As most countries in the Asian and Pacific region, contemporary Mongolia is undergoing mobility transitions. Mongolia is in the midst of its demographic transitions and has pursued model of economic growth that has been more focused on import-substitution. In other hand, Mongolia is in demographic transition, witnessing a moderate, but decreasing, population growth, sustained decline in fertility and a steep increase in the number of young adults entering the labor market.
Population growth reached a peak in the late 1960s and has started to decline since then, mainly because of sharp decrease in fertilityratesfrom7. in 1975to 2. 8 in 1995. In 2000, total fertility rate was 2. 2 births per woman, but it has dropped to the below-replacement level (2. 1 births per woman) by 2004 (2. 0 births per woman). Population growth reached to 1. 2 percent in 2004. Since the transition began (1990), Mongolia has seen a rapid rise in labor migration abroad as well as within the country. There has been a huge movement from rural to urban areas since 1990. The largest outflow during 1991-2000 was from the Western region to other regions, mainly to Ulaanbaatar and Aimagsin the Central region, which received the most number of migrants.
It is common for areas of high in-migration also to record high out-migration. Some aimags in the north near the Russia border and aimags in the South near the China border also witnessed an increase in in-migration Mongolia has placed a high priority on childhood immunization and achieved notable successes in controlling vaccine preventable diseases. The EPI in Mongolia began in 1962. Routine immunization coverage over 90% nation-wide of all EPI vaccines has been achieved in children less than one year of age since 1998.
However, a recently conducted Impact Assessment of Hepatitis-B vaccination programmer in Mongolia (2004} survey data indicates a high prevalence of Hepatitis B infection among vaccinated children, particularly in rural areas. Data Quality Self Assessment also indicates the considerable discrepancy between the measles vaccine official coverage report figure (97. 5%) and the actual coverage figure (77%) in selected rural areas in 2005. These survey data indicate the need to improve the data quality of the EPI programmer, as well as immunization services quality.
The trend for neonatal mortality rates in Mongolia is the same as in developed countries. From 2001 to 2003 the neonatal mortality rate was 14 deaths per 1,000 births. The major causes for neonatal mortality are asphyxia, respiratory distress and congenital defects, which require high tech tertiary level care and improved referral system. The Infant and Under-Five Mortality Rates declined gradually in the last 5 years. Infant Mortality Rate per 1,000 live births was 31. 2 in 2000 and declined to 22. 8 in 2004.
If this decline continues, it will be possible to achieve the MDG goal of a reduction of IMR by 60%. However, the peri-natal mortality rate of 28 per 1,000 live births poses a significant challenge to IMR reduction. The IMR per 1,000 live births was 42. 4 in 2000 and declined to 29. 1 in 2004 There are some positive changes in the mortality and morbidity pattern among children. The Under Five Mortality caused by pneumonia per 1,000 children was 3. 9 in 2000 and decreased to 1. 9 in 2003. The main causes of the U5MR are still acute respiratory infections (ARI), diarrhoeal diseases, and injuries.
The total number of deaths between 0 and 1 year has decreased from 1,390 deaths in 2002 to 1,016 deaths (26% decrease) in 2004. In last few years accidents and injuries among children and adolescent have become one of the public health problems in Mongolia. Nearly 14% of all deaths in the age group from 15-44 result from accidents and injuries, taking third place in the list of the five most common causes of mortality after circulatory system disorders and cancer. 22. 6% of the deaths from accidents and injuries in the capital city of Ulaanbaatar affected children under 16.
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