5TH ASIAN AND PACIFIC
POPULATION CONFERENCE
11-17 December 2002,
United Nations Conference Centre,
BANGKOK
COUNTRY REPORT
MONGOLIA
2002
CONTENTS
Introduction
3
Executive summary
4-7
Section 1. Overview of the population and development situation and prospects, with
special attention to poverty
8-11
Section 2. Fertility levels and trends, and their implications for reproductive health,
including family planning programmes
11-12
Section 3. Mortality and morbidity trends and poverty
12-14
Section 4. Migration, urbanization and poverty
14-16
Section 5. Population ageing
17-19
Section 6. Reproductive health
19-21
Section 7. Adolescent reproductive health
21-22
Section 8. Demographic, economic and social impact of HIV/AIDS
22-23
Section 9. Gender equality and development
23-27
Section 10. Behavioural change communication and advocacy and information and
communications technology as tools for population and development and poverty
reduction
27-31
Section 11. Data, research and training
31-33
Section 12. Partnerships and resources
33-35
Appendix 1.
36
Appendix 2.
37-38
References.
39
2
Introduction
This report describes the primary population and poverty issues and priorities affecting
Mongolia today. It is important to acknowledge at the outset that the dramatic changes in
both population and poverty are set within the context of a rapidly changing country
persevering to transform itself into a modern market oriented economy. The early 1990’s
were marked by great economic and social challenges with which the Mongolian
Government has been compelled to deal. Without argument, the previous decade has
been a great challenge to all Mongolian people. The issues of population and poverty
arguably deserve to rival economic growth at the top of political concerns. In any case,
both are integral elements of all national policies and provide the foundation of
sustainable long-term human development. Establishing a balance between the pursuit of
economic interests and the distribution of the benefits of that enterprise will play a central
role in Mongolia’s social and economic development in the course of the next decade.
Since the early 1990’s the structure and location of the national population and the
incidence of poverty amongst the population in Mongolia has altered considerably.
Population and poverty change has been closely allied to the painful process of transition
to a market oriented economy. During this period the Government has had to address
major macro-economic upheavals. However, it has succeeded in providing a new
constitution, a new framework of legislation and has nurtured the foundations for a new
democratic society. It has liberalized foreign investment and international exchange, restructured financial and public administration and embarked on a systematic programme
of privatization. But despite limited public resources, it is recognized that more will need
to be done in the future to develop the infrastructure of social support to the population to
alleviate Mongolia’s significantly increasing burden of poverty.
3
Executive Summary
Population development and poverty are set in the wake of the immediate economic and
political transition of the country. The generally prevailing economic conditions, as can
be witnessed above, are among the principal drivers of quality of life and social cohesion,
provided that, in the long-run, sufficient benefits reach a sufficient portion of the
population. The virtual collapse and re-structuring of the former centralized and planned
economy (See table 1), and its incremental transformation into a market-oriented
economy is bound to apply irregular pressures on the population that in turn produce
excesses in the levels of poverty. Now that the widespread level of poverty has been
acknowledged, its scale and dept will require a significant and sustained effort over many
years for the burden of its presence to be relieved. Government and its partners, both
international and national, and from all sectors, are beginning to respond.
The following points below, set out as directed in the pre-conference guidance note,
attempt to capture and summarize the main population and poverty issues in Mongolia:
1. Overview of population development situation with special attention to
poverty. Income inequality has been widening alarmingly. In excess of 35% of
the entire population was below the poverty line with 1 in 5 Mongolians now
classified as ‘extremely poor’1. Indicators of poverty reflected in the human
development index, which were previously quite modest, have deteriorated over
the past decade. For example the primary school enrolment rate has fallen (from
100% in 1990 to its lowest ebb of 80.5% in 1993, recovering to 95.6 in 1997).
School drop out rates relate a more powerful image (See section 9 below). Health
indicators have deteriorated (see below) and average income per capita has
plummeted (See table 1). Nearly 20 percent of the workforce was unemployed2 in
the year 2000.
2. Fertility levels and trends, and their implications for reproductive health.
Fertility has decreased sharply over the last decade. The key determinant being
the economic hardship faced by Mongolian families. Annual population growth
reduced from 2.5 percent to 1.4 percent between 1990 and 20003. Total fertility
rate of 4.5 in 1990 more than halved to 2.2 in 20014.
3. Mortality and morbidity trends and poverty. Mortality rates have decreased
over the period. The crude death rate fell from 8.1 in 1991 to 5.99 in 2000. Infant
mortality remains relatively high at 31.2 per 1000 live births in 2000 with
pneumonia and diarrhea being the leading causes of deaths among infants 5. Life
1
Living Standard Measurement Survey (LMIS) conducted in 1998
Population and housing census of 2000
3 Population and housing census of 2000
4 Mongolian statistical yearbook of 2001
5 Health sector of Mongolia –80 years-2002
2
4
expectancy remained stable, increasing from 63.3 as of 1985 to 65.1 as of 2000 1.
Maternal mortality rates are also high at 1.6 per 1000 live births2.
4. Migration, Urbanization and Poverty. Over the last 10 years Mongolia has
experienced rapid urbanization, which has intensified over recent years. Ruralurban migration has been spurred by a succession of harsh winters (dzud) that has
devastated livelihoods (especially of herders) in rural areas. More generally,
economic and social forces have operated in concert to bring rural populations to
urban centers in search of better opportunities, access to markets, higher living
standards, improved job prospects and higher quality public services. Integration
is however difficult. Government policy states that migrants must register at their
destination, however the cost of doing so is excessive to many. This effectively
prohibits migrants from legitimate employment, access to education and health
services. The unplanned nature of urban settlement also places a service
obligation on local authorities that they are unable to meet, which further
concentrates and entrenches poverty within many of the ‘Ger’ districts that have
built up over recent years around the urban centers, in particular around the
capital Ulaanbataar. A regional development strategy that aims to stem the tide of
internal migration from rural to urban areas has been established. It is founded on
job creation and public service improvement in the rural areas. Government is
also reviewing the impact of its policy on urban registration.
5. Population Ageing. Older people suffer principally through lack income and
inadequate health services. Pensions and subsidies for older people, which are
their main source of income, are insufficient to meet even the essential needs of
food and housing. Lacks of permanent income prevent unemployed people from
being covered by health insurance and from receiving the medical assistance. By
2025 the population aged 60 and over will grow by 50 percent (See table 2).
47.2% of total mortality occurred among elderly and leading causes of deaths of
elderly over 55 years old include diseases of the circulatory system 47,1% and
neoplasms 28,5%3.
6. Reproductive Health. Over the period, the advent of effective family planning
programmes has provided parents with greater control and choice over the timing
of their children. Nearly 97 percent of all women have knowledge about family
planning and 60 percent of married women are using at least one modern method
of contraceptive4.
7. Adolescent Reproductive Health. Lack of knowledge and information among
adolescents remains a serious concern as the number of STI cases have increased
sharply during the period, for example around 50% of the population infected
1
Educational sector official data of 2002
Health sector of Mongolia-80 years
3 Survey on living standard of elderly 2001
4 Abortions and unwanted pregnancies in Mongolia-2000
2
5
with STI’s are below 25 years of age1. A dynamic and multi-faceted programme
aimed at raising awareness and changing behaviors has been launched by the
Government and the UNFPA. It targets young people in particular.
8. Demographic, economic and social impact of HIV/AIDS. Whilst the number
of official HIV/AIDS cases remains low, risk of the pandemic spreading across
Mongolia is high, demonstrated by the high prevalence of STI’s and by the high
incidence in bordering territories China and Russia. Government has recently
submitted a revised comprehensive strategy to Global Fund to fend off the threat
of HIV/AIDS in Mongolia.
9. Gender. The Constitution provides equal rights for both women and men.
However, there are large gaps in education and employment. The gap in
education reveals that women are far higher achievers in education. For instance,
65.8% of total graduates of higher and vocational training institutes are female2.
In fact, of greater concern is the high percentage of drop-outs at secondary
education level among boys. By 2000, 1 in 3 boys aged 15 were not attending
school compared to 1 in 5 girls3. A higher percentage of female unemployment
has led to the feminization of poverty. For an illustration, in 1990 unemployment
rate for women was 3.2% compared to 2.9% for men and reached its highest in
1994: 9.9% and 8.0% for men and women respectively4. The percentage of poor
female-headed households is 15% higher than poor male-headed households5.
Finally, only 9.2% of Parliament Members are women6.
10. Behavioral
change
communication,
advocacy,
information
and
communications technology as tools for population and development and
poverty reduction. During the period, the RH IEC succeeded in rising the
population’s general awareness on Reproductive Health issues, raising
understanding and support from the Government on RH issues and in establishing
a network of institution and agencies working with RH IEC.
Numbers of government and non-government organizations are operating with
RH IEC component and they are committed to improve the IEC process, to
produce a variety of high quality, effective IEC materials. A network of
institutions working with RH IEC was established according to the IEC
Subcommittee recommendations in 1999, the IEC Core Group (IEC CG).
11. Data, research and training. There is only one national institution conducting
comprehensive, systematic and incisive demographic research. Its capacity is
gradually developing, however it’s distribution and dissemination of research
1
Official data from the Ministry of Health of 1998
Mongolian statistical yearbook of 2001
3 Population and housing census of 2000
4 Human development report of 2000
5 Living Standard Measurement Survey (LMIS) conducted in 1998
6 Mongolian statistical yearbook of 2001
2
6
outputs remains limited. With UNFPA assistance the quality of research
methodologies in population, gender and development areas has been improving,
for example, data from the 2000 Population and Housing census provided fuel for
policy analysis, monitoring, and evaluation. More recently, population and
development planning processes have also become the subject of a programme to
ensure that human development issues are more fully integrated into the policy
formulation and implementation cycle.
12. Partnerships and resources. From 1990 to 2001 donors invested 2.4 billion
USD into development in Mongolia. To guarantee effective implementation of
poverty relief and population development programmes, the Government is
promoting greater cooperation and collaboration with other government
institutions, international development agencies and donors, national and
international NGOs, private enterprise, academies and individuals. There is still a
need for further increased co-ordination and the acceleration and more careful
targeting of anti-poverty strategies, policies and initiatives among all partners.
