Mongolia’s vast and varied landscape presents one of the most complex and challenging healthcare delivery scenarios in the world. As the world’s second-largest landlocked country, Mongolia is characterized by sharp contrasts—not only geographically but also in terms of its healthcare infrastructure and services. Almost half of Mongolia’s population is densely packed into Ulaanbaatar, the capital and largest urban hub, while the remaining citizens are dispersed across immense, often harsh terrains of the Gobi Desert and other remote regions. These geographical disparities compound the already difficult task of providing equitable and accessible healthcare throughout the country.
Delving deeper, the healthcare system of Mongolia is deeply influenced by a mosaic of historical legacies, particularly the remnants of Soviet-era and Chinese health models. Mongolia’s healthcare delivery today embodies a dualistic structure: on one hand, there are relatively modern and well-established medical facilities concentrated in urban areas; on the other hand, rural communities contend with scarce resources and infrastructural limitations. For many living in remote locations, accessing basic medical services can involve arduous journeys exceeding 95 kilometers across unforgiving terrain, a factor that severely limits timely intervention and routine care.
A team of researchers led by Associate Professor Yae Yoshino at Sophia University, Tokyo, recently undertook an extensive analysis of this uniquely challenging context. Published in the Journal of Global Health in March 2025, their study meticulously articulates how Mongolia’s singular geographical, cultural, and historical contours have combined to fashion a healthcare ecosystem marked by both resilience and fragility. Their analysis not only highlights systemic strengths but also calls attention to critical vulnerabilities, offering actionable recommendations aimed at fortifying healthcare equity across Mongolia’s disparate regions.
One notable strength within the Mongolian healthcare paradigm resides in its foundation of universal healthcare coverage. Mongolia employs a centralized semashko model inherited from its Soviet past, which enables free access to primary care for all citizens. This system has fostered relatively favorable health outcomes among Mongolia’s population, which remains comparatively young and robust, partially due to progressive policies such as early retirement benefits for women with large families. Beyond conventional biomedical frameworks, Mongolia also embraces traditional medicine—a rich and multifaceted practice deeply embedded within its cultural fabric. Drawing from Indian Ayurveda, Chinese traditional medicine, and Tibetan healing philosophies, traditional Mongolian medicine serves as an accessible frontline option for many rural inhabitants, who often rely on treatments that align with their cultural expectations and local realities. The national university’s formal training and certification of traditional medicine practitioners underscore the institutional recognition and continued vitality of this sector.
However, the rural healthcare landscape starkly contrasts with urban realities. Access to qualified healthcare providers in remote areas remains critically limited. According to Dr. Yoshino, the scarcity of trained professionals poses one of the most immediate threats to equitable healthcare. For example, in areas like Altanshiree, entire communities are served by fewer than ten healthcare workers who often travel extensively, sometimes on horseback or by motorcycle, to reach patients living in traditional yurts scattered across the steppes. This shortage undermines not only service delivery but also the system’s capacity for preventative care and chronic disease management.
Structural challenges within the healthcare workforce compound these access issues. A persistent hierarchical model in Mongolia’s health institutions limits the scope of practice for nurses and mid-level professionals. Despite steady progress since 2010, with an increasing number of faculty holding international graduate degrees, most nurses remain classified as assistants to doctors and cannot independently manage patient care, especially in perinatal contexts, without direct physician orders. In remote settings, mid-level practitioners known as assistant doctors fill crucial roles bridging the gap between nursing and physician care. Nevertheless, their potential remains curtailed by institutional norms and regulatory frameworks that restrict autonomous practice, thereby limiting their ability to extend healthcare reach in underserved locales.
