the labor conditions and illnesses of the employees at the metallurgical plant.MRP’s function is to smelting and processing metals for milling, producing, repairing or restoring metal structures of machineries or equipment. MRP employs 639 employees for 185 working places and 568 equals to 88.6% of them have been working n the abnormal condition which reveals that the plant has hard conditions of labor.The research was performed using retrospective research method in fact modeling; and made an evaluation on measurements of 2008-2014, performed by the occupational health laboratory covering 185 working places at MRP; occupational diseases occurred to 639 employees; and perspective status of temporarily invalidity. Electronic logging data base for Occupational Diseases and temporary invalidity at the EMC was used for categorization and conclusion according to the International category of 10 diseases. Research results of labor conditions: As to measurements made between 2008 and 2014 on the working places at MRP, dust concentration reached up to 18mg/m3 and that was excessive than the corresponding average by 9 times of measurements. Results from occupational disease survey: 137 employees have been affected by the occupational diseases at the MRP for the last 27 years. 39, which is a large amount, out of 137 were affected by bronchadenitis caused by dust. Results from temporary invalidity survey: 2293 occurrences were recorded in relation to temporary invalidity at MRP between 2008 and 2012 and the percentage of injuries or toxicities and certain disorders caused by outsources is 15.6%. Reviewing the survey results, common occurrences are bronchadenitis caused by dust, spinal neural inflammations and chronic inflammation caused by dust toxicities, and the large percentages are occupied by temporary invalidity, injuries or toxicities and certain disorders caused by outsources, respiratory organ and system disorders. It shows that those of diseases and disorders are dependent to the working place environments and labor conditions.

Introduction: First family group practices (FGPs) started to function in 1999 and there are 225 FGPs in Mongolia. FGP is a primary health care unit that renders medical assistance for all urban population in the country. Privatized FGPs act as contractors for state responsibility service and this one of the innovations that raises challenges to make primary health care services more accessible improve their quality and strengthen their human resources. Greater equity of service access and provision depends on structure and capacity of human resources of FGPs. Therefore, there is a need to study human resources provision and their specialization profile in FGPs.Objectives: To study human resource provision and its specialization profile in FGPs of Ulaanbaatar city.Design: Cross-sectional study Material and Methods: Developed registration checklists and questionnaire were used for collection data on human resources, their specialization and training needs.Settings: 77 FGPs in Ulaanbaatar were covered by the studyResults: There were 2273 people per one family doctor and 2233 people per one family nurse. This means that a family doctor and a family nurse provide services for population almost twice greater compared to required standards and it was observed in all districts of Ulaanbaatar. Most of family doctors (71.6%) graduated as basic doctors and only 10.5% of them specialized as family doctors or general practitioners. Some 15.5% of all selected family doctors attended an upgrading training in family practice and only 1.6% attended specialization training. There were 180 nurses covered by the study and 143 (79.4%), 24 (13.3%), 4 (2.2%) and only 2 (1.1%) of them were trained as general nurse, midwife, nursing assistant and family practice nurse, respectively. Some 20(11.1%) of nurses participated in the study attended some specialization training. Some 28% of family doctors stressed that they would like to attend upgrading training courses in family practice, 13% of them training on public health, 12% on healthcare management, 11% on imaging diagnostics, 8% on internal medicine, 6% on traditional medicine and 5% on child health. FGP’s nurses preference of training were as follows: 40%, 22%, 11%, and 18% were on general practice nursing, public health, management and physiotherapy, respectively.Conclusions: The FGP’s physicians and nurses have been provided service to population twice greater than in required standards, and there were only 1.6% and 1.1% of doctors and nurses attended family practice training, respectively. Therefore, there is a need to increase number of professionals in FGPs and provide specialization training to strengthen FGPs human resources.

Objective: To clear up of influence of society, economy family and mood of pregnant mother who gave stillbirth.Material and Methods: We chose 50 mother’s who gave stillbirth by case group, 50 mother’s who gave normal birth by control group by randomized method, research was conducted by specially prepared card and descriptive method, we compared placenta of mother’s who gave stillbirth and normal birth by pathologic analyse and working out was done by using SPSS 14.0 programme and difference between index was concluded by X 2 and F criteria.Results: Normal birth of mother’s who participated in the research is 19(16.7%) at the age 11(84.6%), at the age of 40-44 normal birth 1(50.0%), stillbirth 1(50.0%) stillbirth risk is increased under 19 and over 35, it has statistic probability (p=0.026). In 5(17.9%) of mother’s who gave normal birth, 23(82.1%) of mother’s who gave stillbirth. A member of her family smokes, in 45(62.5%) of mothers who gave normal birth, in 27(37.5%) of mothers who gave stillbirth a member of a family does not smoke .Seeing from this smoking of a family member affect to stillbirth and it has statistic probability (p=0.000).18(54.5%) of mothers who live in ger, 12( 35.3%) of mothers who live in a yard and a house, 20( 60.6) mothers who live in a flat gave normal birth. Seeing from this condition of living in a yard or in a house is worse that condition of living in a flat, it influence to stillbirth, it has probability for statistic (p=0.055). Conclusion: When women gives birth to a child under 19 and over 35 increases risk of stillbirth. It has statistic probability (p=0.026). Smoking of family member affects to stillbirth, it has statistic probability (p= 0.000). Condition of living in a yard and house is worse than living in a flat, it affect to stillbirth, it has probability for statistics (p=0.055).