Government is best placed to continue its leadership to ensure the effective
focusing and systematic evaluation of all poverty alleviation efforts.
7
Section 1. Overview of the population and development situation and prospects,
with special attention to poverty
Since the early 1990s Mongolia has embarked on a programme of major political,
economical and social restructuring. The process of reform has aimed to create the right
environment conditions for the operation of a free market economy based on the
principles that ensure democracy, human rights and sustainable human development. In
the early stage of these reforms, economic and social conditions deteriorated dramatically
and living conditions worsened. Widescale population poverty and unemployment have
emerged to a greater extent than existed under the previous system and to a scale that
could not possibly have been imagined. For example, GDP per capita decreased by
nearly 25% percent in the period 1990-1994 in total and by 1999 35% of the population
was described as ‘poor’1 and 1 in 5 of the population was classified as ‘extremely poor’2.
Unemployment reached its highest level in 2000 at almost 20%.
After the virtual economic collapse (1990-1994), gradual progress has been achieved in
economic and social sector. As economic growth stabilized (See picture 1) government
was able to dedicate greater priority to social sector issues, particularly relating to
restructuring the education and health sectors and to providing an improved safety net for
the most vulnerable groups in the population. To ensure these actions many legal acts,
including Law on Social Insurance, Law on Social Welfare, Employment Promotion Law
and etc. and national programmes, such as National Programme on Reproductive Health,
National Programme to Promote Technical Education and Professional Training,
National Programme for Advancement of Women and National Programme on Youtj and
etc. have been developed and approved. However, in terms of resources, the Government
budget expenditure for education system has decreased from 10.7% of GDP to 5.5% of
GDP between 1991 and 1998, while that for health services has decreased from 5.8% to
3.3%3. The State population policy was also adopted in 1996 considering the main
principles reflected in the Programme of Action of the International Conference on
Population and Development that was held in Cairo in 1994. Main objective of this
policy is to provide sustainable population growth and enable a favorable social and
economical environment for human development in all areas. With the update and
approval of main legal acts to enhance human development and to create conditions for
social protection and services, totally new system of social welfare and protection has
been introduced. However continued effort is required to ensure the implementation of
these legal acts and the general workability of the system.
Public investment from the state budget in education and health sector increased from
19.9% to 24.0% in the period 1996-2000. Efforts to ensure comprehensive coverage of
health insurance were made, and by 2001 over 87% of the population were participating
in the health insurance scheme.
1’poor’
persons are those who live under minimum living standard line, identified by Government
resolution
2 ‘extreme poor’ persons are those whose income is less than 40 % of the minimum living standard line
3 Mongolian human development report of 2000
8
Towards the end of the 1990’s human development indicators (which had collapsed in
the early stage of the reforms) began to recover, surpassing their pre-restructuring levels.
For example, increases were achieved in average income per capita, the literacy rate and
in reduced levels of infant mortality (see appendix 2: implementation of the goals in
ICPD and ICPD+5).
Annual population growth has sharply decreased during the course of the reforms, from
2.4% in 1990 to 1.4% in 20001. This downward trend had already begun pre-1990’s,
however it dipped more significantly as the economic difficulties directly impacted on
families. Fertility decline is greater in urban areas. In this same period the percentage of
population aged 0-4 decreased by 25% percent and the share of this age group of the total
population fell from 15.9% in 1989 to 10.4% by 2000. With these changes in age
structure, the dependency ratio has fallen from 90% to 70% in the last ten years, which
resulted in an increased supply of labour relative to per- and post labour population. The
rapid increase in the population of labour age significantly reduces the population
dependency ratio, however, it has done so at a time when unemployment is at its highest
and the economy has lacked the capacity to absorb the increases in the labour force.
Unemployment is the main catalyst for poverty. The drive for a market-oriented
economy has shrunk the overall size of the employed population. The main sectors of the
economy are agriculture and industry. The share of workforce in agriculture has
increased from 33.0% to 48.5% during 1998 and 1998, while that in industry has declined
from 16.8% to 11.9%2. The fewness of employment opportunities in both urban and rural
areas, coupled with the impact of natural disasters on herds in rural areas are the main
contributors to general poverty.
One of the most telling features of the past 10 years has been the widening of income
inequality, such that over a third of all Mongolians now live below the poverty line and 1
in 5 are classified as ‘extremely poor’. Nearly 60% of the ‘poor’ were urban dwellers.
The dept of poverty in Mongolian society has also increased, and this is most evident in
capital city, Ulaanbataar. Most at risk of poverty are single parent headed households
with 4 or more children, households with less than 100 head of livestock, the
unemployed, the disabled, the elderly and uneducated. Below a certain level of income,
the poorest segment of the population (generally the bottom 20%) find they cannot access
primary health and basic education services, even though these are a ‘free’ for all, due to
the cost of providing school uniforms, transport for children to reach schools and
hospitals, especially, people who living in isolated areas.
A longer term problem being stored up is reflected in the enrolment ratios in basic
education and vocational training, which have begun to fall. Of particular concern is the
reduction in the number of boys completing their education or enrolling in higher
education from rural areas. The drop-out rate is less than 3% of all school aged children,
and 3.7% in rural areas compare to 1.4% in urban areas3. The primary reason for drop1
Population and housing census of 2000
Mongolian human development report of 2000
3 Education sector statistics of 2000-2001 academic year
2
9
out is due to poor living conditions. Whilst in the rural areas, drop out is explained in
terms an increase in herding activity, the figures are considerably higher in urban areas.
In summary, the quality of education needs improvement, especially in rural areas. This
includes both the deterioration of the learning environment as well as poor teaching
methods. The Government has recognized the weaknesses in the educational system and
has begun implementing the national program on the development of non-formal
education.
Migration is one of the most important and pressing population issues of the past 10 years
in Mongolia, and a cause for considerable concern. Whilst migration has undoubtedly
contributed to both urban and rural poverty, nevertheless, Micro study on internatl
migration, conducted in 2000 among migrants show that in general they still regard their
relocation to have heralded greater opportunities and benefits than had they remained in
their former location. Migration has been stimulated by a persuasive mix of factors that
essentially leaves migrants up-rooting in flight from rural hardship and poverty, in search
of a better quality of life, access to markets, job opportunities, and to better education,
social and public services. Migrants, once they attain their final destination, are required
to register in order to legitimately access the job market and public services such as
health, education and social support services. Many migrants remain unregistered, since
the fee is prohibitively high for many. As a result, this segment of the Mongolian
population are effectively denied access to their basic rights – to obtain legitimate work,
education system, social support and health services. The policy serves to compound
poverty and is generating an urban underclass.
Gender is also an important issue for the population, both in terms of contributing to
development and in turn benefiting from it. Women tend to have less job security than
male workers and less access to information and credit as entrepreneurs. Middle age
gender disparities are also a problem, particularly in terms of employment for women
over 40, especially in rural areas. Although there is relative equality among boys and
girls in primary and secondary school more girls have enrolled to higher schools.
Women’s participation in decision-making and representation higher levels of
bureaucracy within Government is very low. Regardless of a household’s location,
female-headed households are more affected by poverty. In order to improve the political
and economic status of women and to raise their social status and participation in the
development of the country the Government has launched the “national program of
Action for the Advancement of Women” based on the resolutions of Fourth World
Conference on Women.
Limits to Government spending have also made it difficult for the health sector. In an
attempt to develop a self-financing health sector, a nationwide health insurance scheme
has been established. In principal it allows access to health services for all. However,
lack of income prevents the access of poor people to appropriate health services, as they
are unable to afford health insurance premiums.
Despite gradually improving economic conditions poverty has remained on the increase.
The Government of Mongolia has recognized the necessity of ensuring that poor people
10
benefit more equitably from economic growth. The Poverty Reduction Strategy Interim
Paper is based on the approach of ensuring sustainable human livelihood through private
sector driven economic growth. The priorities of this policy are given to strengthening of
macro economic development, promoting national industries and exports, strengthening
bank and financial institutions, prioritizing rural development, increasing availability and
accessibility to basic social services and employment promotion. The policy also makes
provision for strengthening herders to undertake improved grassland and livestock
management and income earning activities. This policy is intended to play an important
role in reducing poverty as well as ensuring sustainable human development.
Section 2. Fertility levels and trends, and their implications for reproductive health
including family planning
Between 1990 and 2000 Mongolia’s population increased at a rate of 1.4%. This reflects
longer-term trends, for example, fertility levels, which have been decreasing since the
late 1970’s. Whilst, the total fertility rate was 6.7 in 1979, it reduced to 4.6 in 1989, to
2.8 in 1995 and then to 2.2 in 2001. Even since 1996, with the easing of the intense
economic difficulties, the fertility rate has continued to decline steadily. Fertility levels
do however differ by geographical area – the figure is 1.5 in the capital city and 3.7 in
areas of the west region.
The main reason for the sharp decline of fertility were the severe economic difficulties as
the country faced up to the transition period. Families increasingly exercised greater
caution and discretion over the decision to have, and timing of, children. Increased
availability of the family planning services has also helped inform these decisions. Other
key demographic and socio economic factors effecting fertility decline are the increased
age of marriage and relatively high education level of women. Relatively high levels of
women’s education appear to delay marriage and influence fertility. Female literacy rate
is relatively high in Mongolia, and it increased from 94.9 % (among women aged 15
years and above) to 97.5 % over the inter-censal period, 1989-2000.
Marital status is an influencing factor for the decline in fertility. The age at marriage for
both sexes has increased by about two and a half years (between 1989-2000). There has
been an increase in the percentage of the single population, rising from 25.3 in 1989 to 33
percent in 20001. Divorced males were also more likely to remarry than divorced
females.
Knowledge of contraceptive techniques is almost universal and the contraceptive
prevalence rate for modern methods is 33 percent. Whilst a range of family planning
methods are available, and used throughout the country, abortion rates remain high.
