Background: As the world population ages, the prevalence of osteoporosis is increasing, becoming a major health problem. In Mongolia, a trend of bone structural changes and fractures due to metabolic syndrome and its complications has been observed in a study by Baatar N (2017). However, the lack of research on the relationship between central obesity indicators such as neck circumference and bone mineral density, was the reason for conducting this study. Aim: To determine the relationship between neck circumference, an indicator of central obesity, and bone mineral density among citizens attending the First National Central Hospital. Materials and Methods: This study was conducted using an analytical cross-sectional study design. A total of 224 participants aged 30 years and older were included in the study. Participants’ lifestyle and health questionnaires were collected using a standard questionnaire, and anthropometric measurements (neck circumference, waist circumference, height, and weight) were performed. Bone mineral density was measured and evaluated using the EXA-PRESTO (Osteo Sys, 2022) device. The results of the study were processed using the SPSS-26.0 program. Results: There was no statistically significant difference in the association between gender and osteoporosis. The chi-square test (χ²=1.132, p=0.287) showed that gender was not associated with osteoporosis. The odds ratio (OR) analysis showed that women were 1.33 times more likely to develop osteoporosis than men (OR=1.33, 95% CI: 0.78–2.27), but this difference was not statistically significant (p > 0.05). When neck circumference was stratified into groups, there was no statistically significant association in women (χ²(4)=3.137, p=0.535), but in men the association was significant when the neck circumference was ≤ 39 cm (χ²(4)=10.192, p=0.037). Conclusion The results of the study showed that the female group had a higher risk of osteoporosis than the male group (OR=1.33), but this difference was not statistically significant (p>0.05). This may be due to changes in bone metabolism due to hormonal changes in women, especially the decrease in estrogen.

Background: Mongolia’s geographical characteristics limit access to specialist healthcare for residents of remote soums, resulting in out-of-pocket expenditure, substantial travel time, and reliance on accompanying family members. To address these barriers, the store-and-forward “Derma” application was introduced progressively across 334 soums between 2017 and 2020. Nevertheless, challenges persist in sustaining its operation and embedding it in routine clinical practice. Aim: To explore soum doctors’ experiences with the “Derma” application and identify factors influencing the sustainability of teledermatology services. Materials and Methods: Focus group interviews were conducted in seven aimags between December 2019 and June 2020. A pilot interview with eight doctors in Sukhbaatar aimag informed the development of a semi-structured interview guide. Written interview records underwent directed content analysis guided by Donabedian’s structure–process–outcome framework. Response frequencies were interpreted at group and participant levels, accounting for variation in the number answering each question. The analysis examined service interruptions and organisational requirements for sustainability, incorporating recurrent themes, emerging concerns, and critical perspectives on technology use. Ethical approval and written informed consent were obtained. Results: Overall, 98.1% (52/53) of participants reported difficulty diagnosing and treating skin diseases locally. Among respondents to the relevant questions, 85.4% (41/48) considered the application helpful, 95.8% (46/48) perceived little difference in quality between remote and in-person care, and 89.6% (43/48) reported learning benefits. Most participants reported no increase in workload (94.3%; 50/53). Mean case submission time was 9.67±4.42 minutes; the reported specialist response time was 2.5 days (range: 1–14). Barriers included mobile network limitations in five aimags, difficulties obtaining recommended medicines in six, and personal expenditure of 8,000 MNT per month on mobile data among doctors in three aimags. A small number of accounts highlighted the need for standardised response times, access for all doctors, technical maintenance, dedicated data funding, medicine availability, and secure communication channels. Conclusion Soum doctors perceived teledermatology as supporting specialist consultation, continuing professional learning, and healthcare access. Its sustained adoption was constrained by workforce instability and inadequate infrastructural, financial, and organisational support.

Background: The Maternal and Child Health Handbook is a long-term health monitoring tool that records children’s health, immunization, and developmental stages from the prenatal period to age five. By using the MCH handbook together with parents and health workers, it is possible to increase health education for parents and prevent, and detect potential developmental delays in children at an early age. Aim: To detect the knowledge and attitudes toward family use of the MCH handbook Materials and Methods: The study was conducted using an analytical study using cross-sectional design and included a total of 373 parents and caregivers with children aged 1-4 in 4 districts of Ulaanbaatar city. When assessing knowledge, correct answers were scored and grouped. When assessing the attitude, the parents were scored based on whether they were recorded in the MCH handbook. To determine the relationship between influencing factors, a one-way logistic regression analysis was performed, which was considered statistically significant at a 95% confidence interval and p<0.05 and was performed using the SPSS 25 program. Results: The mean age of the study participants was 33.5±6.5. Reading and keeping a handbook completely (p=0.0001) was statistically significantly related to improving knowledge (p=0.0001). In studying the factors affecting handbook records, the following were statistically significant: gestational age (OR=0.956, 95% CI [0.923, 0.990]), number of births (OR=1.206, 95% CI [1.002, 1.452]). Factor influencing knowledge about the notebook is gestational age (OR=0.954, 95% CI [0.918, 0.992]). Conclusions The factor influencing knowledge about the health notebook of children under five years of age were gestational age (p=0.017). The factors influencing the maintenance of the notebook were gestational age (p=0.011), number of births (p=0.048), and whether the notebook was read completely (p=0.008).

