Background The government of Mongolia mandates free access to primary healthcare (PHC) for its citizens. However, no evidence is available on the physical presence of PHC services within health facilities. Thus, the present study assessed the capacity of health facilities to provide basic services, at minimum standards, using a World Health Organization (WHO) standardized assessment tool. Methods The service availability and readiness assessment (SARA) tool was used, which comprised a set of indicators for defining whether a health facility meets the required conditions for providing basic or specific services. The study examined all 146 health facilities in Chingeltei and Khan-Uul districts of Ulaanbaatar city, including private and public hospitals, family health centers (FHCs), outpatient clinics, and sanatoriums. The assessment questionnaire was modified to the country context, and data were collected through interviews and direct observations. Data were analyzed using SPSS 21.0, and relevant nonparametric tests were used to compare median parameters. Results A general service readiness index, or the capacity of health facilities to provide basic services at minimum standards, was 44.1% overall and 36.3, 61.5, and 62.4% for private clinics, FHCs, and hospitals, respectively. Major deficiencies were found in diagnostic capacity, supply of essential medicines, and availability of basic equipment; the mean scores for general service readiness was 13.9, 14.5 and 47.2%, respectively. Availability of selected PHC services was 19.8%. FHCs were evaluated as best capable (69.5%) to provide PHC among all health facilities reviewed ( p < 0.001). Contribution of private clinics and sanatoriums to PHC service provisions were minimal (4.1 and 0.5%, respectively). Service-specific readiness among FHCs for family planning services was 44.0%, routine immunization was 83.6%, antenatal care was 56.5%, preventive and curative care for children was 44.5%, adolescent health services was 74.2%, tuberculosis services was 53.4%, HIV and STI services was 52.2%, and non-communicable disease services was 51.7%. Conclusions Universal access to PHC is stipulated throughout various policies in Mongolia; however, the present results revealed that availability of PHC services within health facilities is very low. FHCs contribute most to providing PHC, but readiness is mostly hampered by a lack of diagnostic capacity and essential medicines.

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In Mongolia, diagnostic tests for the detection of the sexually transmitted mycoplasmas, ureaplasmas, Herpes simplex virus (HSV), and cytomegalovirus (CMV) are currently not routinely used in clinical settings and the frequency of these STIs are enigmatic. The prevalence of these STI pathogens were prospectively evaluated among 200 Mongolian pregnant women and their newborns and correlated with pregnancy outcome. TaqMan PCRs were used to detect bacterial and viral STI pathogens in pre-birth vaginal swabs of the pregnant women and in oral swabs of their newborns. A standardized questionnaire concerning former and present pregnancies was developed and linear regression analysis was used to correlate pathogen detection with pregnancy outcome. Ureaplasmas were the most prevalent of the tested pathogens (positive in 90.5% positive women and 47.5% newborns), followed by mycoplasmas (32.5% and 7.5%), chlamydia (14.5% and 7.5%), trichomonas (8.5% and 4.0%) and gonococcus (0.5% and 0%). CMV was found in 46.5% of the pregnant women and in 10.5% of their newborns, whereas HSV-2 was detected in only two mothers. Multiple regression analyses indicate that colonization of the mothers with U. urealyticum, M. hominis, T. vaginalis or CMV is associated with transmission to newborns and that transmission of M. hominis or CMV from Mongolian pregnant women to offspring is associated with reduced neonatal length and gestational age. Thus, diagnostic tests for their detection should be implemented in the clinical settings in Mongolia.

Mongolia is a landlocked country with a total land area of 1,564,116 square kilometers. The ambient annual average particulate matter (PM) concentration in Ulaanbaatar is 10-25 times greater than the Mongolian air quality standards (AQS). More than 40 percent of the nation's total population lives in Ulaanbaatar. The study aims at defining the relationship between the ambient air PM2.5 level and hospital admissions in Ulaanbaatar in 2011-2014. The pollution data included a 24-hour average PM2.5. The air was sampled daily and recorded by the national air monitoring stations located in Ulaanbaatar. The sampling frame of hospital admissions for cardiovascular disease (CVD) were the records of all outpatient hospitals of Ulaanbaatar. The data covered the period from January 2011 to January 2014. To test the differences of the results, appropriate statistical tests were employed. During 2011-2014, the highest concentration of PM2.5 was in the coldest period and the particulate matter level recorded was 3.7 times higher in the cold period than the warm period. The number of admissions for CVD were the highest during cold periods. Four days after exposure, the PM2.5 impact on hospital admissions weakened but there remained a positive correlation. For PM2.5, 100 μg/m 3 growth of the pollutant led to 0.65 % increase in the hospitalization for CVD on the exposure day. On the second day of exposure, 10 μg/m 3 growth of the pollutant led to 0.66 % increase; on the third day of exposure, 10 μg/m 3 growth of the pollutant led to 0.08 % increase of hospital admissions for CVD, and at the fourth day, such growth led to 0.6 % increase of CVD cases in 2011-2014 in Ulaanbaatar. In conclusion we may state that most incidences of CVD registered during the cold months in Ulaanbaatar in the last four years were a result of PM2.5 exposure. This shows that the PM2.5 exposure and hospital admissions for cardiovascular system chronic diseases are positively correlated. CVD in Ulaanbaatar residents was affected greater on the same and the third day of exposure.