Therefore there is a need to improve family planning services, including the logistical
management and supply of contraceptives, counseling for use of contraception and for
the prevention of abortion.
1
Population and housing census of 2000
11
Abortion is directly affecting a decline in fertility. After legalization of abortion in 1989,
abortions reached a peak in 1992 of 442 abortions per 1000 live births. Since then the
abortion rate has been gradually declining. Official statistics on abortion do not paint the
full picture since they do not include abortions performed in private clinics. Nearly
20percent of women have had an unwanted pregnancy1. Of all women who had an
unwanted pregnancy, 64% stopped the pregnancy by abortion. Most of abortions are
performed by the professionals, but there are still a significant number performed outside
of the health system, which result in complications. Educated, younger aged, employed,
urban women tend to opt for an abortion. On the contrary, poorer women, women living
in remote areas and economically inactive women are less able to afford, or have more
limited access to abortion services if they have unwanted pregnancies. Finally, the
abortion rate is twice as high among non-poor females compared to poor families2.
Fertility is also a function of the income security of the family. Very poor families tend
to have more children (4.3) than non-poor families (3.7)3. In fact, it is claimed that poor
women are often attracted to the short-term benefits in cash associated with pregnancy (4
months) and child rearing (9 months). But they do not consider the difficulties they might
later encounter in providing their children adequate nutrition, better education, heath, etc.
Fertility is projected to continue to decline at a slower rate and TFR will decline from 2.4
to 1.8 children per women during the period 2000-20254. Fertility is likely to be the
determining factor for future population growth. In this scenario, demographic trends
will have considerable impact on the population age structure that will lead to a decline in
dependency rate. Mongolia faces the challenge of job creation commensurate with the
increase in the labour market.
Section 3. Mortality and morbidity trends and poverty
The mortality level has been gradually falling in recent years. For instance, the crude
death rate has reduced from 12.2 per 1000 persons in 1970, to 8.1 in 1991 and to 6.0 in
2001. The morbidity of the population was 3,282 per 10,000 persons in 1991, however, it
rose to 4093 in 2001.
Infant and under five mortality are about two times lower in 20015. The infant mortality
rate was 30 per 1000 life births and under five mortality was 41 per 1000 life births in
2001. 81% of infant mortalities were early neonatal deaths6. Pneumonia (30.4%) and
diarrhea (16.9%) were predominant causes. However there are different data sources
(health statistics and surveys) on infant and under 5 mortality rates which expose large
discrepancies in the figures. Reliability and comparability of the heath data, especially
1
1998 Reproductive Health Survey
1998 Living Standard Measurement Survey
3 1998 Living Standard Measurement Survey
4 Population projections produced by the National Statistical Office
5 According to the heath statistics of 2002, in comparison with 1991
6 i.e. within the first week of birth
2
12
infant and under five mortality are very crucial since they reflect how well the country is
performing towards achieving internationally accepted goals such as MDGs1 Needless to
say, the Government is anxious to improve its existing health information systems and is
taking steps in this direction.
The health statistics for 1998-2000 show that 14.4% of morbidity in total and 16.1% of
total mortality go for children under five. In the past decade, under-five mortality hass
decreases from 87.48 per 1000 live births in 1990 to 42.44 in 2000, in other words by
more than twice2. One in three children aged under 3 suffer from chronic diseases like
rickets, or are underweight. Survey findings showed that of the total children in
Mongolia 8%, or more than 34,000 are registered disabled.
Maternal mortality is an equally important aspect of population and development as it is a
key mortality cause for women. Maternal mortality rate increased during the early years
of transition (1990-1993) and it reached a peak of 259 per 100,000 live births in 1993.
Although maternal mortality level has been declining since then, it is still at high level:
169 per 100,000 live births in 2001. The reasons are manifold, but relate to poor
nutritional health of mothers, lack of early intervention to identify or ameliorate against
potential pregnancy risks and complications, lack of adequate training of midwives,
difficult geography and climate, as well as poor medical services and facilities. A
national programme aims to improve health services, maternal delivery suites and
promote safe-motherhood. New equipment is being gradually installed, however, old
health management styles and practices take time to be re-engineered. Governmental
budget allocation to the sector is also a constraint.
Among the causes of maternal mortality, 27 % are related to pregnancy complications,
27% delivery complications, 17% to puerperium complications and 29% to extragenital
diseases. Diseases not related to pregnancy—extragenital diseases are becoming
increasingly more important, underlying the need for better prevention and higher quality
of antenatal care. Forty percent of pregnant women are chronically anemic, and 33% of
them suffer from some other chronic diseases. A high incidence of maternal mortality
may be attributable to the poor health condition of women, but also to the lack of skill of
health personnel in identifying or responding to complications, lack of basic medical
equipment and drugs, a slow and bureaucratic referral system, and poor general
knowledge about pregnancy and its potential complications
50 percent of the maternal deaths occurred from among herders that compose nearly 30%
of all pregnancies in Mongolia. Over 40% mothers who died lived in the baghs (smallest
administrative unit). This shows the poor quality of, and low access to, the services for
safe motherhood at lower referral levels, especially in the rural areas. Furthermore, in the
last 3 years Mongolia has also been suffering from the severe drought and disaster (Dzud)
in winter which devastates the economy and impacts heavily of local living conditions.
1
2
MDGs- Millennium development goals
Health sector of Mongolia-80 years-2002
13
Such extreme conditions certainly also reap their own impact on isolated and rural
communities and in turn on maternal and infant health.
In response to high maternal mortality, the government developed and approved the
‘Strategy for the Reduction of Maternal Mortality’. It aims to reduce maternal mortality
by 25% by 2004 (as against 2000 figures) through providing accessible, high quality and
guaranteed health care during pregnancy, pre and post-natal periods.
Mongolia is also experiencing an epidemiological transition—from infectious disease to
chronic diseases. This transition is changing patterns of morbidity and mortality. Prior to
the 1990s respiratory diseases, infectious diseases, parasite borne diseases and digestive
diseases were leading causes of deaths. But now the list is topped by blood circular
diseases and followed by cancers, trauma and intoxication. The last decade has also
witnessed an increase in sexually transmitted infections. These now account for 30-40%
of total infectious diseases in the last 3-4 years. Section 8 below contains a more detailed
explanation of the characteristics of these infections.
Mongolia is also experiencing a shift from a curative to a preventive health care system.
Financial constraints have hindered its full implementation and greater effort is needed to
achieve this objective.
The Government of Mongolia has also adopted new legislation and national programmes
aimed at improving the availability and accessibility of health services, namely Health
Act, Drugs Act and Sanitation Act, and programmes on reproductive health, mental
health, iodine deficiency and the strategy for reduction of maternal mortality. But
generally however, health management is weak and inefficient, budget constraints impact
on hospitals, clinical outdated skills need to be updated and revised to international
standards and health facilities need to be upgraded with internationally compliant
equipment. Finally, health professionals need to be systematically retrained.
Migration from rural to urban areas, outlined above, has meant that internally migrating
families, both on route, but also on arrival at their ultimate destination, often lack access
to family doctors, hospitals and medical check ups. There have been a large number of
cases among the females caught in this trap who give birth to babies infected with
syphilis and gonorrhea. A number of people, particularly the poor, are deprived of care
because they are not formally registered, or are unable to participate in the national
insurance scheme and cannot afford the cost of drugs, transport, outpatient or other
services.
Section 4. Migration, Urbanization and Poverty
As the consequences of the reforms been undertaken, national and international migration
has intensified. Before the 1990s migration was regulated by the state, although people
had a legal right to move. A little migration to the capital city was permitted – but was
almost prohibited. Only those officially sent by the State were allowed to re-settle in the
capital city. However the density of population became higher in the capital city, 116.7
14
person per square km, as compared to with the national average of 1.3 person per square
km.
Therefore migration is not a new phenomenon but it’s reasons and pattern have recently
changed. People started to migrate by individual and family choices not by the State plan,
which means that the basic human right of migrating started to occur naturally. Early in
the 1990s there was a net outflow of citizens from urban to rural areas largely in response
to the privatization of the national herd. In parallel, migration to Ulaanbaatar began to
increase as migrants searched for market and employment opportunities, better education
and living conditions. The population of the capital city increased by 21.8% as compared
with 6.1% of national population increase and about 70 % of this city increase was made
by in-migrants between 1995-2000. As of 2000, 12% of the total population in the capital
city consisted of these migrants. The density of population was increased from 137,4
person to 161,7 person per square km between 1995-2000.
The main reasons of the migration to the capital and big cities, which are the most
important push factors, include lack of jobs, poor access to market and information, poor
quality of health and education services and the environmental degradation. The
desertification and degradation of pastureland in some rural areas made herdsmen, in
small percentage, decide to migrate to the cities. The largest in-flow, in absolute
numbers, was to the Central region, with about 156,000 migrants or 86.0% of total inmigrants and 61.2% of these migrants moved to the capital city. The west region is much
affected area by out-migrants and it consisted of 28.0% of total out-migrants. The central
region is also most affected area in both out and in flow migrants since migrants from the
west region moved through central aimags to the capital city, in other words, the
migration flow had not been directly to the capital city. Over concentration of people
largely impacted on infrastructure of the cities and it, consequently, caused unequal
access of the people to development, such as market and basic social services. It has also
caused environmental degradation such as air and water pollutions, especially migrants
with herds in the city are largely contributing to soil erosion and land degradation. The
destination areas, including the capital city, are not fully capable to absorb in flow of
migrants and cannot provide them with adequate housing, employment and services.
Thus, there is a need to improve urban management of resources and widen access of the
people to services.
Movements of families to the big cities has dominated migration issues. Most of the
migrants are found to be young aged 10-29 with higher proportion of male migrants than
female. In terms of education level, educated migrants are higher than for non-migrants.
There has been a sign of increasing “brain drain” from the rural areas.