Background: According to the 2023 report on global water sector development, water consumption has increased by approximately 1% annually over the past 40 years and is expected to rise further due to population growth, socio-economic development, and changes in consumption patterns. Both low- and middle-income countries face risks related to water quality. In many developing nations in Asia and Africa, natural water sources are of poor quality and lack purification infrastructure, with limited research and data available—often restricted to monitoring reports and basic statistics. Although the United Nations' Sustainable Development Goals (SDG-2030), adopted at the 70th UN General Assembly, aim to ensure access to safe drinking water and sanitation for all, around 26% of the global population—approximately 2 billion people—still lack access to safely managed drinking water services. In line with this, Mongolia’s long-term development policy “Vision-2050” sets a target to ensure 90% of the population has access to safe drinking water by 2030 through comprehensive measures. The World Health Organization (WHO) identified ten key chemical contaminants posing significant public health concerns in 2020, including arsenic, along with air pollution, asbestos, benzene, cadmium, dioxins, excessive fluoride, lead, mercury, and hazardous pesticides. Over 140 million people in more than 70 countries are consuming arsenic-contaminated water, exceeding the WHO guideline of 10 μg/L. While Mongolia has conducted studies on arsenic contamination in drinking water in 2004, 2013, and between 2019–2022, there is still a scarcity of research assessing the potential health risks associated with such contamination. Aim: To assess the health risk of arsenic exposure through drinking water. Materials and Methods: Using a document-based research design, we obtained official permission from the Health Statistics, Information and Research Department (Letter No. 01/290) and collected arsenic testing data and well information from 29 internal research reports. A database was created, and secondary data analysis was conducted. Based on the U.S. Environmental Protection Agency (EPA) methodology, the following were calculated: average daily dose (ADD), lifetime average daily dose (LADD), cancer risk (CR), and hazard quotient (HQ) for arsenic exposure through drinking water. Official statistics from 2023 released by international and national organizations such as the UN, WHO, NSO, MCHD, and NCCD were used for risk calculations. Results: Out of 3,575 drinking water samples collected from 1,315 wells in 329 soums across 21 provinces and 2,260 samples from 9 districts of Ulaanbaatar, 61% met the MNS 0900:2018 national drinking water standard for safety and quality. However, in samples from Dornogovi, Dundgovi, Sukhbaatar, Umnugovi provinces and Nalaikh district, arsenic concentrations exceeded the national and WHO recommended limit (10 μg/L) by 1 to 6 times. Health risk assessment showed hazard quotient values ranging between 0.12 and 1.15. Conclusions Arsenic contamination in drinking water is locally prevalent in the Gobi and Eastern regions of Mongolia (Dundgovi, Sukhbaatar, Dornod, Umnugovi, Dornogovi). The hazard quotient for arsenic exposure via drinking water ranges from 0.12 to 1.15, with 8 provinces showing values above 0.3—indicating potential health risks.

Background: Headache disorders are most prevalent public-health problem. Worldwide, among the adults 46% suffer from primary headache, where the migraine presents 11% and tension type headache (TTH) presents 25%. Recently, one type of the primary headache, medication overuse headache tends to increase. Nowadays, there is no sufficient study about primary headache in Mongolia. So that, it is necessary to investigate prevalence, clinical type and risk factors of the primary headache. Purpose: To study prevalence and risk factors of primary headache in Mongolia. Materials and Methods: This cross-sectional study was carried out from June to November of 2017. Participants aged 18-65 years old were randomly selected from four provinces and three districts of Ulaanbaatar city. The diagnosis of headache was made using the International Classification of Headache Disorders-3 beta. Statistical analysis was performed on SPSS-23 program. Results: A total of 2043 participants (812 men and 1231 women) were reviewed. The participant’s average age was 38.6±13.4years. 1350 (66.1%) participants reported recurrent headache within the last 1 year. Of the total study population, the prevalence rate of primary headache was 1305 (63.9%). Number of people who suffered from migraine was 494 (24.2%), significantly greater in female than male participants (p=0.0001), with most frequent attacks at age 26-45 years. The risk of migraine associated with sex, education and family history (p=0.001). 592 (29.0%) of participants had TTH, mean age of them was 37.7±5.24, significant high rate in female than men, risk of TTH depends on education and job. The medication overuse headache was diagnosed at 116 (5.7%), 29.4% in men and 70.5% in women with average of 45.6±11.4 and 43±12.7 respectively. Among the participants 38.6% used medications, 28% people had one drug, 8.5% two drugs and 2% used three or more drugs. Use of non-steroid anti-inflammatory drugs (NSAID) made up major percent in headache patients. Increased frequency of medication and multidrug affected to medication overuse headache (p=0.008). Conclusion More than half of studied population had primary headache. Migraine was in 24.2%, TTH in 29.0% of people, and associated with sex, education and family history. Use of non-steroid anti-inflammatory drugs made up major percent in headache patients.

