Tracking maternal mortality declines in Mongolia between 1992 and 2007: the importance of collaboration.

OBJECTIVE: To describe the declining trend in maternal mortality observed in Mongolia from 1992 to 2007 and its acceleration after 2001 following implementation of the Maternal Mortality Reduction Strategy by the Ministry of Health and other partners. METHODS: We performed a descriptive analysis of maternal mortality data collected through Mongolia's vital registration system and provided by the Mongolian Ministry of Health. The observed declining mortality trend was analysed for statistical significance using simple linear regression. We present the maternal mortality ratios from 1992 to 2007 by year and review the basic components of Mongolia's Maternal Mortality Reduction Strategy for 2001-2004 and 2005-2010. FINDINGS: Mongolia achieved a statistically significant annual decrease in its maternal mortality ratio of almost 10 deaths per 100 000 live births over the period 1992-2007. From 2001 to 2007, the maternal mortality ratio in Mongolia decreased approximately 47%, from 169 to 89.6 deaths per 100 000 live births. CONCLUSION: Disparities in maternal mortality represent one of the major persisting health inequities between low- and high-resource countries. Nonetheless, important reductions in low-resource settings are possible through collaborative strategies based on a horizontal approach and the coordinated involvement of key partners, including health ministries, national and international agencies and donors, health-care professionals, the media, nongovernmental organizations and the general public.

Clinical patterns and major causes of infertility in Mongolia.

OBJECTIVE: To determine the clinical patterns and major causes of infertility in Mongolia, based on the clinical and laboratory findings of both partners, and to compare the findings with data from the published World Health Organization (WHO) multicenter study. METHODS: Four hundred and thirty infertile couples who attended the Infertility Clinic of the State Research Center on Maternal Child Health in 1998-2002 were included in the study. The couples had not had a viable birth after at least 1 year of unprotected intercourse and agreed to be fully investigated according to the WHO protocol 'Standardized Investigation of the Infertile Couple'. RESULTS: The mean duration of infertility of couples was 4.9 +/- 0.2 years. 43.7% of women had secondary infertility. In the females, the prevalence of past history of sexually transmitted infection (STI) and pelvic inflammatory disease were 33.5% and 25.1%, respectively. In the male partner, 44.2% reported a history of STI and 27.7% had previous testicular damage. 32.8% of women had a tubal factor. The most common causes of male infertility were obstructive azoospermia (8.4%), male accessory gland infection (6.7%) and acquired testicular damage (5.4%). In 45.8% of couples, infertility was due to a female factor and in 25.6% of cases, infertility was due to a male factor. 9.8% of couples had no demonstrable cause in either partner and 18.8% of couples had an infertility diagnosis in both partners. CONCLUSION: Patterns of female infertility did not differ significantly from those in the WHO study. Male infertility had a unique pattern, as there was a high prevalence of obstructive azoospermia and previous testicular damage.