1.Effectiveness of School-Based Health Education Intervention
Munguntuul E ; Buyandelger B ; Khulan G ; Enkhjargal Ya ; Odonjil P ; Baigalmaa D ; Tuya S ; Ganchimeg T
Mongolian Journal of Health Sciences 2026;93(3):144-150
Background:
Respiratory and gastrointestinal infectious diseases are the leading causes of morbidity in children. Numerous international studies have demonstrated that handwashing with soap is one of the most effective and cost-efficient methods for preventing these diseases in children. A previous study conducted in Ulaanbaatar found that only 50.1% of general education school students practiced proper handwashing, which is considered insufficient even in areas with relatively adequate facilities. In Mongolia, 56.1% of the 865 schools lack handwashing facilities and soap, and 25% do not meet the WASH standards. Although knowledge about handwashing increased during the COVID-19 pandemic, sustained behavioral change remained limited, highlighting a gap between knowledge and practice and indicating the need for targeted educational interventions. Furthermore, there is limited research comparing the effectiveness of such interventions across different school environments and urban–rural settings, which provides the rationale for this study.
Aim:
To evaluate the effectiveness of a handwashing educational intervention among primary school students and determine differences in knowledge change across four schools in urban and rural areas.
Materials and Methods:
A quasi-experimental study design was used from December 2024 to June 2025. A total of 1,353 students from grades 3–5 in four general education schools (two in Ulaanbaatar and two in rural areas) were included in the study. Preand post-intervention handwashing knowledge scores were analyzed using paired t-tests and one-way ANOVA (α=0.05) with STATA 14.0. Ethical approval was obtained from the Ethics Committee of the Mongolian National University of Medical Sciences.
Result:
The mean handwashing knowledge score increased significantly from 9.68 (±2.64) before the intervention to 10.30 (±2.74) after the intervention, with a mean difference of +0.63 (p<0.001). The differences in improvement between schools were also statistically significant (ANOVA: F(3,1335)=5.90, p=0.0005). The highest improvement was observed in urban School A (+1.49), while the lowest was observed in School B (+0.16). Rural schools C and D showed moderate and relatively consistent improvements (+0.51 and +0.70, respectively).
Conclusion
School-based handwashing educational interventions effectively improve knowledge among primary school students. However, environmental factors, such as infrastructure and geographic location, significantly influence the effectiveness of the intervention. Therefore, educational interventions should be implemented alongside infrastructure improvements.
2.Assessment of health literacy levels among the adult population of Mongolia
Tuya S ; Oyungoo B ; Enkhjargal Ya
Mongolian Journal of Health Sciences 2026;95(5):109-115
Background:
Health literacy is a multidimensional concept encompassing the knowledge, attitudes, and skills required for individuals to obtain, understand, appraise, and apply health-related information. It is essential for accessing quality healthcare services and making informed health decisions in daily life.
Aim:
This study aimed to evaluate the level of health literacy among the adult population of Mongolia.
Materials and Methods:
A cross-sectional quantitative study was conducted involving 1,500 Mongolian adults. Data was collected using the Health Literacy Survey European Questionnaire (HLS-EU-Q47), which evaluates four core competencies: accessing, understanding, appraising, and applying health information. Responses were measured on a 4-point Likert scale ranging from 1 (very difficult) to 4 (very easy). Health literacy levels were categorized based on standardized scores: inadequate (0–25), limited (25–33), sufficient (33–42), and excellent (42–50).
Results:
The mean age of the participants was 34.79±15.04 years, with 42.1% being male and 57.9% female. Socioeconomic data showed that 52.1% were married, 37.7% were single, 43.2% had completed secondary education, and 40.5% held a university degree. Lifestyle assessments revealed that 16.4% were daily smokers, 7.0% consumed alcohol daily, and only 12.5% engaged in regular physical exercise. Regarding education, 50.7% of participants with higher education demonstrated “sufficient or excellent” health literacy, whereas only 27.1% of those with secondary education reached this level. The 18–30 age group exhibited the highest capacity to receive health information (44.0%), with a significant decline in health literacy levels observed as age increased (p=0.014).