Another formidable challenge confronting Mongolia’s health system is the deficient emphasis on disease prevention. The country’s leading mortality causes—respiratory, digestive, genitourinary, and circulatory diseases—point to an urgent need for more robust preventive strategies. Yet, Mongolian national guidelines inadequately incorporate routine screenings for prevalent risk factors such as hypertension, diabetes, and colon cancer. Cultural dietary habits exacerbate these health burdens; high consumption of salty milk tea, sugary desserts, and meat-heavy meals contribute to the increasing prevalence of non-communicable diseases. This confluence of lifestyle and systemic gaps highlights the pressing necessity for culturally tailored public health interventions that resonate with Mongolian traditions while promoting disease prevention.
Looking forward, the research team forwards multiple pragmatic strategies to enhance Mongolia’s healthcare landscape. Paramount among these is strengthening Mongolia’s ‘third neighbor policy’—a diplomatic framework aimed at fostering international partnerships beyond its immediate neighbors, Russia and China. By deepening relationships with countries like the United States and Japan, Mongolia could harness technical assistance and knowledge exchange to bolster healthcare education, workforce development, and the integration of World Health Organization (WHO) guidelines on preventive health.
The potential of technology also figures prominently in the researchers’ roadmap for a transformed healthcare system. Telemedicine and online platforms could bridge vast physical distances, connecting urban-based specialists with healthcare providers and patients in remote communities. This virtual extension of healthcare expertise would dramatically reduce geographical barriers and improve timely care access. Additionally, redefining the professional boundaries of nurses and midwives, empowering them with greater autonomy, would optimize scarce human resources and enable more comprehensive care delivery across Mongolia’s diverse settings.
Moreover, embedding health screenings and preventive services into existing community and religious gatherings offers a culturally sensitive avenue to expand disease prevention. Mongolia’s unique social fabric and community cohesion present opportunities to integrate health promotion into traditional events, enhancing uptake and reducing stigma associated with medical interventions. Dr. Yoshino underscores that such approaches could cultivate a healthcare environment that is not only more accessible but also more deeply aligned with the lived realities of Mongolian people.
In conclusion, this analysis paints a nuanced picture of Mongolia’s healthcare system—one fraught with challenges yet buoyed by significant strengths. The country’s centralized healthcare coverage, rich traditions of medicine, and committed workforce provide a sturdy foundation. Nonetheless, overcoming geographic isolation, workforce shortages, and preventive care gaps demands multidimensional approaches underscored by policy innovation, international collaboration, and technological advancement. By capitalizing on these opportunities, Mongolia can craft a healthcare model tailored to its unique environment and population needs, ensuring equitable and effective care from the nomadic steppes of the Gobi Desert to the bustling streets of Ulaanbaatar.
Ultimately, Mongolia’s journey toward a more resilient and inclusive healthcare system reflects broader global themes—the need to adapt health delivery to diverse geographies, respect cultural practices, and harness innovation to overcome structural inequities. As other nations grapple with similar dilemmas in rural healthcare provision, Mongolia’s evolving strategies may serve as instructive exemplars of how traditional strengths and modern science can be harmonized to meet twenty-first-century health challenges.
Subject of Research: Healthcare system analysis and improvement strategies in Mongolia
Article Title: The strength and weakness of Mongolian healthcare: From nomadic Gobi to Ulaanbaatar
News Publication Date: March 14, 2025
Web References:
https://jogh.org/2025/jogh-15-03015
http://dx.doi.org/10.7189/jogh.15.03015
References:
Chen W-T, Mangal O, Munkhbaatar K, Vankhuu E, Arbing RH, Yoshino Y, Sophia University Global Health Practicum Team. The strength and weakness of Mongolian healthcare: From nomadic Gobi to Ulaanbaatar. Journal of Global Health. 2025 Mar 14;15:03015. DOI:10.7189/jogh.15.03015.
Image Credits: Associate Professor Yae Yoshino from Sophia University, Japan
Keywords: Mongolia healthcare, rural health disparities, traditional medicine, healthcare workforce, telemedicine, disease prevention, semashko system, global health, healthcare policy, health equity, nomadic populations, healthcare innovation