For many migrants, their living conditions have improved once they have arrived and
settled in destination areas. Their employment status, professional skills, housing
conditions, access to markets and living conditions have improved. The survey on
internal migration, 2000 revealed that about 25%-45 % of the migrants to the capital city
have experienced better employment opportunities and about 60% of the migrants
reported that their living conditions are improved. However, a significant number of
15
migrants also faced many problems upon arrival. They placed mostly in suburban areas
and contributed to larger squatters. Lack of income, no access to clean water and
unhealthy environment are affecting their health and leading to an increase of
malnutrition and other infectious deceases. Also schooling cost for children, although
universal education for children is a free, such as clothing and training facilities are
pressuring on family expenditures and it is reasoning of an increase of drop-outs among
poor migrants. Thus migration, in certain amount, is increasingly contributing to urban
poverty. The Government is urgently required to develop policies on mitigating
difficulties faced by migrants through increasing capability of the cities to manage urban
resources effectively and making these resources availability to all people. At the same
time we should also reassess the registration fee especially it’s high cost in the context of
ensuring equal access of migrants to basic services.
In future migration of the herdsmen who loose their herds, which are their basic asset, in
natural disasters such as heavy snowing, flood and drought, likely to move to the cities in
searching for employment, for markets as well as for social assistance. Therefore the
Government of Mongolia is putting much attention to developing pastoral risk
management, sustaining livestock farmers through establishing community-based
services among vulnerable herdsmen to facilitate community prioritization, co-financing
and execution of investments in basic infrastructure and social service provision.
Promotion of rural development is also needed in order to ensure better services and
living conditions for the people living in these areas. The Parliament approved the
Regional Development Concept in 2001, which defines the general policy on rural and
urban development for the next 15-20 years. The main objective of the concept is to
accelerate economic development of the regions and reduce urban/rural development
disparities based on comparative advantages, improvement of infrastructure, extension of
market relations and sound principles of government and private sector partnerships. It is
important to ensure balanced distribution of the population through strengthening
economic and social development in rural areas. In accordance with the regional
development concept the capital city development strategic plan up to 2020 was approved
by the Government, which would play an important role for managing urban migrants.
Out migration of Mongolia has also been increasing since international cooperation with
other countries has also increased. Many citizens have been emigrating to Korea, Japan
and America, legally or illegally, for a better salary and improved living conditions.
However, there is no detailed statistical data and information about people emigrating
abroad. It is evident that many families have still been contributing and their living
improved by larger remittances. Briefing from the incomplete information, money
transferred from foreign countries was equal to significant proportion of the GNP in
1996. This amount has increased two folds between 1996-2000. The Government is
urgently required to improve the system and quality of registration and information to be
used for formulating national policy on external migration.
16
Section 5. Population ageing
The elderly issue is one of the priority social welfare issues of the Government. It has
been implementing health and social welfare programs for the elderly based on the
Constitution and other laws and legislations such as Labour code, Pension law, Social
Insurance law, Social assistance law, Health law, etc.. Particularly, the law on social
benefits and services for the elderly was adopted in 1996 and became a fundamental legal
base of the state benefits and services for thousands of elderly during the critical
economic situation of the country. In 1998, the National Programme on Health and
Social Protection for elderly was adopted by the Mongolian Government with the goals
of improving quality of life and creating healthy and favorable environment for ensuring
active participation of elderly in social life through improved health of elderly and social
protection of them.
According to the 2000 Census data, the population aged 60 and over is 124,300 or 5.2%
of total population. The sex ratio for the population aged 60 and above is 79.3 males for
100 females. There are slightly more elderly in the rural (5.7% of the total rural
population) than in the urban (4.9% of urban population) areas. The proportion of the
elderly population vary from 3.8% to 7.2% among provinces/aimags. The variations in
ageing by provinces may be explained by life expectancy, fertility level and age-selective
migration.
Marital status of the elderly is very different by gender. The proportion currently married
or living together is 70.8% for elderly males whereas the corresponding figure is only
33.1% for elderly females. Elderly females are predominantly widowed (62.7% of
women aged 60 and above), whereas only 24.4% of elderly men are widowers. As age
increases, the number of widows increases relative to the number of widowers by more
than 23,000. This is related to higher life expectancy for females as compared with males.
Elderly women are expected to care for their spouses, however but when they themselves
need care they are usually in a disadvantaged situation because they lack income,
resources, and are emotionally distressed due to the loss of their spouses. They tend to
live alone in a greater proportion. Therefore, ageing issue is very much a gender issue
with clear challenges for women and calls gender sensitive policies and approaches.
According to 2000 health statistics, the mortality level of older people per 1000
population over age 60 was 66 for males and 52 for females. The 1999 Survey result
showed that 66% of the elderly responded that they have been suffering from at least one
chronic disease. This indicates the great need of quality health services for the elderly
population. The most common disease among the elderly is blood pressure (26.5%)
followed by cardiovascular, digestive system.
The state pays health insurance premium for the elderly: when the elderly receive
hospitalized services, the cost should be covered by health insurance. Also rehabilitation
units for the elderly are functioning in each districts of the capital and each provinces/
aimags centers. But in practice, they often pay some amounts related to the treatment they
17
received. Many older people can not afford to pay such expense that in fact they should
not have to pay.
Health care for the elderly is considered as primary health care and thus adds
responsibility of family doctors. Due to their overburden of responsibilities, family
doctors tend to provide minimum care for the elderly. Also financial constraints,
improper functioning health insurance system, inadequate health services specially in
remote areas are influencing quality of health care for the elderly. Policies measures need
to be directed not only to improve health care for the elderly but also to prevent from
illness addressing the factors effecting their health.
The 1999 Survey on Living Conditions of Elderly, conducted by NSO, a high proportion
of the elderly are living in extended families (49%) or with their children (38%). The
elderly in Mongolia are still very much integrated into families and cared for by their
children or relatives. But this might be changing due to increased urbanization,
modernization, like other countries experienced. 12% of the elderly lived alone: but there
are great sex differentials: 28% of females lived alone whereas only 5% of males did so.
The Government has put attention for the improvement of elderly housing conditions.
Especially, housing condition of poor elderly and veterans were given a high priority and
construction work of houses for them has commenced. The government also runs special
care center for elderly who are not able to support themselves and do not have relatives to
help. But the facilities and quality of services of those centers need to be improved.
According to the 2000 Census, 12.3% of elderly people aged 60 and above were
economically active: either working or looking for a job. The percentage of
economically active among the elderly was higher, in fact more than double, for males
(17.7%) than for females (8.0%).
It should be emphasized that retirement age for women in Mongolia is 55 whereas it is 60
for men. Considering women of 55 and above, and men of 60 and above, as per the 2000
census, 163,666 people are on pension. In Mongolia, the pension coverage is not an
issue, because those who are not illegible for pension receive social assistance. However,
the critical issue is the adequacy of the pension on social insurance for the elderly. Also
according to the law on “Benefits and Services for Elderly”, elderly, specially poor
elderly are entitled to varies kind of benefits including housing benefits, grant aid, free
admission for sanatorium, free domestic transportation, free artificial organ services, etc.
For instance, 12% of social assistance fund are spent annual for such services and
benefits. But centralized system for social welfare services still exist in Mongolia. Given
the financial constraints and inefficient current system, the government is directing the
services to more of community based services and care by changing social psychology,
privatizing the institutions for social services, preparing trained social workers,
encouraging private sector and NGOs participation in service provisions, etc.
The employment status of employed elderly shows that elderly are mostly self-employed
(57.4%) or working without payment in family businesses (22.1%). This could be
18
explained by the fact that a large proportion of the Mongolian population still relies on
the primary sector - particularly on herding. This contributes to creating an environment
where elderly people can still work after age 60. But last few years, many households
have lost substantial amount of their livestock which has had adverse impact on family
livelihood.
Older males have more opportunities to work in the formal sector with payment where as
the majority of old females are involved in family businesses without payment. Again it
indicates a disadvantage of elderly women in earning activities. The 1999 Survey found
that the majority of the elderly (82.1% of males and 89% of females) expressed that their
monthly pension (income) was not adequate to cover minimum living expenses. Also
50.7% of women aged 55-59 and 51.3% of men aged 60-65 are interested to work. It is
interesting that more old people among those who just retired want to continue to work.
The mandatory retirement age applied now forces the elderly out of economic activities,
while many still want to continue to work. Therefore, there is a need to ensure income
security of elderly and provide them job opportunities and engage them in income
generation activities.
In this regard, some policy measures have been taken by the Government. The amended
Labour law stated that pensioners are allowed to work and employers should consider
requesting the elderly to shorten working hours. The government is considering
increasing the minimum retirement age for both sexes to 62 years and initial estimates are
being made on what kind of implications the changes would have.
A quarter of the elderly population is illiterate. 32.5 % of elderly aged 60 and above had
completed secondary or higher level of education. This relatively high level of education
affects their ability to help themselves and would widen job opportunities for them.
Due to fertility decline, there is a tendency of increased number of population aged 60
over and the percentage of elderly in the total population assumed to be at 10,2% in 2025.
54% of the total elderly will be women as compared with 46% is men. The annual growth
rate of the elderly will be reached to around 7.1 and the highest growth rate with 11.4
percent will occur in the capital city. 42.9 percent of the total elderly will be in the capital
city while lowest percentage with 11.3 in the West region. Therefore there is a need to
take actions on developing appropriate decentralized care for the elderly with prevented
from financial burden on the state budget.
