1.“Clinical hospital management” study result
Sodnompil Ts ; Dulamsuren S ; Shirnen L ; Barkhas A
Mongolian Medical Sciences 2010;153(3):12-15
Goal: To outline possible approaches in improving clinical hospital management upon reviewing of its current setting Materials and Methods: The study was conducted by qualitative method and data was collected through applying discussions and participatory approaches. In total, 155 participants were enrolled in the study, from which 72 were covered by the Focus Group Discussions, and the remained 83 were studied for Organizational Diagnostic Analysis.
Conclusions:
1. Advantages and Disadvantages of the Clinical hospital management levels, although they vary, management aspects are reasonably unsatisfactory. If to view in a isolation by each key role and direction of the management functions, organization, planning, quality assurance, monitoring and evaluation management encompass comparatively predominant advantages whereas human resources, information, finance, motivation, and decision making management enclose prevailing disadvantages. In terms of marketing management, it is extremely poor.
2. Healthcare Organizations’ strategic planning is advantageous focusing on essential skills and tools needed to enhance quality and accessibility of health care as new models of care delivery. Nevertheless, it is weak in operational processes resembling of introduction of technology initiatives and improving of health care targeted to vulnerable groups of the population.
3. Human resources management surrounds in a large amount of disadvantages, particularly, career development of personnel, workforce selection and research capability are inadequate.
4. Although management decisions made are usually accepted by working groups and are enforced their implementations, issues associated with any decisions to involve representaitives of community, regular dialogue of managers with staaf and clients and provision of supervision are fairly poor.
5. By and large, leading skills of managers are quite pleasing and the orders given by managers are executed on a timely manner. Conversely, awarding, incentives and motivation of personnel is highly problematic.
6. The following actions were in good shape, e.g monitoring and evaluation is performed according to the given guidelines, and performance evaluation is recognized by employees followed by inclusion of the findings in planning design. Notably, issues linked with cooperation with other agencies, ensuring quality assurances at the all levels and transparency to inform the cases for not being accountable and for poor performamce of the commands are in low morale.
7. Application of internal information network and provision of transparency and responsiveness has considerably been improved, while predominant mono communicative management, availability of electronic health security data, proper information utilization and time management is deficient.
8. Marketing and its management for High-Performance Healthcare Organizations are underprivileged and absolutely disadvantegious.
9. Even though financial management aspect has gained an introduction of software applications compatable with the Internationally Accepted Standards and Requirements and the projected resources have well mobilized, the necessary investment required for introduction of new technology, the budget for hospital expansion, the insufficient resources for risk management, mobilization of additional assets are limited.
10. International cooperation and collaboration is subject to the legal environment, economic, financial factors, inflation and other technical dynamics. Moreover, partnership with other sectors, private entities, civil society, and the public is scarce, and even, there is no adequate mechanism to gain supports of diverse aspects and to work effectively together.
2.Epidemiological features of some sexually transmitted diseases among the population of Ulaanbaatar city
Mongolian Medical Sciences 2023;204(2):46-57
Introduction:
According to the World Health Organization (WHO), more than a million cases of sexually transmitted
diseases (STDs) are registered in the world every day. Our country is among the countries with a
concentrated spread of HIV infection among the population at risk According to the WHO classification.
Although Mongolia is one of the countries with a low prevalence of HIV/AIDS, it is considered to a
country with a high risk of STD caused from the location in the middle of the two countries where the
HIV infection is spreading as fastest, thus it is important to study.
Purpose:
The aim is to study the epidemiology of sexually transmitted diseases in the population of Ulaanbaatar.
Material and Method:
The study was conducted using a single-moment descriptive research design. The following
information was obtained from the statistics of the Health Development Center. Including as following:
• Annual indicators of the disease: Statistical data of sexually transmitted diseases between 2017-
2021 (Ulaanbaatar city)
• Annual indicators of the disease: 2017-2021 statistical data on the state of sexually transmitted
diseases (city average and provincial average)
Result:
Considering the prevalence rate of sexually transmitted infections per 10,000 population by age
group, as of 2017-2021, the population aged 20-39 had the highest rate of infection with 9.4-154.2
cases, and in 2018, the population aged 30-39 had 146.2 cases was the highest.