Abstract To study adverse drug reactions registered in 2010-2012 in Mongolia. This study has descriptive design. 280 yellow forms for recording adverse drug reaction, which were registered by the Drug assurance department of the Department of Health-Implementing Agency of the Government, were used. Yellow forms were from 2010- 2012. Statistical analysis was performed in SPSS 17.0. More than half of cases (51%) of drug adverse reaction were in people over 41 years old. Psychotropic medications and antibiotics were the most drugs with adverse reaction having 31.1% and 27.1% respectively. The common adverse reactions were dysfunctions of central nervous system (38.6%), skin rashes (22.5%), dysfunctions of digestive system (11.1%), allergic reactions (7.9%) and other symptoms (15.5%). In 4% of cases the symptoms were not described. Countries of production of medications causing drug reactions were Russia in 26.1%, China 13.2%, Моngolia 12.2%, India 11.4%, Indonesia 3.2% and other countries in 15.3%. In 18.6% the country was not recorded. In 18.9%, 16.4% and 9.6% of reactions were from tablets, intramuscular injections and drippings. The forms filled in by the patients in 31% did not have their names, and in 48% there were no records on reasons for taking medicines. Conclusion Psychotropic medications and antibiotics were the most drugs with adverse reaction. The common adverse reactions were dysfunctions of central nervous system, skin rashes and dysfunctions of digestive. Adverse drug reactions were identified insufficiently and forms for recording the adverse reactions were filled incompletely and incorrectly.

BACKGROUNDAir pollution issue has become the largest problem of Ulaanbaatar city in the last decade affecting health and wellbeing of its citizens. Air pollution levels are increasing considerably in winter as a result of coal burning by city dwellers living in ger areas. Our study purpose was to survey the impact of air pollution on infant health of Ulaanbaatar city in 2012.METHODSData of 7484 on births at Khan-Uul and Sukhbaatar districts residence mothers and infants of Ulaanbaatar city from 2012 and corresponding daily air pollution level data (CO, NO2, SO2 and PM10) from the Ulaanbaatar city air quality monitoring stations were used.RESULTSAir pollution levels in Ulaanbaatar city significantly affect birth outcomes. Exposure to high levels of СО2 of during the third trimester of pregnancy reduces newborn’s weight. Exposure to NO2 is not influencing to newborn’s weight. Mothers who lived in more polluted area during pregnancy period more likely had baby reduced weight in 44 grams.

Goal: The aim of the study was to identify economic burden from hypertention in Ulaanbaatar and develop some recommenadations. Material and Method: The top down approach was used to calculate direct costs of hypertension in five hospitals of the secondary and tertiary levels. To calculate cost of hypertension financial reports and cost centres data were used. A self-administered questionnaire was used to calculate indirect costs from the disease. Patients, admitted to six UB district and three tertiary level hospitals due to hypertension filled in the questionnaire. Data was analysed using SPSS 15 programme.Results: Some 114 patients were surveyed. The average cost of hypertension was 143914 ± 38189.5 (average bed days 8.7) and 264756 ± 40760.4¥ (average bed days 9.5) in the selected district and tertiary level hospitals respectively. The average cost for per out-patient visit was 4237 ± 2123.5¥ in the selected district hospitals and 3,162 ± 308.3¥ in the selected tertiary level hospitals. The indirect costs included transport cost to and from hospital, food, transport cost of relatives to visit them, cost of medications, and some other expenses related to their admission. Average indirect cost of an admission of patients with the hypertension was 253,395 and 212,717.44¥ in district and tertiary level hospitals respectively. Economic burden from temporary loss of working ablility due to hypertension was 177.1 millions tugrigs. National average wage was 300500¥ in 2009. Some 65.8% of respondents used antihypertension drugs at least once a day and average cost was 653.4¥ per patient per day. Annual and 10 years drug use estimates were 238491 and 2.3 million tugrigs per patient respectively (Inflation and price changes were not counted).Conclusion: Indirect and direct costs for admission were 1.1 billion (49.6%) and 939 million (42.5%) tugrigs respectively. Cost of hypertension in Ulaanbaatar was 2.2 billion tugrigs in 2009 and it is 1.1% of total health sector financing.