Section 6. Reproductive Health
With the objective of reducing the high incidence of maternal morbidity and mortality as
well as reducing the very high number of illegal and unsafe abortions, in 1989-1990, the
Government of Mongolia introduced family planning and legalized abortion. The family
planning programme was aimed at supporting women’s rights to make decisions on being
a mother considering their wish, interest, living conditions and postponing their unwanted
pregnancy, respecting sexuality choice, reducing the abortion and maternal and infant
mortality and morbidity. This marked the beginning of a relatively successful family
19
planning. After ICPD, the Government of Mongolia introduced the reproductive health
approach. Until now, efforts have focused mainly in the improvement of RH services,
and some progress on the reproductive health of the population can be observed. By the
1992, 15 percent of all reproductive age women used modern contraceptive methods and
it has increased and reached 50 percent in 1998. The introduction of family planning, and
later, of the reproductive health program adopted in 1997 was facilitated by the existence
of an intensive health system, with clinics in every soum (administrative unit equivalent
to districts), hospitals in every aimag (province), and high ratios of doctors, nurses and
beds per population. Another facilitating factor was the extremely high level of literacy
among the population-with, for example about 97.5 percent of women literate. As results
of a first RH implementation nearly 96.7percent of Mongolian women have had
knowledge about family planning, 60 percent of married women are using at least one
method of contraceptives. The knowledge about safe delivery, family planning, STI
prevention, sexuality health of the population has been improved and there have been
observed a change in their attitude and behavior. Within the framework of the national
RH programme aimag and sums(lowest administrative units) have developed RH subprogrammes in accordance with their local specifics. However, related challenges
included old clinical techniques and approaches that needed to be upgraded, a curative
focus as opposed to a preventive approach, poor management, limited data collection and
monitoring system, large distance and climate-related constraints (especially during the
winter), poor living conditions of the people in particular in rural area have had a
negative impact on successful implementation of RH programme. Maternal mortality rate
for last three years was 163 per 10000 live births, it is much higher than that the
reproductive health programme was targeted. 40 percent of pregnant women were
observed to be with anemia and 3301 percent are with chronological diseases. Social
problems such as, alcohol, domestic violence have also effected a high abortion rate.
Male participation in the reproductive health initiatives is still weak, it is not recognized
yet. Due to lack of provision of knowledge and information to youth, adolescents’
pregnancy has been increased. About 9 percent of adolescents aged 15-19 girls have
given a birth. Proportion of this figure is as much as twice higher in rural areas than urban
areas.
In 2001, the implementation of a first national RH programme was assessed and a new
national RH programme was adopted for 2002-2006. On the basis of the assessment of
the previous RH programme the priority issues to be addressed in the next RH
programme were identified. These are included high maternal mortality and abortion rate,
lack of equal access of varies population groups as well as different regions to RH
services, increasing rate of teenager pregnancies and STI and HIV/AIDS among youth
and limited male involvement in RH responsibilities. Policies, standards, guidelines were
developed and widely disseminated in the country, refresher training was provided to
most health care providers involved in RH, down to the grass-roots levels, essential RH
drugs and contraceptives were made available, free of charge, RH coordinators were
recruited in each aimag to coordinate RH related activities and to provide RH services in
newly established RH cabinets. IEC materials, first low costs one, and recently high
quality ones, were developed and massively distributed throughout the country, and some
TV and Radio programmes broadcast.
20
The goal of the RH programme is aimed to support a sustainable population growth and
promote health through improving RH status of the population of Mongolia. The
objectives of the programme are put on the following directions:





To develop accessible, quality and client oriented RH services
To develop knowledge and promote healthy behavior of individuals and
families to prevent unwanted pregnancies, STIs and HIV/AIDS
To educate adolescents on RH knowledge, safe sex behavior and making
proper decision and healthy choice on RH issues
To build the national capacity and the coordination mechanisms for RH
programme management through strengthened linkage between the
implementers and participating organizations
To build a RH supportive political and socio-economic environment through
improved knowledge, support and participation of decision makers at all levels
and NGOs in information dissemination, advocacy and training including RH
rights, gender equity and improved male participation.
Section 7. Adolescent Reproductive Health
In 1997, the Government issued the National Reproductive Health Programme and the
National Adolescent Health Programme. These programmes were promulgated within the
framework of the implementation of the Programme of Action of the International
Conference on Population and Development (ICPD).
In 1999 a needs assessment was conducted to profile the situation of adolescents in
Mongolia. Issues of concern that became apparent, and which is still areas of concern,
include rise of sexually transmitted infections among young people. Almost 20 per cent of
boys have experienced sexual intercourse by the age of 17, and nearly 1 in 10 girl has
become pregnant before the age of 20. Almost half of these pregnancies are unwanted and
about one fifth are terminated. Fewer than half of the adolescents interviewed had some
knowledge about STIs, and half of all cases are among persons under 25 years of age. An
integrated, multi-sectoral, country-wide programme, funded by UNF, aimed specifically at
youth, which includes provision of youth-friendly reproductive and sexual health services
and information as well as skills development has been launched. The programme is being
developed in close collaboration with adolescents, local communities, government agencies
and NGOs.
Much attention has been given to reproductive health and sexuality education programme of
the formal education system and to developing IEC materials for adolescents; a baseline
survey was undertaken; RH Master Trainer’s have been trained; the secondary school
curriculum for reproductive health and sexuality has been revised; a book of lesson plans,
teacher’s background materials, posters, and two students books were developed, approved,
published and distributed to every school in Mongolia. A teacher-training programme was
developed and over 300 teachers were trained to provide reproductive health and sexuality
21
education using learner-centred interactive methodologies. Institutionalisation of the
teacher-training programme is in progress. Lecturers at the State Pedagogical University
and other teacher training institutions have been trained, following which they have
developed a curriculum for an elective course for university students training to become
teachers. The course was taught for the first time during the fall semester of 2001. NGOs
have also been trained and a significant number of IEC materials were developed for
adolescents and for parents. These included 14 issues of the UerkheLove newspaper, which
continues to spearhead the discussions on ARH in Mongolia. Translation of two books for
young people, monthly radio programmes, a series of eight 8-minute TV programmes for
teens and a poster, fact sheet and pamphlet for parents and adolescents are among the other
activities done.
General health services, including RH, for adolescents are now being piloted. Counselling
capacity is being developed, NGOs are being encouraged to develop programmes for youth,
and distance education programmes targeting young people out of school and parents are
being implemented.
While much has been accomplished, there remains considerable work to be done to ensure
that Mongolian adolescents have the knowledge, skills and services that they need to protect
and manage their reproductive health. The institutionalisation of the education programs in
the formal education system needs to be strengthened and more teachers need to be trained
to ensure the quality of the RH education in secondary schools. The number of hours of
Health Education is generally regarded to be insufficient, and major advocacy activities are
ongoing in order to have the number increased, when Ministry of Science, Technology,
Education & Culture in 2005 will revise the present curriculum. The curriculum, originally
conceived as a pilot, needs to be revised and the materials for teachers and university
students improved and expanded. Programmes for out of school youth have been lacking;
these need to be developed and implemented. Services for adolescents are almost entirely
non-existent. Additional IEC materials and programmes are needed to reinforce education
programs and to reach as many adolescents as possible. Parents also require education and
skills so that they can provide knowledge and guidance to their children. Institutionalisation
of previous activities accomplishments needs to be further developed and strengthened.
Section 8. Prevalence and prevention of STIs, HIV/AIDS
As seen in a 2001 final report of HIVAIDS, siphilis accounted at 7.0, honorrhea at 24.0
and trichonomias at 39 per 10000 persons. In addition, incidence of herps, candid and
clamid is likely to increase. Infants born with syphilis has been observed in recent years.
Almost 100 infants born with syphilis were still or died immediately after the delivery
during 2000-2001.
Many negative social phenomena such as unemployment, poverty, trapping, alcoholism,
drug addiction, prostitution and ignorance of own health care have emerged during the
transition period. More than 50% of people sick with sexually transmitted diseases are
unemployed. A lack of permanent income source disable unemployed people to be
22
covered by health insurance and receive the medical assistance. Thus, they go untreated
for quite a long period hence provoking others to dangers of infections.
Prostitution caused by a lack of income sources has gained ground. The medical
examination made to 180 prostitutes in the capital Ulaanbaatar and Darhan-Uul, Selenge
provinces/aimags revealed that 70-80% of them being sick with sexually transmitted
diseases and about 50% were diagnosed to have invisible syphilis.
The public seems to remain ignorant and relieved of STD because patients of STD are
not charged with treatment costs and deaths of syphilis or other STDs are not made
known to the public. Since the total population of Mongolia is relatively young
economic policy makers and decision makers are not paying attention to STDs and
allocating the necessary fund to fight with them.
The harm of STDs in the long run is a damage to reproductive organs of human beings
and adverse effect on population growth. If net population growth stands lower than 0
negative implications will persist and cause harms in a duration of specific period
irrespective of whatever actions taken. Once the net growth of population comes to
standstill there will be shortage of labour force. And shortage of labour force will impede
social production and reproduction. A lack of material wealth production might lead to
severe poverty. Therefore, the projection should be made as for STDs and preventive
actions need to be taken. SDTs are an issue which is related to multi-faceted aspects of
society, demography, health, economy and biology. STDs are mainly caused by poverty,
unless stable measures are not taken they cause a severity of poverty. The Mongolians
used to suffer from harms of STDs and accumulated adequate experience of how to get
rid of SDTs.
It is due to develop an overall strategic guideline to fight with and prevent STD at
regional levels. As well it is necessary to abolish the behavior of accusing each other
and seeking the blame from others. Instead it should be ensured that the society,
community and individual can participation in fight and prevention of STDs with equal
duties and rights.
Section 9. Gender equality and development
In Mongolia 50.4 percent of entire population, 48.7 percent of economically active
population and 48.5 percent of the working population are women. Unemployment rate
among women are higher than the average unemployment rate by 0.4 percent, while 16.0
of households are women headed.
There are considerable changes in legal status, education, health, employment and
position in the family of women since the International conference on population and
development, 1994.
Aiming at creating favorable condition by the state for and mainstreaming social
resources to ensuring equal participation of men and women in all political, economical
and social processes including health protection, educational attainment, development
23
and decision making and basing on resolutions of the 4th World conference of women, the
Government of Mongolia adopted and implemented “National programme on
advancement of situation of women” in 1996 and reformed the National committee on
women issues as National committee on “Gender equality”, to improve its management
and coordination, creating intersectoral coordinating mechanism. Such, it has a positive
impact on coordination of problematical issues on gender equality, integrating with other
socio-economic policies in national level.
The Government of Mongolia is reviewing and revising the “National programme on
advancement of situation of women” and modifying it into “National programme on
ensuring gender equality”, to be consistent with current situation and needs. The
preparatory work to discuss and achieve consensus on the newly developing programme
at the National session on gender issues, planned in October, 2002, is under process.