In terms of the source of infection, 83.1 percent of the total cases in 2017-2021 were sexually
transmitted.
Comparing the prevalence of sexually transmitted infections in the population of Ulaanbaatar by
location and the number of cases per 10,000 population, as of 2017-2021, Bagakhangai district
had more cases in 2017 and 2019, and Sukhbaatar district had 221.4 cases in 2018, which was the
highest in the 5-year period, Nalaikh district recorded 64.7 cases in 2020 and 48.4 in 2021, which was
the district with the highest number of cases in these years.
In terms of education, people with secondary education or below accounted for 94.1 percent of all
cases in the 5-year average.
About the marriage status, 35.9 percent of all cases registered in 2017 were never married, and 53.5
percent were married. As of 2018-2021, there has been no significant increase or decrease in this
indicator.
Conclusion
1. During 2017-2021, the cases of sexually transmitted infections (syphilis, gonorrhea, trichomoniasis) per 10,000 population was in 2018, the incidence of infection decreased by 2.7 cases, in 2019 it increased by 7 cases, and in 2020 it decreased by 2.2 cases, in 2021, it decreased by 18.3
cases from the previous year, and it is believed that sexually transmitted diseases are expected
to decrease in the future.
2. The average rate of syphilis infection (2017-2021) per 10,000 population in Ulaanbaatar was 4.4 cases higher than the average of the provinces, the average of 4.1 cases of gonorrhea infection
is likely to increase, and the average of trichomoniasis was 13.4 cases or was equal to average
of the provinces and Ulaanbaatar. The problem affecting the incidence of sexually transmitted
diseases is related to the level of education of the citizens. 9 out of 10 people have completed
secondary education or less.
3.Community knowledge, attitude and practice on preventive service and attitude of primary health care providers
Dulamsuren S ; Enkhmaa U ; Shirnen L ; Suvd B ; Ariunbileg Z
Mongolian Medical Sciences 2013;163(1):42-47
Aim and objectivesTo assess the community health seeking behavior, knowledge, attitude, practice and the attitude ofprimary health care providers and to determine methodologies for developing of voluntary attendanceof preventive screening services. This included:• Assessment of community knowledge, attitude and practice related with preventive healthservices and health seeking behavior;• Assessment of the attitude of primary health care providers on preventive healthservices;• Identify methodologies to establish a practice of voluntary attendance of preventivescreening services;Materials and MethodsIn this survey both quantitative and qualitative research methods were used. 846 individuals wereinvolved in the quantitative survey and 112 family doctors, nurses, social workers of the selectedaimags and districts participated in the qualitative surveys.ResultsThough the participants demonstrate knowledge that the primary health care facilities should beapproached on the initiative of the patients themselves (85%), while healthy (50%) and for earlydetection of a disease (70%), this knowledge on preventive care is not evolving into actual practiceas most of them visit the primary care facilities only as they become sick (70%). The communityparticipants demonstrate incorrect attitude that preventive services do not require personal initiativesand engagement of patients (42%), primary care facilities are visited in order to obtain a referral tothe next level of care (46%), primary care facilities should be visited only when there are symptoms ofdiseases (32%) and only when the patient has free time. The participants of the survey also noted theinsufficient attitude and communication manners of the doctors and health professionals (31%), thatpatients are not received with smile when they visit for preventive screening (60%), dissatisfaction withthe services of primary care facilities (28%).ConclusionsThe majority of the respondents know that visit to primary health care clinic for health check-up isrequired. Although most of the participants demonstrate knowledge that primary health care unitsshould be visited voluntarily for preventive screening services, most do not practice this knowledge.The attitude of most of the participants was that the benefit of visiting a primary care facility is obtaininga referral to the specialist doctor. One out of three of the survey participants had an incorrect attitude asthey perceive that health check-up is only necessary if a patient is sick with one or more conditions.
