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Rehabilitation of the hospital infrastructure in a developing country.

Mongolia is in fact not a developing country at all but a country of transitional economy (since 1990) with a fairly comprehensive health care infrastructure. However, the health care is facing great difficulties comparable to those in a developing country. Hospital infrastructure rehabilitation was a part of a wider health sector development project with 3 remote aimags (provinces) as the target areas. The Mongolian system of health care has been built up over many years as a country-wide network of community-based feldschers and doctors, supported by a hierarchy of hospitals and mobile emergency teams. Health standards are also impacted by many factors (better housing, water supplies, better roads and rail links) outside the control of the Ministry of Health, and of health care providers. The majority of the rural hospitals lack the basic facilities. There are operating theatres without running water, hospitals with electricity only from 8 to 10 in the evening etc. The hygienic standard is unacceptable. Central heating systems do not function. Many of the facilities are underutilised and in poor condition due an ongoing lack of maintenance. The project aimed for a network that would offer services for all people, including nomadic people. The number of rural hospitals was slightly reduced and some of them were upgraded to first referral unit with basic clinical services. Approximately one third of the rural hospitals had to be rebuilt. The project recommended and started multiphased long-term master planning for those 3 aimag hospitals, all of which displayed difficulties similar to the rural hospitals.