The revised programme is designed to have the following main components:




Economy and gender equality
Family development and gender equality
Rural development and gender equality
Gender equality in decision making.
On legal rights: Human rights and freedom were embodied as a key state policy in
Mongolia’s Constitution, adopted in 1992. Although, during the transition period
Mongolian economy has faced difficulties, the State policy of Mongolia has been aiming
at provision of human rights and human development.
Positive legal environment for Mongolian citizens and individuals to enjoy human rights
and freedom, has been creating gradually and a new concept of human rights has been
introduced and being formed in social sense.
However, survey on situation of human rights in Mongolia, conducted in 2001, has
revealed existence of some violation and disadvantages in situation of human rights. For
illustration, the number of position of women at political and socio-economic
administrative level is not increasing adequately. Due to socio-economic severity and
constrains, human rights’ realization of vulnerable social groups, including poor and
unemployed people, women headed households and poor women, street children,
disabled people and elderly in low living conditions, is still under concern. The human
rights’ violation among vulnerable groups is mainly triggered by poverty and
unemployment.
Even though, there are many state actions and programmes, aimed at provision of human
rights of vulnerable people, their implementation is not sufficient and scope is limited. In
spite of existence of approved social welfare laws for vulnerable groups, implementation
mechanism and monitoring system are inadequate, and therefore impacts are negligible.
On the other hand, vulnerable people tend to stay outside the social welfare services due
24
to their poor knowledge on legislations, insufficient access to information and weak
capacity to protect their own rights1.
The Government of Mongolia confesses the importance of national programme on human
rights’ provision to overcome these difficulties and started to develop the programme.
On education and gender: Mongolian law on education has legalized and declared
attainment of universal basic education, while more than 20 percent of state budget
revenue is spent in educational sector, as a result of state policy to increase investment in
educational sector. According to the Population and Housing Census of 2000, the literacy
rate among adult men is 98.0 percent and adult women is 97.5 percent. The enrolment
rate of all school grades was continuously increasing until 1991, but between 1991-1993
the number of students, studying in secondary schools and primary and secondary
vocational schools has significantly decreased and school drop-outs have increased,
causing major drop of enrolment index compare to the previous achieved level. However,
this indicator bit increased in the last few years.
Gender balance among students studying in secondary schools of some provinces has
been spoiled. In rural areas, school drop-outs among boys due to study in primary and
middle grades of secondary schools has increased in order to help in household chores,
which influences the increasing proportion of girls among students studying in upper
grades of secondary schools, as well as in colleges and universities.
On Gender concerns in employment: During the previous system, as the result of policy
to promote active participation of population in labour market, the employment rate for
men and women has achieved the same level. However it has both, positive and negative
consequences. The positive consequences include that women earn income themselves,
and therefore possess some economic power and actively participate in social life,
contributing to country’s development. The negative consequences are overload for
women, because they are still engaged in household chores and traditional duty to bring
up their children.
According to the statistic data of 1992-2000, unemployment rate among women is higher
in 4.6-8.6 points than that among men and unemployment is mainly caused by the
reduction of the job positions. At present, there are very limited opportunities to find jobs
in labour market for those women who have many children, who are poor, living in
remote districts of the city and households heading women. There are many cases of
discrimination of women, looking for a job. According to the survey on employment of
women, 28.5 percent of respondents are unemployed because of their sex, 23.5 percent of
that is unemployed due to their age and 8.5 percent of respondents are remaining
unemployed because they have infants.
According to the annual statistic data of 2000, 50.2 percent of working aged population,
47.8 percent of workers and 53.7 percent of unemployed are women. In 1992-2000,
working aged population has increased by 21.1 percent and the number of workers
1
Summary of the Situation of human rights in Mongolia, 2001
25
increased by 3.0 percent; and economically active population has decreased by 1.4
percent, while unemployment rate has decreased by 28.5. To compare, during that period,
working aged women has increased by 18.8 percent, and the number of female workers
has increased by 2.7 percent; and economically active women has increased by 0.3
percent, while the number of unemployed women has reduced by 28.6 percent. In the
frame of legal reform, laws on cooperatives, companies and employment promotion have
been adopted, thus creating legal environment and basis for employment opportunity for
all Mongolian citizens to be employed in formal and informal sectors and private entities
without any discrimination. However, data and survey findings on workers in informal
sector are very limited.
Another concern of gender equality is disparity between men and women in employment.
In some extent this is related to their biological capability, however it is considerable that
in many cases such a disparity exists in biologically acceptable and internationally
balanced job positions. For instance, according to the Population and housing census of
2000, 71.3 percent of workers in educational sector and 80.1 percent of workers in health
and social protection sectors are women. As of qualification, 69.8 percent of lawyers,
officials of state and non-governmental organizations and managers are men, while 66.7
percent of technical workers and assistant workers are women.
On Family and gender issues: The State policy on population, adopted following the
Cairo conference, has stated that “basing on the consideration of family as a primary
environment for one’s life and as a basic unit of society, the family development issues
should be under concern of state policy ” and this statement serves as the root for current
state policies on family issues1. According to the Population and housing census of 2000,
541.1 thousand families were accounted and each family has 4.3 members in average.
Between 1990-2000, the general marital ratio declined from16.9 to 9.0, decreasing by 47
percent. Due to living standard changes and increasing level of education, age of
marriage has increased, influencing fertility rate decline. On the other hand, inequality in
educational attainment is negatively influencing the marriage and fertility rate2.
There are 14.0 thousand women headed households and the number of women, heading
households has increased by 22.7 percent between 1996-2000. According to the Living
standard measurement survey, conducted in 1998, 42.4 percent of women headed
households are poor, while 27.7 percent of men headed households are poor.
The traditional household duties are still kept so far and unpaid household works are
mostly done by women, which is more common in rural areas. According to the pilot
survey on time utilization, conducted by the National statistical office in 2000, women
spend 2 times more hours for household daily activities than men do. Thus, there is a
need to advance legal environment to value women’s reproductive contribution and
efforts to bring up their children healthy, to reflect issues on reduction of time spent by
women in household works into national policies and programmes and expand scope of
1
2
State policy on population, 1996.
Material of the conference on current tendency of family development in Mongolia,2002, page 8.
26
training and advocacy activities among decision makers and the public aimed at rising
awareness on value of house works and increasing men’s responsibility in family.
Legal environment to deal with joint property owned by couples and family members
through relevant laws and contracts has been created. However, attention needs to be paid
at increasing knowledge on legal rights of citizens, couples and family members and
ability to protect their legal rights.
During the transition period, cases of violence against women has increased both in
numbers and manners, and it became one of the most problematical issues. There is no
official statistical data on violence against women. Vulnerable poor women are more tend
to be affected by violence. Family violence against women registered in Ulaanbaatar is
20.6 percent of all crimes occurred in households in 1998 and that has increased up to
25.2 by 20001. The Association of women lawyers and National center against violence
have initiated the draft law on family violence in 1998 to prevent from violence, however
it has not been realized so far due to inactive participation and inadequate support of
relevant organizations of lawmakers.
On gender issues at decision making level: Following the election of 1992, the rate of
women representatives in Parliament has declined from 24.9 to 3.9 percent and it has
increased up to 10.5 and 11.8 by 1998 and 2002 respectively. However, the objective
declared in the National programme on advancement of situation of women, to increase
the rate of women representatives at all levels of administration and management up to 20
percent by 2000, has not been met.
Moreover, 16.9 percent of directors of departments of ministries and state agencies, 4.5
percent of chairs of Citizens representatives Khurals of cities and provinces /only 1
person/, 12.9 percent of Citizens khural representatives of cities and provinces, 25.0
percent of Citizens khural representatives of soum and districts, 3.3 percent of soum and
district governors, 37.6 percent of government agency officials and 41.3 percent of local
government officials are women.
It indicates that compare to attained education of women, their representation at decisionmaking level is very low and in spire of high level of education, women have limited
opportunity to fully use it. It is connected in many ways with social psychology and
public understanding about women.
Section 10. Behavioural change communication and advocacy and information and
communications technology as tools for population and development and poverty
reduction
a/ Information education and communication and advocacy
Reproductive Health Information, Education and Communication (RH IEC) has always
been an important component of the National Reproductive Health programmes, started
first in 1992.
1
Data and arguments on violence against women, National center against violence, 2001
27
The main objectives of the IEC activities have been determined to help Mongolian people
to make free and responsible choice in reproductive health, regarding to their living
conditions and health status.
During the period, the RH IEC succeeded in rising the population’s general awareness on
Reproductive Health issues, raising understanding and support from the Government on
RH issues and in establishing a network of institution and agencies working with RH
IEC.
Numbers of government and non-government organizations are operating with RH IEC
component and they are committed to improve the IEC process, to produce a variety of
high quality, effective IEC materials. A network of institutions working with RH IEC
was established according to the IEC Subcommittee recommendations in 1999, the IEC
Core Group (IEC CG).
A wide range of IEC materials on different RH issues, such as family planning, safe
motherhood, prevention of STI/HIV/AIDS, reproductive health of adolescents, was
developed, produced and distributed nationwide through the different media channels,
including print and broadcast media. The quality of the produced IEC materials has
significantly increased in the last several years.
The National IEC Strategy on STIs/HIV/AIDS was developed and implemented along
with a multi-faceted and coordinated work plan. Several campaigns for specific
audiences on HIV/AIDS prevention were conducted.
Despite that the IEC activities were mainly focused to support RH services, the IEC
activities result the quality of life, as it is empowering peoples though better information
and accessible education to take thought-based decision, regarding to the reproductive
health, as to an essential part of the well-being.
Although, the number of behavior change studies on different reproductive health issues
is limited mostly to STI/HIV/AIDS, it is commonly agreed that the general population
already possesses adequate information on the different RH issues, such as family
planning, STIs, HIV/AIDS. However, the real impacts of the IEC/BCC (behavior change
communication) activities, or changes in their reproductive health behavior, on their
lifestyles still remain to be seen.
