Mongolia: Difference between revisions

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'''OVERVIEW'''  

Since the 1990s, Mongolia has improved its sexual and reproductive health care services. However, improvements are still very much in progress, and there are still major issues to address. You will find that contraceptive options, like condoms and birth control pills, are available in pharmacies and clinics. However, Mongolian pharmacies have historically experienced periods of stock-outs, especially in urban areas like Ulaanbaatar, so there is no guarantee that any one pharmacy will have what you are looking for. It should also be noted that hospitals and clinics provide other contraceptive options, such as IUDs and contraceptive injectables, and NGOs like Marie Stopes also help provide critical health care services.

In Mongolia, you can obtain emergency contraceptive pills (morning after pills) without a prescription at pharmacies. You can obtain medication for yeast infections at pharmacies and for UTIs at hospitals or clinics. There are some alternative menstrual products, such as menstrual cups, sold by online vendors, but this is generally extremely rare. It is much more common to see pads or pantyliners sold in stores. If you need to see a gynecologist, there are options available to you at public hospitals and private clinics/hospitals (see the "Gynecological Exams" section for recommendations and details). Furthermore, abortion is fully permitted and available upon request during the first three months of pregnancy.  

Historically, Mongolia has been a patriarchal society. However, Mongolian women have exercised greater autonomy and responsibility than women in many other societies. The demanding nomadic lifestyle, combined with the harsh climate and difficult winters of the Mongolian steppe, required that women took an active role in tasks such as horseback riding, making clothes, tending livestocks, milking sheep and goats, making cheese, and preparing food.<ref>[https://asiasociety.org/education/women-modern-mongolia Women in Modern Mongolia]</ref> <ref>[https://www.historyonthenet.com/mongol-women-in-society/ Mongol Women and their Social Roles]</ref>

'''General Note:''' There are many types of contraceptives, also known as "birth control," including IUDs, oral contraceptives, patches, shots, and condoms, etc. If you would like to view a full list, click [https://www.plannedparenthood.org/learn/birth-control here]. It is recommended that you consult with a health practitioner to determine the best contraceptive choice for you. If you want to find which hormonal contraceptives are available by brand, manufacturer or country, click [http://contraceptive.ippf.org/search here].

In Mongolia, you can obtain condoms and oral contraceptives (birth control pills) without a prescription at pharmacies or clinics.<ref>[http://ocsotc.org/wp-content/uploads/worldmap/worldmap.html Global Oral Contraception Availability]</ref> <ref>[http://freethepill.org/where-on-earth/ Free the Pill: Where on Earth?]</ref> You can access other forms of contraception, such as intra-urine devices (IUDS) and contraceptive injectables, at certain hospitals and clinics as well. However, Mongolian pharmacies have historically experienced stock-outs, especially in Ulaanbaatar, so contraceptives may not be available at certain pharmacies. Furthermore, there has reportedly been a lack of contraceptives available at youth-friendly clinics, so you may need to contact more than one clinic to find the contraceptive services you desire.<ref>[http://mongolia.unfpa.org/sites/default/files/pub-pdf/UNFPA_FPsitutionalanalysis_ENG.pdf SITUATION ANALYSIS OF FAMILY PLANNING IN MONGOLIA, 2016]</ref>

Generally speaking, Mongolian women use contraceptives, but not at a high rate. According to a 2015 United Nations report, around 58% of Mongolian women (who were married/in unions and of reproductive age) used some form of birth control, including traditional methods. This rate of usage was lower than the Eastern Asian median, where approximately 82% of women used a form of contraception overall. Furthermore, it was found that around 14% of Mongolian women had unmet family planning needs. The most common forms of contraception used by Mongolian women were IUDs (23%) and birth control pills (13%). This was followed by male condoms (7%), the rhythm method (6%), and contraceptive injectables (5%). Finally, there were very low rates of usage for female sterilization (3%),  male sterilization (0.4%), contraceptive implants (0.3%), and vaginal barrier methods (0.1%).<ref>[http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf Trends in Contraceptive Use Worldwide 2015]</ref>

