Background: According to the WHO, WB estimation, there are over 1 billion people living with some form of disability in the world.² Out of which, 284 million people have vision impairment, 360 million people have hearing and speech impairment, ten percent of them living in developing countries.³ According to the National Statistical Office’s 2018 data there are 105,730 people with disabilities in the country which is 3.2% of the total population.⁴ In Mongolia, 28% of the disabled population in the working age are employed while 43% of the population aged 6-18 are illiterate. People with vision, hearing and intellectual disabilities have the same right to access health, education, employment, social welfare and protection services as others, but due to the lack of access to facilities and public transport, they cannot fully access social services. Also, the legal framework that provides equal opportunities for social contacts is not enough. There is virtually no comprehensive study on access of social service and environmental accessibility for the disabled people in the country. Therefore, there is a need to study in detail of social services and environmental accessibility of the people with visual and hearing impairment and adapt their demands into policy and develop policy recommendations and to further improve legal regulations. Purpose: Main objective of the study is to assess social service delivery and environmental accessability of the people with visual and hearing impairment Methods: The direct-observation, household based survey and document review, methods have been used for this study. Direct observation method has been applied for 100 public constructions. Total of 100 disabled people, out of 50 people with visual impairment and 50 people with hearing impairment has been covered for the public transportation accessibility assessment questionnaire survey. Information and communication accessibility studies carried out among 100 organizational websites and 31 broadcasting internet television including Univision and Sky media.
Household survey covered 148 people with visual and hearing impairments to assess social service accessibility. Results: The public construction’s environmental accessibility for the people with vision impairment was assessed at 48.8 percent: 36.8% for the people with poor vision impairment and very bad for blind people at only 16.5%. The public transportation accessibility assessed as not accessible (3.43 odds) for people with vision impairment and as moderate accepable for blind people (2.87 odds). Information and communication accessibility through website assessed at 25% for people with vision impairment which shows not sufficiently accessible for blind people (32%). Total accessibility of information regarding to the organizational website assessed at 34.8% which shows moderately accessible. Services of the Univision, Sky media internet TV (IPTV) wasn’t accessible for people with vision impairment. Regarding to the people with hearing impairment, public construction environmental accessibility assessed at 31.7%, 48.5% for people with moderate hearing impairment which is average accessibility and 21% people with severe hearing problem. The public transport accessibility assessed in high discrepancy (3.51 odds ratio) which means there is an in-sufficient access. Information and communication accessibility for people with hearing impairment assessed at 5% which shows very bad accessibility.
Health service coverage is 64% for the people with vision impairment while 36% for the people of hearing impairment. Education service coverage for vision impairment people is 36% and 18% to people with hearing impairment. Regarding to the accessibility to social service, the coverage is 33% for people with vision impairment and 31% for the people with hearing impairment. Employment rate among people with vision disability resulted in 19% and 24 % for the people with hearing imapirment. Conclusion The public constructions accessibility for people with vision and hearing impairment (37.7%), public transport accessibility (2.90 odds ratio), information accessibility (34.8%) assessed at “moderately accessible”. Assessment result of below 50% considered as “insufficient” for education service -27%, employment service-21.5%, social welfare services -32%. There is a need for special laws and regulations concerning to social services and environment accessibility.

BACKGROUND: Children’s development and childhood disability are a public health issues to their consequences on quality of life and productivity not only for affected children but also for families and populations as a whole. WHO and the World Bank estimate that more than a billion people live with some form of disability, which equates to approximately 15% of the world’s population (1). Citing the Global Burden of Disease study of 2004, the World Report further estimates that amongst those aged 0-14 years, roughly 5.1% of all children (93 million) live with a ‘moderate or severe’ disability and 0.7%, or 13 million children, live with severe difficulties. Many children younger than 5 years in developing countries are exposed to multiple risks, including poverty, malnutrition, poor health, and other risks, which are affect their cognitive, motor, and social emotional development. There are few research result and national statistics on the childhood disabilities of under 5 years children in Mongolia. OBJECTIVES:The objective of the screening was to determine the rate of disabilities in children aged 9 months to 5 years in Ulaanbaatar. MATERIALS AND METHODS: Population based cross-sectional study design used childhood disabilities screening among under 5 years children in Ulaanbaatar. TQ-(ten questions) screening method used to determine childhood disabilities. The structured interview checklist (TQ) and a guide to collect background and risk factors information were administered in a face-to-face interview of the child’s caregivers. The screening covered 8838 children from 6 districts, Ulaanbaatar. RESULTS: The study covered totally 8838 children (50.4 %) were male and 193 (48.4 %) were female. Over 81 % of the persons responding to the questions were mothers of the children, 10 % fathers. 9 % were the child’s relative and child’s sibling. Based on the ‘ten questions’ screen, 1960 out of 8838 children were positive (disabled). CONCLUSIONS: The positive rate of disabilities by TQ was a higher. At the post verification stage there is need to estimate sensitivity, specificity and negative predictive value of TQ. The second step of evaluation among positive cases should take diagnosis by comprehensive evaluation and clinical assessment.