The challenges for the RH IEC activities had been clearly identified in the current
National reproductive health programme (2002 – 2006), which was developed to
incorporate new ideas such as provision of RH policy which is gender sensitive and
respectful to RH rights, calling for an active support of decision makers, and improved
male involvement as stated in the ICPD+5 of “Population and Development” Conference,
which was approved by 21st special session of UN held in 1999 and supported by the
Government leaders of the countries , as: 1\ to create behaviour and knowledge among
families and individuals on protecting themselves from, and preventing unwanted
28
pregnancy, STI and HIV/AIDS, to improve adolescents knowledge on RH, and 2\ to
meet specific needs and demands of particular population groups, given that knowledge
about RH and sexual behavior affect the RH status of the population.
Following actions are going to be done to meet above objectives:

to develop and implement the IEC strategy based on surveys on population's
RH knowledge and behavior, carried out with the assistance of UNFPA and
other donor organizations

to develop and build the capacity of the National Center for Health
Development (NCHD) as the leading organization for carrying out RH IEC
activities among the population
to establish RH information, data and IEC materials resource fund at the
NHDC and set up an intersectoral coordinating council at the NCHD


to enhance the capacity of the NCHD which is responsible for RH advocacy,
information and education, and direct concerted efforts towards producing
IEC materials according to the IEC strategy that will satisfy the needs of
target groups; printing and dissemination of IEC materials in sufficient
quantities; production of regular radio and television programs and publishing
periodic newsletters

to establish a network of mass media organizations focusing on RH, to
collaborate with international organizations on training press and media
journalists, specialized in RH issues
The IEC activities will focus primarily on behavior change communication, since the
general population already has much information on RH. The next step is to apply
acquired knowledge, thus promoting healthy lifestyle and sexual health.
The National RH IEC strategy is under development process now. The IEC strategy is
taking into account population and development strategies, including gender issues as
well as other emerging issues, such as increasing poverty, disparities by region and socioeconomic group, unemployment and increasing migration and urbanization.
There are no political and public consensus on gender equity, abortion, family planning
and welfare measures and protection for families. This presents certain impediments to
improving the legal environment for RH, thus, negatively affecting the implementation of
RH programme as a whole. The recently developed Advocacy Strategy for Population
and Development and Reproductive Health is aimed at responding to the above
challenges.
The IEC and Advocacy components will build target audience oriented, strategic
communication to address RH issues to the different levels, including high-policy makers
to the ultimate audience and vulnerable groups.
29
b\ Information and communication technology
Development of the Information and Communication Technology is very important for
providing emergency services in society, reducing costs, improving knowledge, learning,
changing information, opening and sufficient information, improving quality of life and
activating foreign relation. Likewise, many countries take special attention to the
development of this sector, because the ICT became the key accelerator to economic
development of the country providing with many important social development tasks. In
other words, the ICT development has already changed techniques and technology in the
social civilization. Particularly, the Internet network can make available the followings:
- to change the traditional style of development and the way of human thinking,
observing, speaking, working and living,
- to provide every person and country with opportunity to reach the achievements
in short term, which was available before to reach in several decades or century
by widening information and knowledge frame.
It is estimated that one of every 3 people in South Asia is poor. In other words, these
people have limited opportunity to participate in political structure, receive social
services, live in freedom and self-development. Therefore, it is required to provide them
with essential services and primary education, take attention to their health and give them
at least small opportunity to improve their way of living. Although, it is evident that
poverty is increasing negative aspects such as corruption and robbery.
The disparity between rich and poor in global economy and information is improving. It
is important to receive daily information on global economy due to avoid staying behind
global development and be in one step with them. Introducing and using ICT gains in all
socio-economic sectors will decrease poverty and be an effective bridge between rich and
poor.
All policies and activities, conducted by the Government of Mongolia, are focused on
using ICT more often and introducing it in socio-economical sectors successfully due to
develop own country by improving competitiveness of our country, increasing own
resources (wealth, mineral resources, livestock), qualifying human resources,
production/output, and improving export production/manufacturing. Accelerating service
sector development, making it fast, improving outputs/production and quality of services,
and developing open and E-Government by using ICT is required.
ICT development is not only defined by Information, Communication and Technology
sector development, but also by optimally and efficiently introducing technical
achievements of the sector in other sectors. For example: ICT should be introduced, as
soon as possible, in the government agencies (E-Government), tourist agencies, and in
others sectors as fuel and energy, road and transportation, education and culture, and
science in order to achieve tasks to get the public information open and sufficient,
become every activities fast and quick, and eradicate bureaucracy.
30
As a result of setting tasks and implementing activities on ICT development, the living
standard of Mongolian people will be improved, in other words the following
achievements will be reached, such as improved employment, increased incomes and
access to different kind of services with low costs.
Creating social services and electron work market through making communication and
information services available especially in rural areas (because Mongolia has a vast
territory with low population density), conducting Distance Learning based on ICT,
providing with health services including tele-diagnosing and distance treatment,
delivering information on market, banking and financial services. It is required to create
Information Services Centers due to make condition of providing rural population with
information.
Information and Communication Technology develops global partnerships and becomes
a key tool against poverty throughout the world, besides having an important role in one
parts of many measurements of poverty as information and knowledge shortage,
opportunity of poor people to participate in politics, and getting information in the
market, the.
Section 11. Information, survey/research and training
Without reliable information and research systems on population and poverty it is
impossiible to make assessment
on existing situation and to develop policy
recommendations on population and poverty related issues and it is hard to monitor and
influence to the governments.
In Mongolia, the National Statistics Office and the Population Teaching and Research
Center at Mongolian National University are key institutions which deal with the
population and development related data collection, data processing and research.
The most of population and development related research work are being carried out
within the framework of the donor funded projects.
The main information source is the population and housing census which is carried in 10
years interval. Mongolia carried out the population and housing census 9 times since
1918. Last population census was carried out in 2000 with financial and technical
assistance from UNFPA based on UN recommendations and principals. Results and
findings of population census have been disseminated timely to users.
The living standards measurement surveys carried out twice, in 1995 and 1998 with
financial and technical assistance of World Bank and UNDP. The third survey is being
conducted by the National Statistics Office again with the financial and technical support
of UNDP and World Bank. Another important information source is the Reproductive
Heath Survey. The first Reproductive Health Survey was carried out by the National
Statistics Office with financial and technical support of UNFPA. The second one will be
carried out in 2003 also with support of UNFPA. It’s preparation work is well underway.
31
All above mentioned surveys were carried out with close support of international experts
using the internationally accepted standards and methodologies.
Although there were positive actions taken by the government of Mongolia following the
recommendations made by above mentioned international conferences, the population
and living standards measurement surveys are still not sufficient yet in terms of
frequency and timing.
During the period between two censuses, the National Statistics Office collects statistical
reports and conducts sample surveys, in addition, the Population Teaching and Research
Center, MNU also conducts sample surveys on specific topics. Of course, the sampling
frame of these kinds of surveys is much different than that of census. But the
“Millennium Development Goal” requires collecting the population and poverty related
data by the main indicators in relatively short period, for example, annually, it also
suggests assessing and monitoring the indicators in each 2-3 years.
Although Mongolia does collect lots of data on population and poverty issues, the data on
population movement is quite limited, especially reliability of data on immigration is
weak. First ever time, data on internal migration was collected through 2000 population
and housing census. Due to the social problems occurred during the transitional economy,
there is a need for a good, reliable data on migration, and it is hard to wait until the next
population census which will be conducted in 2010 to get data on it.
There is a need for reliable population and poverty related data collection system which
could replace population and housing census data between the two census period. One of
main problems facing Mongolia today is the difficulties and weak financial capacity of
the government during transitional economy.
Another challenge for Mongolia is to build and strengthen the national capacity for
conducting comprehensive demographic studies at internationally accepted standards. For
this purpose, there is a plan of activities for training the researchers at advanced level,
strengthening the Population Teaching and Research Center, promoting NGOs
participation in population and development studies, specially, supporting the Mongolian
Population and Development Association.
There is a need to pay more attention to the population and poverty related research
initiatives and involvement of researchers. Good data analysis, information
dissemination, practical use of research findings are also important challenges. For this,
there is a need for expanded advocacy programme.
There were carried out a number of training activities directed to the raising awareness
and understanding about population and development issues among decision makers. The
serial in-service training programmes have been developed for aimag and soum officers
in charge of population issues, administrative staff, senior policy makers. Within the
UNFPA third country programme, a number of activities are being proposed, such as,
32
policy assesment in relation to the population and development issues, identifying the
needs for advocacy and training on popualtion and development for decision makers, and
etc.
We would note that our next step is to develop methodologies for defining the concepts
and indicators which are required for assessing the implementation of Millenium
Development Goals. Although the concepts and definitions of indicators are exist, those
are still brief and insufficient, but there is a possibility that each country could make it’s
own estimations in accordance with it’s specifics. Thus, we would be able to develop a
good information system for international comparison.
The Bali Declaration recommended that “In order to promote effective dissemination of
population related data, it is important to establish a good data and reference system at
national, regional and local level”. Following this recommendations, Mongolia is
planning a project with support of UNFPA “Establishing the Data Base on Population
and Development” using the data set of the population and housing census and data set of
demographic and reproductive health surveys. In addition, it is planned to make
population projections with 4 options for the period to 2025 using population and housing
census data set.
Section 12. Partnerships and resources
In solution of population and development issues, only Governments’ efforts and
resources are not sufficient, and therefore partnerships with government agencies,
national and international NGOs, private entities, academies, citizens and international
organizations are essential. In this era where the World is very much connected, one of
our country’s main objectives is to get assistance from the World Commonwealth
Association and to use it in appropriate way to develop the country.
There is a special role for donors in Mongolia in assisting to build democracy, in
intensifying the transition to the market economy, in ensuring good governance, in
improving the living standards of the people and in reducing poverty. The community of
donors has been supporting Mongolian Government reforms and holding donor group
meeting since 1991.
From 1990 to end 2001, donor commitments for all types of Official development
assistances amounted to 2.3 billion USD, while disbursements were equal to 2.4 billion
USD.