Historically, the Mongolian government has neglected family planning services -- and, in fact, the country had essentially no family planning services until the 1990s. Before that time, the Mongolian government had a pro-natalist policy. The importation of contraceptives was highly restricted,<ref>[https://www.popline.org/node/270884 Knowledge, attitude and practice of family planning in Mongolia, 1997]</ref> and most Mongolian women could only access intra-urine devices (IUDs). No other contraceptive options were available.<ref>[http://mongolia.unfpa.org/sites/default/files/pub-pdf/UNFPA_FPsitutionalanalysis_ENG.pdf SITUATION ANALYSIS OF FAMILY PLANNING IN MONGOLIA, 2016]</ref> In the 1990s, the Mongolian Family Welfare Association (MFWA), an affiliate of the International Planned Parenthood Federation (IPPF), created a branch of the organization that specifically targeted women in rural communities. MFWA provided reproductive health lessons to schools, though it struggled to reach many Mongolians who lived in remote and rural areas, often nomadically.<ref>[https://www.ncbi.nlm.nih.gov/pubmed/12293466 Family planning reaches Mongolia's spacious steppes, 1997]</ref>

As of 2018, some NGOs in Mongolia are working to help train local workers. According to Marie Stopes Mongolia, "The team are working with the Mongolian government and partner clinics to train doctors and nurses in administering medical abortion and fitting IUDs and implants. By looking beyond the simple delivery of services, Marie Stopes Mongolia has been able to expand access to long-term contraception and medical abortion for thousands more women. We have also been able to improve the quality of care they get, ensuring that it is more centred on their needs."<ref>[https://www.mariestopes.org/where-we-work/mongolia/ Marie Stopes Mongolia]</ref>

* In Mongolia, you can obtain '''condoms''' from many places, including pharmacies, markets, hotels, online vendors, family health centers, Soum Health Centres (SHC), the Aimag health centers, district health centers, specialized centers, hospitals, and Regional diagnostic and treatment centers (RDT). The nomadic and rural population often obtain condoms from BaghFeldsher, which are community health workers who distribute health services in remote areas.  

** Tip: At [https://mariestopes.org/where-we-work/mongolia/ Marie Stopes Mongolia], an NGO that focuses on sexual and reproductive health care services, you can find Trust and Mungulung brand condoms. According to the Marie Stopes Mongolia website, "Despite the country’s logistical challenges, our condom brands ‘Trust’ and ‘Mungulug’ are available nearly everywhere in Mongolia. They’re distributed in a range of places including markets, pharmacies, hotels, and even taxis, and they’re an affordable option for many poor and young Mongolians. We specifically market our ‘Trust’ condom brand to young Mongolians, who are particularly at risk of STIs. Through advertising, packaging and making the brand accessible via youth-friendly channels, we’re working to ensure young people in Mongolia can have safe and healthy sex."

* You can obtain '''contraceptive implants''' at the Aimag health centers, district health centers, specialized centers,, hospitals, and Regional diagnostic and treatment centres (RDT).

'''Important Notes:''' Emergency contraception may prevent pregnancy for three days (72 hours) and sometimes five days (120 hours) after unprotected sex. Take EC '''as soon as possible''' after unprotected sex to prevent pregnancy. If you don't have access to dedicated EC, oral contraceptives can be used as replacement EC, but remember the following: 1) Only some contraceptives work as EC 2) Different contraceptives require different dosages and time schedules to work as EC 3) For combined pills, you must only use the first 21 pills in 28-day packs and 4) They may be less effective than dedicated EC. For general information on emergency contraceptives, click [https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception here] and [http://ec.princeton.edu/info/ecp.html here].

In Mongolia, you can legally obtain emergency contraceptive pills (morning after pills) with a prescription.<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/mongolia/ EC Status and Availability: Mongolia]</ref>

* In Mongolia, you can legally obtain emergency contraceptive pills (morning after pills) with a prescription at pharmacies, clinics, social marketing programs (such as PSI, DKT, etc), and at programs affiliated with the International Planned Parenthood Federation (IPPF).<ref>[http://www.cecinfo.org/country-by-country-information/status-availability-database/countries/mongolia/ EC Status and Availability: Mongolia]</ref>

* Aside from pharmacies, you can also consider obtaining emergency contraceptive pills (morning after pill) from the [https://www.mariestopes.org/where-we-work/mongolia/ Marie Stopes Mongolia support office]. They also distribute condoms and birth control pills. Address: Marie Stopes International Clinics & Contraceptives (MSICC), 3rd Microdistrict, 14th khoroo, L. Enebish Avenue 11/1, Bayangol District, Ulaanbaatar, Mongolia. Phone: +976 11 7711 6194

* You can also get an intra-urine device (IUD) as a form of emergency contraception. To learn more details, you can visit the "Contraception" and "Gynecological Exams" section.

