Mongolia, the world’s second-largest landlocked country, presents a unique healthcare landscape owing to its distinctive geography and historical influences. Nearly half of its population is concentrated in the capital city of Ulaanbaatar, and the remainder is scattered across vast semi-desert areas known as the Gobi Desert. Because of this, Mongolia faces significant challenges in delivering equitable healthcare. On top of this geographical divide, the lingering impact of Soviet and Chinese healthcare models has created a system of stark contrasts—modern facilities abound in larger urban centers, while limited resources are common in remote areas, where travel distances to healthcare can exceed 95 km over rough terrain.
In a recent paper published in the Journal of Global Health on March 14, 2025, a research team led by Associate Professor Yae Yoshino from Sophia University, Japan, examined these and other unique features of the Mongolian healthcare system. Their comprehensive analysis goes over how Mongolia’s unique geographical, cultural, and historical circumstances have shaped its healthcare delivery system, reviewing its core strengths and weaknesses and offering practical recommendations to improve healthcare access across the country.
Despite the above-mentioned challenges, the researchers identified several strengths in Mongolia’s approach to healthcare. The country maintains a relatively young and strong population thanks to early retirement policies, particularly for women with four or more children. Mongolia also provides universal healthcare coverage with free access to primary care for all citizens through a semashko-style centralized system established during the Soviet era. Moreover, traditional Mongolian medicine, which has been influenced by Indian, Chinese, and Tibetan traditional medicine, remains deeply embedded in cultural practices and serves as a primary healthcare resource in remote areas, offering treatments that are both culturally appropriate and easily accessible. At the national university, specialists in traditional medicine are trained and hold national qualifications.
However, in many remote areas, healthcare delivery often faces substantial obstacles. “The shortage of healthcare providers in rural areas is a significant concern,” notes Dr. Yoshino. “The limited workforce strains the system and hampers the ability to offer timely and comprehensive medical services in rural communities.” In some remote areas like Altanshiree, fewer than ten healthcare professionals serve entire communities, often traveling directly to patients living in traditional yurts across challenging terrain.
The researchers also highlight structural issues within the healthcare profession itself. Since 2010, there has been a slight increase in the number of faculty members who have completed master's and doctoral programs at overseas graduate schools and are now teaching. However, more than 90% of the faculty members at nursing universities are doctors. “Nurses in Mongolia are still largely viewed as assistants to doctors and are unable to act independently in patient and perinatal care without a doctor’s orders. In remote areas, healthcare is often provided by mid-level professionals known as assistant doctors, who serve roles between those of doctors and nurses. Reaching care can be challenging—residents sometimes travel by horse, motorcycle, or on foot for more than half a day to access the nearest clinic,” explains Dr. Yoshino. This hierarchical structure undermines the potential contributions of these professionals, especially in rural areas where they could significantly expand access to healthcare.
Disease prevention is another significant challenge. The leading causes of death in Mongolia include respiratory, digestive, genitourinary, and circulatory system diseases, yet preventive screenings for conditions like hypertension, diabetes, and colon cancer are not routinely included in national health guidelines. Unfortunately, cultural dietary practices, including salty milk tea, sweet desserts, and heavy meat consumption, contribute to this problem.
To address these issues, the paper outlines multiple practical recommendations. The authors argue that Mongolia could strengthen its ‘third neighbor policy,’ which promotes relationships beyond Russia and China, to build healthcare partnerships with countries like the USA and Japan. These collaborations could improve healthcare education and workforce capacity, and encourage the implementation of WHO guidelines on disease prevention.
Technology represents another area with potential for improvement, as online platforms could help connect urban expertise to remote locations through telemedicine. Expanding the professional roles and autonomy of nurses and midwives would also help optimize Mongolia’s scarce healthcare resources in such places. Meanwhile, integrating health screenings into community and religious events could make preventive care more accessible and culturally relevant. “These strategies could lead to a more robust, accessible, and culturally sensitive healthcare system, improving the well-being of individuals and communities across Mongolia,” concludes Dr. Yoshino.
Overall, the research team emphasizes that by acknowledging Mongolia’s unique challenges while building on its existing strengths, the country can develop a healthcare model that effectively serves all citizens.
Reference
Title of original paper:
The strength and weakness of Mongolian healthcare: From nomadic Gobi to Ulaanbaatar
Journal:
Journal of Global Health
DOI:
10.7189/jogh.15.03015
Authors:
Wei-Ti Chen1, Otgonchimeg Mangal2, Khulan Munkhbaatar3, Enkhtuya Vankhuu4, Rachel HA Arbing1, Yae Yoshino5, and 2024 Sophia University Global Health Practicum Team
Affiliations:
1School of Nursing, University of California, 2Dornogovi Medical School, Mongolian National University of Medical Sciences, 3Sho-ei Kai, Social Welfare Corporation,4International School of Mongolian Medicine, Mongolian National University of Medical Sciences,5 Department of Nursing, Faculty of Human Sciences, Sophia University
About Sophia University
Established as a private Jesuit-affiliated university in 1913, Sophia University is one of the most prestigious universities located in the heart of Tokyo, Japan. Imparting education through 29 departments in 9 faculties and 25 majors in 10 graduate schools, Sophia hosts more than 13,000 students from around the world.
Conceived with the spirit of “For Others, With Others,” Sophia University truly values internationality and neighborliness, and believes in education and research that goes beyond national, linguistic, and academic boundaries. Sophia emphasizes the need for multidisciplinary and fusion research to find solutions for the most pressing global issues, like climate change, poverty, conflict, and violence. Over the course of the last century, Sophia has made dedicated efforts to hone future-ready graduates who can contribute their talents and learnings for the benefit of others, and pave the way for a sustainable future while “Bringing the World Together.”
Website: https://www.sophia.ac.jp/eng/
About Associate Professor Yae Yoshino from Sophia University
Yae Yoshino is an Associate Professor at the Faculty of Human Sciences, Department of Nursing of Sophia University. She obtained a Ph.D. degree in Medical Sciences from Kitasato University and MSc. PH and DPHTM degrees from the London School of Hygiene and Tropical Medicine. Her research focuses on human resource development for maternal and child health in developing countries, as well as the creation of a database of early childhood development situations in foreign countries and in Japan. She has published over 14 research papers on these topics and received numerous awards for her contributions, especially in Mongolia.
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