Overall assistance provided to Mongolia on population and gender issues from United
Nations Development Programme and United Nations Agencies, including Population
Fund, Children’s Fund, Development Fund of Women, International Labour Organization
and World Health Organization and projects and programmes aimed at socio-economic
development of the country, implemented by the international banking and financial
organizations, such as International Monetary Fund, World Bank and Asian Development
Bank are contributing to the development of Mongolia. Particularly, Country
33
programmes of assistance to the Government of Mongolia, implementing by the UNFPA,
are playing a very big role in improvement of quality of needed data and researches for
development and implementation of population related policies and strengthening
national capacity in integration of population factors into national policies and
programmes.
UNFPA has been cooperating with the Government of Mongolia since 1972. The first
country programme was implemented from 1192 to 1996 and focused mainly on
strengthening of Maternal and Health Center, Information and Education
Communication, National Statistical Office and the establishment of the Population
Teaching and Research center at the National University of Mongolia. The second
country programme was implemented from 1997 through 2001. It has a total budget of
US$ 9.3 million, of which US$ 7.65 million was allocated to the reproductive health subprogramme. The population and development strategies sub-programme of the second
country programme supported 4 component projects.
The evaluation report of the second country programme noted that the Reproductive
health survey of 1998 and the population census of 2000 produced much high quality
data not previously available. While the population and development strategy subprogramme accomplished a great deal between 1997 and 2001, especially in data
collection and dissemination and in training, coordination among line ministries and other
programme partners, such as national statistical office and population training and
research center, remained weak. The translation of broad policy principles into effective
programmes with measurable impacts was also difficult to achieve. The gender
component of the sub-programme not adequately addressed. While much useful research
was conducted under the second country programme, research capacity as well as
utilization of data in the country are still very limited.
The population and development strategy component of the third country programme is
designed specifically to address the weaknesses identified at the conclusion of the second
country programme, particularly in access to comprehensive databases of social statistics,
research capacity and the integration of population and gender concerns in development
policies and programmes.
Under the population and development strategy sub-programme, UNFPA will assist the
Government to attain its development goals by incorporating population and gender as
central concerns in the formulation of social policy and social development programmes.
The planned interventions will aim at the achievement of the goal set for the Third
country programme, which is to have contributed to the improvement of the quality of
life of the Mongolian people through better reproductive health, the attainment of a
harmonious relationship between population and development and gender equality.
In order to solve challenging population issues as a complex, the Government of
Mongolia is developing and implementing policies and programmes, reflective of the
specific demands and needs of the population, while intensifying increasing participation
of international organizations, state and non-governmental organizations, private sectors,
34
communities and citizens. For instance, State policy on population, National programme
on advancement situation of women, National programme on Mongolian youth, National
programme of action for children, National programme to support disabled people and
National programme on health and social welfare of elderly aimed promotion of
population development and National programme on household capacity promotion,
National programme on employment promotion, Green revolution, White revolution and
Programme on nutrition, aimed at reducing unemployment and poverty; and many other
policies and programmes on education, health, environment and information technology
were being implemented. Implementation of these policies and programmes have resulted
numerous achievements, including, advanced cooperation of state and non-governmental
organizations, accumulated experience on execution of some state functions by NGOs,
increased participation and responsibility of private sector and enhanced support and
assistance of international organizations. However, it is essential to mention that due to
economic constrains, the Government has limited financial resources to support NGOs
and there is lack of information exchange and experience sharing between NGOs. There
is a need to strengthen capacity of staff of NGOs, create system of information exchange,
cooperation, monitoring and evaluation in order to expand cooperation between state and
non-governmental organizations.
The Government of Mongolia has been focusing on cooperation with National and
international NGOs and has achieved in gathering a lots of experiences. Namely,
possibilities are open to NGOs to participate in conducting surveys and collecting data on
population issues and planning, implementing, monitoring and evaluating population and
development related activities. Moreover effective measures were taken to provide NGOs
with opportunities to execute some state tasks through a contract and undertake joint
actions with the Government. For instance, the Mongolian population and development
association, established with UNFPA support, has set up a qualified team and undertakes
different activities, such as conducting surveys on population and development,
participating and counseling in policy development and planning and providing with
information policy makers, decision makers, research organizations and the public.
35
Appendix 1.
Table 1.
Economic indicators, 1990-2000.
Indicators
Unit of
measure
Mln.MNT
1990
GDP (At constant
208641.9
price of 1993)
GDP per capita
USD
1245.0
GDP (annual
%
-2.5
average growth)
Annual inflation
%
rate
Unemployment
%
…
rate
Poverty
Source: Human development report, 2000
1995
1996
1997
1998
1999
2000
180775.4
185047.7
192508.3
199205.2
328.9
6.3
401.4
2.4
442.0
4.0
452.0
3.5
53.1
44.6
20.5
6.0
10.0
8.1
5.4
6.5
7.5
5.8
4.6
Table 2.
Projection of elder population
Percentage of
population afed
60 and over
2000
2373493
124295
5,2
2005
2526186
144404
5,7
2010
2659283
159928
6,0
2015
2780633
191293
6,9
2020
2887423
254426
8,8
2025
2962679
347337
11,7
Source: Population projection , 2001 îí, National statistical office
Year
Total population
Population aged
60 and over
Sex ration of
population aged
60 and over
79,4
83,0
82,7
83,3
83,9
84,3
Dependency
ratio of elderly
8,9
9,0
9,0
10,2
13,1
17,7
Picture 1.
GDP per capita
100
80
60
GDP
40
20
0
1990
1995
1996
1997
1998
1999
2000
36
Appendix 2.
Implementation of quantitative indicators of ICPD AND ICPD+5
Targets
Targets set forth within ICPD
Public education
1
To eradicate gender inequality in primary
and secondary education attainment by the
year of 2005
2
To ensure the primary school enrolment of all
girls and boys prior to 2015
Mortality reduction
3
To reduce infant and under five mortality by
one third or down to 50-70 per 1000 live
births and to reduce infant and under five
mortality down to less than 50 per 1000 live
births by the year of 2005
4
To reduce maternal mortality by a half in 2000
as compared with 1999 and further reduce it
by a half until 2015(lower than 60 per 100000
live births in countries with high maternal
mortality)
Reproductive health
5
To introduce and promote all safe and reliable
family planning methods among all the people
and provide them with reproductive and sex
health services in 2015
ICPD+5
Public education
6
To reduce illiteracy rate of women by a half in
2005 than that in 1990 and increase the net
primary school enrolment of girls and boys up
to 90 minimum
Implementation status(as of 2001)
As of 2001 gender ratio in primary education
attainment was 50.0 percent, in basic education
attainment was 52.8 percent and in complete
secondary education attainment 58.7 percent.
Starting from 1999, this indicator is tend to get
stabilized and the percentage of girls studying in
secondary school declining by 0.1-0.2 percent
annually. But it indicates increasing number of
boys, not decreasing number of girls.
As a result of undertaking and implementing a
number of measures to ensure the full primary
school enrolment with support of the Ministry of
education, science and technology, UNESCO and
other organizations that are working in the field of
child and youth promotion, school enrolment rate,
particularly, primary school enrolment rate is
increasing. As of 2001, primary and basic education
enrolment rate is 92.6, compare to 83.0 in 1995.
As of 2001, infant mortality per 1000 live births is
30.2 percent, while under five mortality stands for
40.8 percent.
In the past decade infant and under five mortality
has declined twice.
Maternal mortality per 100000 live births stood 200
in 1992, 185 in 1995, 158 in 2000 and 169 in 2001,
which shows that maternal mortality is not declining
sustainable. The Ministry of health is implementing
strategic plan aimed at reducing maternal mortality
in 2001-2004.
Nearly 97 percent of all women, and 99 percent of
currently married women stated that they know at
least one contraceptive method.
According to 1989 Population and Housing Census
the literacy rate of women aged 10 and above stood
98.4%. It fell down by 0.9% or at 97.5% as per
2000 census. The drop in literacy rate is associated
to a variance in education level of rural and urban
population. In rural areas the literacy rate of men is
down than that of women. In response to this,
informal education programmes involving rural
residents are being provided with the support of
UNESCO and other international agencies and
donors.
37
Mortality reduction
7
To ensure 40% of all the births are to be
delivered with medical assistance in countries
experiencing high mortality and further
increase this percentage up to 80 by 2005
Reproductive health
8
To provide 60% of all the people in 2005,
80% in 2010 and everyone in 2015 with
services of public health centers, family
planning methods, safe and effective means of
family planning, delivery of basic
gynecological services, prevention,
management and immunization of infectious
diseases of reproductive organs such as STD
9
To reduce a gap between the share of use of
anti-pregnancy methods and unmet needs of
anti-pregnancy methods by a half in 2005 and
further reduce by 75% in 2010 and by 100%
in 2015
10 To ensure the provision of training and
information for 90% of men and women aged
15-24 in 2005 and 95% in 2010 aiming at
raised awareness of how to prevent and lower
the risk of HIV AIDS using the fund of UN
Anti-HIV/AIDS programme and other donors
To reduce the incidence of HIV infection in
high-risk countries by 25% in 2005 and all
across the world by 25% in 2010.
In 2001, out of 48634 births 99.7 percent was
delivered with medical assistance.
Between 1995-2001 the first national programme on
reproductive health was successfully completed and
the second national programme on reproductive
health, to be implemented in 2002-2006 is
approved.
As of 2001, 49.7 percent of reproductive aged
women are using contraception and the most
commonly used methods include IUD, condom and
pills.
Since 1990, 9852 training teachers were prepared,
while training on prevention from HIV/AIDS
covered 16820 youth.
38
References
1.
2.
3.
4.
5.
6.
7.
8.
9.
2000 Population and housing census
2001 Mongolian statistical yearbook
Health sector of Mongolia-2002
Survey on living standard of elderly
Micro study on internal migration of 2000
Reproductive health survey of 1998
Living Standard Measurement Survey (LMIS) of 1998
Abortions and unwanted pregnancies in Mongolia of 2000
Mongolian human development report of 2000
39