4.Role of family health centres in prevention, screening and addressing risk factors of cardiovascular diseases, cancer and diabetes, methodological support
Dulamsuren S ; Sevjid N ; Shirnen L ; Unurtsetseg T
Mongolian Medical Sciences 2013;163(1):48-55
IntroductionProvide evidence necessary for effective implementation of the National Programme on Prevention and Control of NCDs by studying the services delivered by family health centers for prevention, screening and reduction of risk factors of cardiovascular diseases, cancer and diabetes, problems encountered and professional support.GoalStudy the role of family health centers in prevention, screening and reduction of risk factors of cardiovascular diseases, cancer and diabetes and the methodological and professional support they are receiving.Materials and MethodsThe study covered 30.7% of family health centres of UB city and 18.9% of family health centres in rural areas, which are together 19.7% of all family health centres.Results and conclusions18 family health centres from Central, Dornogobi, Orkhon aimags and 25 family health centres from Bayanzurkh, Sukhbaatar, Nalaikh districts of Ulaanbaatar city as well 258 doctors and 18 managers who provide with qualified methodology were involved in the survey. Informal training activities such as lecture, discussions, memo printed on the reverse side of the check-up numbers, e-mails, SMS messages and advice during visits need to be used to promote healthy behaviour and healthy lifestyle. There are no incentives for promoting health, and preventing non-contagious diseases, the budget for these activities is really minimal around 60,000-200,000 tugrugs per annum. Cooperation with international organizations can be enhanced in order to receive financial support for these activities. The staffs of family health centres consists in average of 11-15 personnel, they are overloaded with the treatment of patients and less time is available for them to work for prevention, screening, and addressing risk factors. The instructing and counselling skills of medical staff are low.
5.The utilization of biotinylated RNA baits on captured sequencing of cancer marker genes functional regions
Byambasuren B ; Dulamsuren O ; Lkhagvadorj G ; Amarsanaa E ; Khurelbaatar S ; Shiirevnyamba A ; Batsaikhan B ; Zanabazar E
Mongolian Medical Sciences 2021;198(4):3-14
Background:
Nucleic acid sequencing is a multi-step process taken place in medical research or diagnostic
laboratories. Since the emerge of second generation sequencing technology generally referred as
next generation sequencing (NGS), the mass parallel reads covering human genome or transcriptome
is achieved by cost cut down over thousand folds. Though the technology made tremendous push
forward to various applications, its data analysis time and effort still takes worrisome time and human
effort, bringing the emerge of next-step demand: targeted mass sequencing of only desired part
from human genome or transcriptome with lower material cost and labor. By targeted sequencing,
both run cost and data analysis process can be further cut down, and the read results are more
reliable on changes such as determining varied number of repeats, heterozygote alleles, deletions,
chromosomal scale abnormality and more.
Objective:
In this study, we explored the utilization of biotinylated RNA baits on captured sequencing of cancer
marker genes functional regions.
Method:
Targeted NGS was achieved by capturing desired genomic regions using preparatory nucleic acid
probes. RNA bait capturing of desired genomic regions has shown to have high specificity and quality.
The study was carried out with informed consent obtained from patients, with the approval №53 in
2018.03.15 by Medical Ethics committee, Ministry of Health, Mongolia.
Result:
By preparing library of biotinylated RNA baits with 75000 unique sequences, we achieved mass
parallel sequencing of human 410 cancer-marker-genes’ exons and UTRs with average read depth
~760, and covered thousands of SNPs on 5 genomic DNA samples. Tissue samples derived from
breast cancer and ovary cancer had SNP and deletion on 7 marker genes (BRCA1, BRCA2, ATM, BRIP1, PTEN, TP53, RAD51C) not registered in database.
Conclusion
Experiments showed RNA baits with up to 117 nucleotide length, produced from ssDNA oligonucleotide
stock, can be utilized to capture desired regions of human genome, and bring the cost of captured
mass sequencing to 1500 USD, with 93.14-93.33% of Q30 read quality.