Since the 1920s Mongolia has developed an extensive and well-staffed health care system
that has made modern health technologies accessible to most of its population. In addition,
the country experienced rapid economic and social development whose benefits were
equitably distributed among the population. In spite of this progress, infant and child
mortality levels are high by contemporary standards and during the past 20 years these
rates have remained virtually constant.
The modern health care delivery system, externally imposed, failed to take into account
the specific characteristics of the Mongolian culture; this fact is identified as one of the
major determinants of the unexpected levels of early-age mortality. The excessive
orientation toward curative medicine, the lack of health prevention and promotion
activities and the lack of community participation have resulted in the people continuing to
believe in traditional therapeutic patterns and self-care. They perceive the modern system
exclusively in curative terms and not with regard to health preservation and disease
prevention.
Most Mongolians do not fully understand the health care system, and use its services
mainly because they have no alternative, or because of coercion rather than conviction
based on the learning and internalization of its basic principles. In practices and ideas of
child care, preservation of health and disease prevention, people seem to identify more
with the traditional health care system.
Like other former socialist countries, Mongolia is experiencing deep economic and
social transformations, whose implications for the health care system are discussed. An
economic crisis whose end is nowhere in sight, emergent social inequalities, a vague health
insurance model with unclear financing sources, and lack of concern by most policy-makers
in strengthening the preventive component of the health system, are not positive factors for
substantial infant and child mortality decline in the near future. A clear advantage is,
however, the fact that there is a wide space for major improvements with existing internal
and external resources.