The health status of the Mongolian population, especially amongst women, deteriorated in the conduct of the medical socio-economic changes. Mother and Child Health (MCH) was badly affected by insufficient infrastructure such as dismantled maternity wards, lack of transport, poor communication network as well as by other factors such as poor quality of care, lack of health education, poor or unbalanced nutrition. Maternal mortality increased from 114 deads per 100,000 live births - which was the average rate in the pretransition period 1985-1989 - to 212 in 1994. Sexual health indicators worsened as well: Sexually Transmitted Diseases (STD) went up. Abortions increased in both rural and urban areas. To cope with the deteriorations the Mongolian and the German government agreed on technical assistance in the field of reproductive health. A mission consisting of a team leader staffed by GTZ and an EPOS expert was assigned to design the Terms of Reference for a project which aimed at improving reproductive health in four selected districts in Mongolia.
The EPOS short term expert conducted field surveys in three provinces (Selenghe, Tuv Omnogobie and city district Nalaikh) to obtain a comprehensive understanding of the public health status with reference to reproductive health. The survey enabled the expert to analyse the health sector, including health policy and health service infrastructure with regard to reproductive health, management and organisation, maintenance systems, drugs and contraceptives, the health management information system, staff requirements and training needs, Information Education and Communication activities, the role of non-governmental organisations and the community. The expert proposed innovative approaches to improve maternal and reproductive health. The findings of the field surveys were presented in a workshop during which a project planning matrix was jointly elaborated with the Mongolian partners. A rough cost estimate of priority activities within the available budget was developed.