Conclusion
Although the overall health literacy level among the adult population of Mongolia is generally sufficient, the capacity to access health information remains limited.
3.ЭКСГУМАЦИ ШИНЖИЛГЭЭГЭЭР ГЭМТЭЛ ИЛРҮҮЛЭХЭД ЛЕПЕНИЙ БУДГИЙН АРГЫГ ХЭРЭГЛЭХ НЬ
Ariunzul B ; Ganbold Ts ; Enkhjin B ; Tuya N
Innovation 2017;11(2):39-40
BACKGROUND. When the body of musty and changed, a long time in the water can be difficult to identify soft tissue injury. For detecting hemorrhage in changed tissues we are using the method named after German doctor G.Lepchne, born in 1887. The method, based on the peroxidase activity of hemoglobin pigment. It is recommended to stain frozen slices.Erythrocytes and hemoglobin are colored in a dark brown color. Reagent: 2 ml 0.6% benzidine solution, 0.5 perhydrol, 4.5 ml of 70% ethyl alcohol
Since 20148 we have been using the method in four cases. The result was useful for detecting injuries.
4.SURVEY FOR CUSTOMERS SATISFACTION OF THE HEALTH CARE ORGANIZATIONS IN 2016 OF DARKHAN-UUL PROVINCE
Oyun M ; Tuya B ; Uuganbayar G
Innovation 2017;11(4):32-36
BACKGROUND: Assessing the customer’s satisfaction of the health care services, professional organizations suggest the special methods to study what they want and don’t want and how much can pay for the service. For this purpose, we conducted the study to determine the satisfaction of the customers of Darkhan-Uul province health care organizations in 2016, according to the international experience.
The survey was conducted in the Darkhan-Uul province Health Department, in general hospitals, public and private medical institutions in 2015 and 2016 respectively.
On the basis of a unified methodology according to the order of the Ministry of Health No. 13 of 2014, the survey was conducted on the basis of a special questionnaire prepared in accordance with articles 22 and 23 of the Minister of Health No. 448.
The results of the consumer survey, customer satisfaction in Darhan-Uul province by 2016 were higher than in 2015, a good estimate of 1.4%, an average rating of 10.4% and below was a poor estimate of 11.8%. The survey shows the need to consider the issue of equality, which is a key issue in the field of human rights, the formulation of political environments and the regulation of their situation.
5.Cases of inherited disorders of amino acid metabolism in population at risk
Enkhjargal Ts ; Khishigbuyan D ; Gantuya P ; Sodnomtseren B ; Tuya E ; Dorjkhand B ; Оtgonzaya B ; Оtgonjargal S
Mongolian Medical Sciences 2016;178(4):3-6
Introduction:
Oligophrenia makes 7.3% of all mental disorders in our country. It is known that almost 4% of all diagnosed cases of oligophrenia developed as a result of an inherited disturbance of amino acid metabolism. In most countries, the frequencies of inherited diseases of amino acid metabolism in the population are determined, and preventive screening programs of newborns are implemented.
No study has been conducted so far into the issue of inherited diseases of amino acid metabolism
in the Mongolian population. The goal of our survey was to detect inherited disorders of amino acid
metabolism in the population at risk.
Materials and Methods:
The collection of samples and the laboratory analysis were carried out in the following two stages:
1. The screening analysis of 514 individuals diagnosed with mental retardation was performed by paper chromatography;
2. The positivecases detected by the screening were analyzed using high-performance liquid chromatography.
Results:
The screening testing detected twelve potential disturbances of amino acid metabolism. Out of the
twelve positive cases four individuals refused to participate in the confirmatory stage of the survey.
Among the remained eight individuals, cases of hypertyrosinemia, hypervalinemia, hyperglycinemia,
hyperlysinemia and pyridoxine-dependent epilepsy were detected.
Conclusions
1. The fact that cases of inherited disorders of amino acid metabolism were detected among mentally
retarded individuals show that the disorder is one of causes of oligophrenia.
2. A screening program of newborns should be implemented for early detection of inherited disorders
of amino acid metabolism.