'''Important Notes - Learn about PEP and PrEP:''' If you think that you've been recently exposed to HIV (i.e. within 72 hours), seek out PEP (Post-Exposure Prophylaxis). It's a month-long treatment to prevent HIV infection after exposure, and it may be available in your city. Take PEP as soon as possible. For more information, click [https://www.aids.gov/hiv-aids-basics/prevention/reduce-your-risk/post-exposure-prophylaxis/ here]. If you are at risk of HIV exposure, seek out PrEP (Pre-Exposure Prophylaxis). It's a daily oral pill that can prevent HIV infection before exposure. To learn more about PrEP, click [http://www.whatisprep.org/ here].

In Mongolia, there are no travel or residency restrictions related to HIV status. This means that, if you're a foreigner who is HIV-positive, you can visit Mongolia, and you will not be asked for a medical certificate or proof of your HIV status. Furthermore, if you apply for a visa or long-term residency in Mongolia, you will not be asked about your HIV status. While Mongolia did have restrictions related to HIV-positive foreigners in the past, these restrictions were lifted in 2013 under the Law on Prevention of Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=125 MONGOLIA - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref> <ref>[http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2013/january/20130131psmongolia UNAIDS applauds Mongolia for removing restrictions on entry, stay and residence for people living with HIV]</ref>

Historically, Mongolia has had a low rate of HIV infection. In 2016, it was found that less 500 people in Mongolia were infected with HIV, which was less than 0.1% of the population. Furthermore, less than 100 people in Mongolia were infected with HIV each year.<ref>[http://www.unaids.org/en/regionscountries/countries/mongolia UNAIDS - Country factsheets - MONGOLIA 2016]</ref> The government of Mongolia takes HIV prevention and treatment seriously. The National Committee on AIDS (NCA) was established in 2006, which was followed by the revision of the National Strategy Plan on HIV, AIDS and STIs (2010-2015). Furthermore, the National Monitoring and Evaluation plan for HIV/AIDS and STIs was developed and approved by the government.<ref>[http://www.wpro.who.int/mongolia/topics/hiv_aids/en/ WHO Representative Office - Mongolia]</ref> To learn more about the Mongolian government's response to HIV/AIDS, click [http://www.wpro.who.int/mongolia/topics/hiv_aids/en/ here], where you can read various reports on HIV/AIDS in Mongolia.

* Public Hospitals - If you visit a public hospital in Mongolia and request an HIV test, you should be able to receive the test free of charge if you are a Mongolian citizen or covered by Mongolian health care.<ref>[http://theubpost.mn/2017/11/22/doctors-report-on-mongolias-hivaids-situation/ Doctors report on Mongolia’s HIV/AIDS situation]</ref> You can visit the [http://www.sgh.gov.mn/ official website of the Mongolian health care system] to learn more information. Please note that the website does not currently have an English version. You can also try to book an appointment at PUBLIC HOSPITAL NUMBER 2, which caters to high-ranking Mongolian officials and seems to be the best of the public hospitals in Ulaanbaatar. Address: Peace Avenue, Bayanzurkh District, Ulaanbaatar, Mongolia. Tel: +976-70150222. Emergency: +976-70150235. Email: sh_mikah@yahoo.com. Work hours: Monday-Friday 8:20AM-4:20PM.

* [http://www.songdo.mn/ Ub Songo Hospital]: This private Korean hospital, opened in 2007, has modern facilities, well-equipped laboratories, and relatively affordable prices. They cater to both the local Mongolian population and foreigners. The cost of an STI tests is 13500₮ per 1 test, as of May 2018 (according to our email correspondence with the hospital). The hospital is a part of the Bumungrad Health Network, meaning it's affiliated with Bumrungrad Hospital in Bangkok, Thailand. Address: Sukhbaatar District, Choidog street 5. 8 story building next to 1st Central hospital of Mongolia, Ulaanbaatar, Mongolia. Tel: +976-70111163. Fax: +976-70111164. On-call service available. Email: info@bumrungrad.mn. Work hours: Monday-Friday 8:30AM-5:30PM; Saturday 8:30AM-12:30PM

* [http://www.unaids.org/en/regionscountries/countries/mongolia UNAIDS Mongolia]: Contact - Eamon Murphy, Director, Regional Support Team, Asia and Pacific. Email: murphye@unaids.org

* If you visit a public hospital in Mongolia and request an HIV test, you should be able to receive the test free of charge if you are a Mongolian citizen or covered by Mongolian health care.<ref>[http://theubpost.mn/2017/11/22/doctors-report-on-mongolias-hivaids-situation/ Doctors report on Mongolia’s HIV/AIDS situation]</ref>

* If you visit a private hospital in Mongolia and request an STI test, you can expect to pay around 13500₮ per 1 test.

