Introduction: Safe and accessible WASH services in healthcare facilities are crucial for maintaining high quality care, especially for maternal and newborn health. The WHO-UNICEF JMP on Water Supply, Sanitation, and Hygiene provides reports on progress in water supply, sanitation, and hygiene services at global, regional, and national levels, covering populations, schools, and healthcare facilities. This assessment was conducted to address the insufficient data on the level of hand hygiene services in healthcare facilities, following the methodology of the JMP. Materials and Methods: A cross-sectional study was conducted in 319 healthcare facilities. Availability of hand hygiene services in the study healthcare facilities was assessed using questionnaire of methodology of the JMP. Data were analyzed using SPSS 25.0 software. Relevant parametric and non parametric statistical analysis were conducted. Results: Overall, 72% and 28% of healthcare facilities had basic and limited hand hygiene service respectively. About 18% of private healthcare facilities had limited hand hygiene service compared to 34% of state healthcare facilities. While 20% of urban healthcare facilities had limited hand hygiene service, 56% of rural healthcare facilities do. When examining the level of hand hygiene services by type of medical care, specialty hospitals have 100% basic services. Among primary care facilities, 83% of family health centers provide basic services, while 41% of soum and village health centers meet these standards. Conclusion The basic hand hygiene services in urban healthcare facilities and specialty hospitals were generally sufficient. There need to enhance basic hand hygiene service at the soum and village level. Among the assessed facilities, 81.0% met four out of the five key hand hygiene requirements outlined in the national standard. However, additional budget allocation for maintenance and operational costs for keeping soap and sustaining water running remains crucial to ensure sustained compliance and quality.

Climate change and child malnutrition Introductions: Globally, one billion children are living in areas at high risk of climate change exposure. Among them, over 200 million children under the age of five suffer from severe malnutrition, and 148 million experience growth and developmental stunting. Climate change affects key determinants of child health such as the nutritional value of food, environmental conditions, and living standards. Mongolia is classified among countries with a high climate vulnerability index. Therefore, it is essential to study the impact of climate change on children's health in the Mongolian context. We aimed at determining the prevalence and trends of nutritional deficiencies among children under five years of age and to assess the impact of climate change on these deficiencies. Materials and methods: This study was conducted using international databases. Climate change was evaluated using indicators such as the Climate Change Index, average annual land surface temperature, air quality, soil contamination, and precipitation levels. Data on child nutrition were collected from the Institute for Health Metrics and Evaluation (IHME) database and the Mongolian National Statistical Information Service for the period 2000–2019. Nutritional deficiencies were measured using indicators including wasting and overweight among children under five. Trends in the prevalence of nutritional deficiencies were analyzed using the AR(I)MA model to forecast changes between 2020 and 2030. Regional variations were assessed using panel regression models, and the impact of regional climate variables on child nutrition was estimated. Results: The climate vulnerability index in Mongolia has been increasing, with trends indicating further rises in temperature variability. From 2000 to 2019, the prevalence of wasting and stunting among children under five showed a decreasing trend, with annual reductions projected at 0.5% and 1.8%, respectively. In contrast, overweight and obesity among children under five are projected to increase until 2030, with Ulaanbaatar showing statistically significant high values. A correlation was found between climate change indicators and childhood overweight. Conclusions: There is a rising trend in overweight and obesity among young children. Climate change has both direct and indirect impacts on child nutrition, food safety, and nutritional deficiencies. These associations must be taken into serious consideration in public health planning and policy.

Relationship between quality of life, depression and burden of mothers with child withсerebral palsy Background: Regular care and treatment of children diagnosed with cerebral palsy can be time-consuming and costly, increasing the risk of burden and depression, and adversely affecting quality of life. So there are many reasons why mothers' quality of life is poor socio-economic status and support related to the family, cerebral palsy from child care techniques and understanding of the disease the quality of life of mothers with sick children depends. There are few studies in Mongolia that assess the quality of life and other factors of mothers with cerebral palsy. We aimed assessing the relationship between quality of life, stress and depression in mothers with children with cerebral palsy. Materials and methods: The survey was conducted to the cross-sectional design of the analytical study based on the NCMCH. The study included 70 mothers with children with cerebral palsy. The survey data were collected using a general demographic questionnaire and three groups of questionnaires (WHOQOL-BREF, Stephen Zarit, Beck’s ). Quality of life and burden were measured as minimum <5, maximum 95 and minimum >20, maximum <88 respectively. Depression score measured as minimum >10, maximum <40. Results: The average quality of life of all mothers was 52.43 ± 11.95, environment was 44.8 ± 15.8. Maternal depression rates were 21 (30%), 90.0% of mothers had burden, and quality of life was statistically likely to be inversely related to depression and stress. Conclusion: The poor quality of life of mothers with children with cerebral palsy, high levels of depression and stress indicate the need for policies to reduce the quality of life.

BI-RADS assessment using for diagnosis of invasive ductal carcinoma Introduction: Scientific evidence is needed to introduce non-invasive and effective diagnostic methods for early detection of breast cancer. One of these methods is the BI-RADS (Breast Imaging Reporting and Data System) assessment, which has entered the field of imaging. However, in the United States, 58% of all cases diagnosed negatively by ultrasound (BI-RADS1-3) were diagnosed by breast biopsy. The significance of BI-RADS assessment in Invasive Ductal Carcinoma will be investigated in the National Cancer Center of Mongolia Materials and methods: The study was conducted using the descriptive design from January 2021 to August 2021, based on the National Cancer Center of Mongolia. The study data were initially collected using a database of tissue and immunohistochemical analyzes and breast ultrasound. Of the 75 women aged 23-86, 81.3% were diagnosed with breast cancer. Results: The study found that 75.4% of women diagnosed with breast cancer by biopsy had a suspected BI-RADS cancer (4a-5). In addition, a woman's age is a statistically significant predictor variable in the diagnosis of peritoneal breast cancer (ROC = ROC = 0.736, p = 0.006). Conclusions: BI-RADS assessment can be used for invasive ductal carcinoma. Our study retrospectively included only women with cancer and other breast disease. In the future, it is necessary to study in detail the relationship between BI-RADS evaluation indicators and invasive ductal carcinoma.