To evaluate the efficacy and safety of bevacizumab monotherapy or combined with laser versus laser monotherapy in Mongolian patients with visual impairment due to diabetic macular edema.Prospective, randomized, single-center, a 12 month, laser-controlled, clinical trial. Participants: One hundred twelve eligible patients, aged ≥18 years, with type 1 or 2 diabetes mellitus and best corrected visual acuity (BCVA) in the study eye of 35 to 69 Early Treatment Diabetic Retinopathy Study (ETDRS)letters at 4 m (Snellen equivalent: ≥6/60 or ≤6/12), with visual impairment due to center-involved diabetic macular edema (DME). Methods: Patients were randomized into three treatment groups:(I) intravitreal bevacizumab monotherapy (n=42), (II) intravitreal bevacizumab combined with laser (n=35), (III) laser monotherapy (n=35). Bevacizumab injections were given for 3 initial monthly doses and then pro re nata (PRN) thereafter based on BCVA stability and DME progression. The primary efficacy endpoints were the mean change in BCVA and central retinal subfield thickness (CRST) from baseline to month 12.Bevacizumab monotherapy or combined with laser were superior to laser monotherapy in improving mean change in BCVA letter score from baseline to month 12 (+8.3 and +11.3 vs +1.1 letters; both p<0.0001). There were significant difference detected between the bevacizumab and bevacizumab combined with laser treatment groups (p=0.004). At month 12, greater proportion of patients gained ≥10 and ≥15 letters and with BCVA letter score >73 (Snellen equivalent: >6/12) with bevacizumab monotherapy (23.8% and 7.1% and 4.8%, respectively) and bevacizumab + laser (57.1% and 28.6% and 14.3%, respectively) versus laser monotherapy. The mean central retinal subfield thickness was significantly reduced from baseline to month 12 with bevacizumab (−124.4 μm) and bevacizumab + laser (−129.0 μm) versus laser (−62.0 μm; both p<0.0001). Conjunctival hemorrhage was the most common ocular events. No endophthalmitis cases occurred.Bevacizumab monotherapy or combined with laser showed superior BCVA improvements over macular laser treatment alone in Mongolian patients with visual impairment due to diabetic macular edema.

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.

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

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.

BACKGROUND: Worldwide, the number of people killed in road traffic accidents (RTA) each year is estimated at over 1.2 million, while the number f injuries reaches as high as 50 million. In Mongolia, the number of road accidents, crimes and road safety violations is on the increase, and it is forecasted that this trend will continue in the future The third leading cause of mortality in Mongolia is injury, and more injuries are caused by traffic accidents (18.9%) than any other cause. According to the National Statistics reports, health and demographic studies, it can be seen that there are a high number of road traffic accidents and injury cases in Mongolia.OBJECTIVE: The main objective was to identify the risk factors of road traffic injuries and deathsMETHOD: Primary data on Road Traffic Accidents (RTAs) of the Road Traffic Police was used. 4000 investigation forms were randomly selected and analyzed. Within the research objectives, necessary descriptive and analytical statistics were calculated and the results were illustrated by tables and charts.RESULT: The rate of road traffic accidents is high in urban areas from January till May while it is high in rural areas from February till October. The rate of road crashes caused by alcohol is significantly different in rural and urban areas (36% in rural and 16% in urban). The statistically significant risk factors for Road Traffic Injuries (RTIs) were the fault of pedestrians, drunk driving, failure to stop the vehicles, turning maneuver, inadequate estimation of the distance between cars and collation of lane and for Road Traffic Deaths (RTDs) the alcohol consumption, speeding, vehicle defects, driver’s negligence, cross the intersection, turning maneuver, failure to keep distance, fault of pedestrians and transportation people or goods.CONCLUSION: To decrease the risk factors of injuries and deaths of RTAs, specific actions are required to enhance the road traffic safety control and patrolling during certain months, weeks, days and times when accidents mostly happen in urban and rural areas.

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.

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.