* If you have a '''yeast infection''', you can go to the pharmacy for medication. You can ask the pharmacist for Fluconazole, which is the type of medication used to treat fungal infections. While they may not specifically have Fluconazole, they may have similar products that you can use.

* If you have a '''urinary tract infection (UTI)''', you will need to go to a doctor to get tested. If the tests find that you have a UTI, you will be prescribed antibiotics. At [http://www.songdo.mn/ Ub Songo Hospital], a doctor's appointment costs 25000-30000 (as of May 2018). You can walk in (no advanced booking required). If you think you have a UTI, be prepared to pay around 100,000 for possible blood, urine test, and doctor's consultation (as of May 2018).

* There is currently no '''Pre-exposure Prophylaxis (PreP)''' program in Mongolia, as of May 2018.<ref>[https://www.prepwatch.org/ PrEPWatch World Map]</ref>

'''Note:''' In addition to pads and tampons, you can also use menstrual cups and menstrual underwear for your period. To learn more about menstrual cups, click [https://en.wikipedia.org/wiki/Menstrual_cup here]. To learn more about menstrual underwear, click [http://menstrualcupreviews.net/best-period-panties-reviews/ here].

* Regarding menstrual cups, there is a [https://www.facebook.com/MCinMongolia/ Menstrual Cup in Mongolia] Facebook page. We're still gathering information from them on what they provide.

* [http://www.sgh.gov.mn/ Public Hospital Number 2]: This public hospital, which is modern and higher-quality than many other public hospitals in the country, tends to cater to high-ranking officials in the Mongolian government. They have a 24-hour ambulance service and a few private rooms. If no English-speaking doctor is available, they can provide translation services to those who need it. Address: Peace Avenue, Bayanzurkh District, Ulaanbaatar, Mongolia. Tel: +976-70150222. Emergency: +976-70150235. Email: sh_mikah@yahoo.com

* [http://www.intermed.mn/ Intermed Hospital Mongolia]: This modern hospital, founded in 2011, has an obstetrics and gynecology (OB&GY) clinic, and it has been recommended by locals. It was the first Mongolian Joint Commission International accredited hospital. The doctors are generally Mongolian and Korean, and many doctors speak English. A doctor's consultation is 35,000 MNT and Pap smear is 33,400 MNT (as of May 2018), according to our email correspondence with the hospital. It's located in the Khan-Uul district, northwest of Bogd Khan Palace Museum and east of APU Company. Address: Chinggis Avenue 41, Khan-Uul District 15, Uildver 17040, Ulaanbaatar, Mongolia. Tel: +976-77011111. Emergency/after hours: +976-77000103. E-mail: info@intermed.mn

* [http://www.songdo.mn/ Ub Songo Hospital]: This Korean hospital, opened in 2007, has modern facilities, well-equipped laboratories, and relatively affordable prices. They cater to both the local Mongolian population and foreigners. The cost of a gynecological examination is 30,000₮, pap smear test costs 49500₮, test results usually takes 3-4 working days, as of May 2018 (according to our email correspondence with the hospital). The hospital is a part of the Bumungrad Health Network, meaning it's affiliated with Bumrungrad Hospital in Bangkok, Thailand. Address: Sukhbaatar District, Choidog street 5. 8 story building next to 1st Central hospital of Mongolia, Ulaanbaatar, Mongolia. Tel: +976-70111163. Fax: +976-70111164. On-call service available. Email: info@bumrungrad.mn. Work hours: Monday-Friday 8:30AM-5:30PM; Saturday 8:30AM-12:30PM

* [http://www.sosmedica.mn/ SOS Medica Mongolia]: This international clinic tends to cater to foreigners and expats in Mongolia. It's a membership-based facility, meaning that they mostly work with existing members. You can visit if you're not a member, but only if you're a short-term visitor to Mongolia and you can show your passport. They have a gynecologist on staff (Dr.Bolorchimeg, as of May 2018). Address: 4A Building, 7th Khoroo, 15th Micro District, Bayanzurkh District, Big Ring Road, Ulaanbaatar, Mongolia. Tel: +976-11-464325/6/7. Fax: +976-11-454537. Emergency:+976-91913122(24hours). E-mail: admin@sosmedica.mn, clinic.manager@sosmedica.mn. Work hours: Monday–Friday 9:00AM-6:00PM. Duty doctor, on call doctor /domestic/ 6:00PM-11:00PM