Child psychiatric disorders are common and treatable, but often go undetected and therefore remain untreated.To assess the Strengths and Difficulties Questionnaire (SDQ) as a potential means for improving the detection of child psychiatric disorders in the community.SDQ predictions and independent psychiatric diagnoses were compared in a community sample of 1959 11- to 17-year-olds from the 2013 Mongolian National Center for Mental HealthMulti-informant (parents, teachers, older children) SDQs identified individuals with a psychiatric diagnosis with a specificity of 66.8% (95% Cl 61.4-73.0%) and a sensitivity of 64.4% (59.9-71.3%). The questionnaires identified over 65% of individuals with conduct, hyperactivity, depressive and some anxiety disorders. Sensitivity was substantially poorer with single-informant rather than multi-informant SDQs.Community screening programmers based on multi-informant SDQs could potentially increase the detection of child psychiatric disorders, thereby improving access to effective treatments

Introduction.M.Colombo, W.Lange studies showed that 30-40% of people became chronic after suffering fromHepatitis B and C virus, about 50% of chronic cases transformed into primary liver cancer. There arefew studies in our country were conducted on hepatitis among healthcare professionals, particularnursing personnel.Goal.To identify antigens and antibodies of hepatitis B and C virus among nursesMaterials and Method.We carried out cross-sectional study among selected nurses, to determine surface antigen of hepatitisB virus and antibodies to hepatitis C virus. For identification of these antibodies and antigen, andvalidation of results Serodia tests from Fujinebo Company (Japan) and Beringnost (Germany) wereused respectively.Results.There were 598 nurses from the State Central Clinical Hospital, Shastin’s State Hospital, Hospitalof Military of Justice and Internal Affairs, and the National Center of Maternal and Child Health, whoparticipated in the study. From 5 hospitals a 598 nurses surveyed and revealed the hepatitis B virussurface antigen positive 18.9%, hepatitis C virus antibodies in 23.2%, B and C viruses detected by1.2% combined.Conclusion.The study identified that 43.2 percent of nurses surveyed on hepatitis B and C viruses were detected;it shows a high prevalence among the nurses. There is an urgent need to provide knowledge tomedical personnel regarding standards during procedures, concerning hepatitis infections, monitoringand improve technology used during procedures.

Introduction. The survey was conducted to establish the midterm evaluation of the National Program on NCD Prevention and Control, and to establish baseline data for a health project funded by the Millennium Challenge Account (MCA).Goal The goal of the survey was to determine the prevalence alcohol consumption pattern among Mongolian adults using WHO-approved methods, and to inform on NCD and injury control activities.Objectives:To compare the current prevalence of alcohol consumption to that identified in the previous STEPS survey. Alcohol consumption patterns, frequency of drinking and risks associated with alcohol consumption will be studied according to gender, age and place of residence of the survey respondents.Materials and MethodsThe cross-sectional survey used WHO STEPS survey methodology adapted to the countries specifics. A total of 5638 randomly selected 15-64 year-old Mongolian residents of both sexes from 36 soums of 20 aimags and 6 districts of Ulaanbaatar city participated in the survey. The survey data was fully collected using small handheld computers (PDAs). Because the data was comprised of only a sample of the large population, it was necessary to weight the data, Thus sample weighting and adjustments to correct the differences in the age-sex distribution of the sample compared to the largest population were performed. Data analysis was conducted using EPI INFO version 3.5.1 using appropriate methods for the complex sample design of the survey. Outcome measures (prevalence and mean variance) and differences between groups (age, gender and urban\ rural groups) were calculated with 95% confidence intervals (95%).Results:34.2% of Mongolian adults did not use alcohol in their life-time and 65.8% of them used alcohol to some extent. The prevalence of binge drinking was 39.7% in men and 15.1% in women, and binge drinking was 2.5 times more common in males compared to females.

Introduction: The issue of meeting need of rehabilitation care service required to elders is one of determinants which influences in enabling quality of life of elderly people. In our country, we lack of survey on determining current need of long term care and one of its form rehabilitation care service for the elderly, so it became the background of the research. Goal: Reveal some needs of rehabilitation care service through determining the Activities of daily living and Instrumental Activities of daily living of Mongolian elderly people Materials and Method: The research was carried out by cross sectional method. In the research was involved 1207 elderly, who are retired, of which 60 and over for male and 55 and over for female from one cluster of each economic and geographic regions of Mongolia. The research was conducted by using ADL and IADL tests as well as questionnaire to determine the needs of rehabilitation care service. Results: Out of survey involved 1207 elderly, 32.5 percent (392) referred to men, 67.5 percent (815) to women, and their mean age was 68.1±8.1 (68.9±6.5 in male and 65.7±8.5 in female). While 473 elderly were from Ulaanbaatar city, 734 of them were from 4 regions of countryside. Among survey involved elderly, the mean of ADL ability was 87.4 percent, of which, the following abilities were better such as: continence (92.5%), toileting (91.3%), dressing (87.9%), while bathing ability was impaired mostly or 18.2 percent. Subsequently, the mean of IADL ability among survey involved elderly was found to be 29.9 percent. The health needs of elderly were differed. Due to extensive indicator, 24.8 percent of elderly wanted to admit in a hospital, 20.8 percent - home nursing care and 32.6 percent -involvement in rehabilitation care service. In terms of amount, the maximum needs were eight, while most of elderly requested 1-3 kinds of needs. Conclusions: 1. The impairment of Activity of Daily Living was found to be approximately 22.6 percent, while Instrumental Activity of Daily Living was 29.9 percent among Mongolian elderly people. 2. The impairment level of Activities of Daily Living and Instrumental Activities of Daily Living indicated the requirement of occupational and physical therapy in health care service for the elderly.