“Rapid urbanization in Mongolia over the last 30 years has increased the burden on health and social services in Ulaanbaatar and provincial centers, meaning health care services function poorly and are more costly than many can afford,” said ADB Senior Social Sector Specialist Mr. Rikard Elfving. “This investment program represents ADB’s long-term commitment to the development of Mongolia’s health sector and will help ensure that all Mongolians can access affordable and quality health services when needed without a heavy financial burden.”

Doctors and other health workers serve a steady stream of patients in a modern clinic in Zuunmod town. Photo: Kevin Hamdorf/ADB

Challenges facing Mongolia’s health sector include a shortage of human resources, funding, and equipment, which are undermining people’s access to quality health services. Out-of-pocket health expenses are also high in the country, accounting for about 41% of total health expenditure of households, one-third of which goes on medicines because of their high cost and their inappropriate use. Public spending on health, meanwhile, accounted for 2.4% of the country’s gross domestic product, which is well below the 5% target of the World Health Organization.

ADB’s investment program consists of three projects targeting the urban poor that will run until 2029. The projects will establish 10 family health centers in Ulaanbaatar that will provide expanded health services and six provincial-level health centers to strengthen primary health care. Integrated primary and secondary health care models will also be implemented in at least five districts and 10 provinces, employing public–private partnership schemes for maintenance and service delivery.

The program will establish a model, gender-sensitive district hospital in Chingeltei district and upgrade Khan Uul district hospital in Ulaanbaatar by linking in- and outpatient services for surgery, obstetrics, gynecology and other disciplines. Khovd and Uvs subdistrict hospitals will also be expanded through a new outpatient department.

With support from the Japan Fund for the Joint Crediting Mechanism, one of ADB’s trust funds, innovative low-carbon technologies such as energy efficient ventilation systems, ground heat source pumps, solar power generation, and smart green design will be introduced to the upgraded Khan Uul district hospital and selected family health centers.

The program will support health financing reform to ensure more efficient use of resources to meet the medium- and long-term needs of the sector. Finally, it will help the Ministry of Health and key stakeholders to build capacity to mitigate risks associated with procurement and financial management.

ADB has been Mongolia’s key health sector development partner since 1993, providing five loans totaling USD84.9 million, seven grants totaling USD37 million, and 15 technical assistance projects totaling USD10.65 million. ADB also supported the drafting and enactment of key health polices and laws in Mongolia, including the Health Law in 2016 and laws related to health insurance, medicines and medical devices, and medical care and services./.

Khac Kien