3. A genetic counselling and testing centre could assist in reduction of number of individuals with
inherited disorders.
6.To screen for child emotional and behavioral problems in a community sample
Bayarmaa V ; Nasantsengel L ; Batzorig B ; Tuya N ; Chimedsuren O
Mongolian Medical Sciences 2016;175(1):54-57
BackgroundIn accordance with WHO investigation, most of the mental disorders onset in childhood and 20 percentof children (1 of fi ve) with mental and behavioral disorder currently. In 2005, by assessment of mentalhealth system in Mongolia (WHO-AIMS) it was concluded that special attention needs to be given todevelop professional competence and services in the area of child and adolescents mental health so itis a reason of the this study.AimTo early identify common emotional and behavioral problems among children and identify risk factorsfor itMethodsThe study was randomly selected 3500 child aged between from 4 to 17 years in 5 districts of Ulaanbaatarcity and 46 soums of 11 aimags of Mongolia.A main tool is Strengths and Diffi culties Questionnaire (SDQ) and included the 25-item child andparent versions were used to record each informant’s perception of four problem domains/subscales.SDQ was differently used child ages such as child aged 6-10 years used by parent version child agedbetween11-17 years used by both child and parent versions.ResultsOf 2920 child who participated in the study, 382 (13%) studied in kindergarten, 2423 (82.9%) school. Anaverage age of participants was 10.9±4.ConclusionThe abnormal emotional reaction was dominantly occurred in urban girls aged between from 6 to 10years and the abnormal behavioral reaction was dominantly occurred in urban boys aged between from6 to 15 years. The family relationship was a risk factor for developing emotional and behavioral problemsin child.
7.Water quality analysis of Kharaa and Orkhon river
Tuya E ; Nyamsuren L ; Khongorzul B ; Undarmaa P ; Amardulam N ; Khishigt J ; Burmaajav B ; Bolormaa I
Mongolian Medical Sciences 2015;171(1):25-29
INTRODUCTION:According to the report from 2010, Mongolian water consumption was 550 million cubic meter andapproximately 9.1% of the total Mongolian population obtain their water from inadequate hygiene waterresources - springs and rivers. Due to non-hygiene water usage has caused water-born communicableand non communicable diseases among the population. In the last years there has been issue of pollutionof one of the Mongolia’s more representative river Selenge and its following rivers -Kharaa, Orkhon andit is necessary to evaluate water pollution of these rivers.GOAL:To determine water chemical and biological pollution of Kharaa and Orkhon river and to evaluate waterqualityMaterials and MethodsWe collected water, sediments and macro invertebrates sample from three points of river -upstream,midstream, downstream and for Kharaa river the samples were collected from Tunkhel, Mandal andBayangol soum, fo Orkhon river the sequence was Orkhontuul, Orkhon, Khushaat soum. Samples werecollected June, August, October of 2011, 2013.In water sample, we determined physic-chemical 15 parameters including temperature, pH, total dissolvedsolids, conductivity, smell, color, hardness, sulfate, chloride, nitrate, nitrite, ammonia, dissolved oxygen,biological oxygen demand and mercury using their standard methods. Macro invertebrate samples werecollected to evaluate water quality and we determined mercury in sediments and macroinvertebratesamples to evaluate mercury contamination.RESULT:Physic-chemical results of the water showed that water of Kharaa, Orkhon rivers were classified lowmineralized, soft water and nutrient pollution indicators for ‘slightly polluted’category. For dissolved andbiochemical oxygen, they were belong to the category of ‘pure water’.There were no correlation between 2012 and 2013 results and mercury in water, sediments and macroinvertebrates were qualified standard value.CONCLUSION:According to research results water quality of Kharaa, Orkhon river was good and have less pollution andit is possible to use in household consumption after proper cleaning and disinfection.