In Mongolia, women are entitled to 120 days of maternity leave (60 days before the birth and 60 days after the birth).<ref>[http://www.ilo.org/dyn/natlex/docs/WEBTEXT/57592/65206/E99MNG01.htm MONGOLIA LABOUR CODE, 1999]</ref> Their leave is covered by the Mongolian Social Insurance system. There is no equivalent paternity leave policy. However, women and single fathers my receive an additional "Baby Care Leave" period, which is optional and at the discretion of the employer.<ref>[http://lehmanlaw.mn/blog/basics-of-maternity-leave-in-mongolia/ Basics of Maternity Leave in Mongolia]</ref> It should be noted that many Mongolian women live in rural and remote areas, and many live nomadic lives, and in such cases, they may not be entitled to take off such time for maternity leave. Their time "off" may be more informally decided upon amongst themselves and their family members.

'''Important Note:''' There are two main types of abortions: medical (also known as the "abortion pill") and surgical (also known as "in-clinic"). For medical abortions, you take a pill to induce abortion. For surgical abortions, a procedure is performed to induce abortion. For general information about medical and surgical abortions, click [https://www.plannedparenthood.org/learn/abortion here].

In Mongolia, abortion is fully permitted and available upon request during the first three months of pregnancy. This means that, during this time, all reasons for abortion are permitted, including: to save the life of the pregnant person, to preserve physical health, to preserve mental health, if the pregnancy is the result of rape or incest, if there is risk of fetal impairment, economic or social reasons, or if the pregnant person simply requests an abortion. After three months of pregnancy, an abortion is permitted if the pregnant person is suffering from an illness that threatens the health of the mother or fetus, if the woman is under sixteen years old or over forty-five years old (and she requests an abortion), if the pregnancy is due to rape or incest, or if the pregnant person suffers from a mental disorder. In these cases, the approval of a family member or spouse is required.<ref>[http://www.un.org/esa/population/publications/abortion/profiles.htm Abortion Policies, A Global Review - Mongolia (United Nations Report]</ref> According to Article 36, Health Law of Mongolia (1998), an abortion should "be performed only in the facilities that meet the requirements and be performed by medical doctors who have been certified" and "the regulations related to abortion in article 36.1 should be approved by the central government administrative body in charge of health issues."<ref>[https://www.womenonwaves.org/en/page/5136/abortion-law-mongolia Women on Waves: Abortion Law in Mongolia]</ref>

* Fire Station: Call 101

* Police /Traffic police: Call 102

* [http://www.safefuture.mn/en/ National Center Against Violence, Mongolia]: "The National Center against Violence (NCAV) is a non-profit, non-partisan and non-governmental organization established in 1995 with the goal of combating domestic and sexual violence against women and children in Mongolia." Address: #03, 06, Building-40, 6th Khoroo, Baga Toiruu, Chingeltei District, Ulaanbaatar, Mongolia. Phone/Fax: 976-70119949 Counseling Hotline: 976-96490505. E-mail: mongolcav@mongol.net

* Click [https://www.equaldex.com/region/mongolia here] to learn about LGBTQ rights and laws in Mongolia. As of May 2018, homosexuality is legal in Mongolia, and there are laws to protect LGBTQ people from housing and employment discrimination. Same sex marriage is not recognized. The laws around gender change are ambiguous (i.e. it is not clearly legal or illegal). However, it is important to note that homosexuality was illegal and technically punishable by imprisonment in Mongolia until 2002.

* [http://mones.org.mn/en/ Women's Fund Mongolia (Mones)]: "MONES was established in 2000 with the purpose of contributing to: Increasing participation of women in decision-making levels; Creating an enabling environment for women to carry out social change projects and implement their ideas; Development of Mongolian women’s movement; Fostering networking and collaboration with women’s movement around the world; Creating a society respectful of human rights, equality and social justice." Address: Mongolian Womens Fund, Sukhbaatar District, Baga Toiruu, 6th khoroo, 48th Building, Room #305, Ulaanbaatar City, Mongolia. Phone: 7711 9991. Email: info@mones.org.mn

* [http://www.safefuture.mn/en/ National Center Against Violence, Mongolia]: "The National Center against Violence (NCAV) is a non-profit, non-partisan and non-governmental organization established in 1995 with the goal of combating domestic and sexual violence against women and children in Mongolia." Address: #03, 06, Building-40, 6th Khoroo, Baga Toiruu, Chingeltei District, Ulaanbaatar, Mongolia. Phone/Fax: 976-70119949 Counseling Hotline: 976-96490505. E-mail: mongolcav@mongol.net

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