8.Some results of the study on morbidity of gastrointestinal infectious diseases among population of soums in Selenge River Basin
Nyamsuren L ; Oyun-Erdene O ; Tuya E ; Dorjkhand B ; Erdenechimeg E ; Burmaajav B ; Bolormaa I
Mongolian Medical Sciences 2015;171(1):30-35
INTRODUCTION:Waterborne diseases, especially diarrhea, related to water quality and safety, personal sanitation and hygienehave been still reported very high in developing countries. Globally, there are an estimated 1.4 million casesof hepatitis A every year. The hepatitis A virus is transmitted through ingestion of contaminated food and wateror through direct contact with an infectious person. Hepatitis A is associated with a lack of safe water and poorsanitation [2].Dysentery is bloody diarrhea, i.e. any diarrheal episode in which the loose or watery stools contain visiblered blood. Dysentery is most often caused byShigella species (bacillary dysentery) or Entamoeba histolytica(amoebic dysentery) [3].Kharaa and Orkhon River are tributaries of the Selenge River-basin, in which many mining and other industries,agriculture, and residential areas reside. It has become a one pollutant factor for water of the Kharaa andOrkhon rivers. As a result, water of the Tuul, Kharaa and Orkhon River was reported to be highly contaminated(Mongolian Human Development Report 2010: Water and Development report) [4].GOAL:The aim of the research was to study incidence of gastrointestinal infectious diseases among population ofsoums are located in Selenge River Basin.MATERIALS AND METHODS:Data on health statistics 2009-2013 years of gastrointestinal infectious diseases, including dysentery, diarrhea,hepatitis A virus and others, were collected and analyzed.RESULTS:Incidence of dysentery was registered highly among people who live in Mandal soums in 2009-2013 years. Butincidence of dysentery (per 10 000 population 2.82) among population ofMandal soum lower than the Selengeprovince and National average. Incidence of hepatitis A virus was registered highly among people who livein Orkhon (74.46), Orkhontuul (48.86) soums and it was greater than 1.3-2 times than the Selenge provinceaverage. Incidence of diarrhea was registered highly among people who live in Khushaat soum and it wasgreater than 2.18-3.8 times the than Selenge province averageCONCLUSION:Incidences of diarrhea and hepatitis A virus were registered highly in Orkhon, Orkhotuul and Khushaat soumscompared to other target soums and it was greater than 1.3-3.8 times than the Selenge province average.Especially, these diseases were registered highly among 0-16 aged children.
9. USING THE STRENGTHS AND DIFFICULTIES QUESTIONNAIRE (SDQ) TO SCREEN FOR CHILDREN BETWEEN 11-17 YEARS OLD IN A COMMUNITY SAMPLE
Bayarmaa V ; Nasantsengel L ; Batzorig B ; Chimedsuren O ; Tuya N
Innovation 2015;9(1):34-36
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
10. STUDY ON PARAMETERS OF PERSONALITY CHANGES OF CHILDREN WHO LINE IN RESIDENTIAL SERVICES
Nyamtsetseg J ; Gantsetseg T ; Tuya B ; Enkhtaivan B ; Uyanga G ; Tsogzolmaa D
Innovation 2015;9(1):46-49
In pathopsychology, one branch of mental analysis, recently we are using qualitative analyzing methods for mental phenomena. But improvement of professional methods of study, generalization of the new computer based technology, children’s psychology assessment and many other problems are becoming an urgent issue in this field.Our study involved 45 children from orphanage and the High School Personality Questionnaire (HSPQ) computer based questionnaire is used to measure the personality characteristics of orphan children. Spielberg-Hanin test is used to reveal anxiety. Study is analyzed by SPSS program.In total, 45 children (age from 9 to 18), 22 boys and 23 girls participated in our survey. 8.9% of them measured as a high intelligence, 91.1% measured as a lower and an average intelligence. Interestingly, 60% of children were good at controlling their emotions and behavior. Thus 55.6%had symptoms of flexible mind, imagining and probability of affect illness. Having more stress is due to introverted preference and self-blaming, also a feeling of self-blaming is due to not being bold. 51.1% of them assessed that they have dependent, emulative personality and submissive behavior which was very considerably. The anxiety of condition was high in 34.1% of children andlow in 12.2% of them, thus anxiety of individual was high in 36.6% and low in 7.3% of children. Therefore, it’s essential to help orphan children and consider reducing anxiety and improving their self-independence.
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