Erdenee, Oyunchimeg

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Changes in handwashing knowledge, attitudes, and practices among primary schoolchildren in Ulaanbaatar, Mongolia during the COVID-19 pandemic
(2025)
Enkhbat, Munguntuul
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Togoobaatar, Ganchimeg
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Erdenee, Oyunchimeg
;
Takekuma, Katsumata Asako
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has highlighted the critical importance of handwashing as a preventive measure against the spread of SARS- CoV-2. This study aimed to assess changes in handwashing knowledge, attitudes, and practices (KAP) among primary schoolchildren in Ulaanbaatar, Mongolia, before and during the pandemic. METHODS: A longitudinal study was conducted with 399 children aged 8-11 years, with data collected in December 2019 (pre-pandemic) and January 2021 (during the pandemic). A self-reported questionnaire was used to assess the children's handwashing KAP, focusing on four critical moments for handwashing: after using the toilet, before eating, after touching visibly dirty or unhygienic things, and after coming home. RESULTS: The results showed a significant increase in handwashing knowledge and attitudes during the pandemic, with the average knowledge score rising from 9.8 to 12.3 and the percentage of correct responses about critical handwashing moments increasing from 23.0 to 80.4%. Handwashing practices also improved, with an increased frequency of handwashing at critical moments, although practice before eating remained unchanged. Sociodemographic factors, such as sex, grade level, and parental education, were associated with handwashing behaviors. Girls were significantly more likely to engage in proper handwashing (AOR = 4.50, p < 0.01), while fourth-grade students showed higher odds of practicing proper handwashing than third-grade students (AOR = 5.27, p < 0.01). Fathers' higher education and maternal self-employment were positively associated with proper handwashing, whereas fathers' employment in public service was negatively associated. The overall KAP scores showed a significant increase during the pandemic, with a mean difference of 3.68 [95% CI = (4.06, 3.29), p < 0.01], indicating a notable improvement in handwashing behavior. DISCUSSION: These findings highlight the importance of health education and interventions in shaping children's hygiene behaviors during global health crises, with lasting implications for public health strategies, particularly in resource-limited settings.
Scopus© Citations 1
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Distribution of midwives in Mongolia: A secondary data analysis
(Elsevier BV, 2020-07)
Erdenee, Oyunchimeg
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Tumejargal, Amartuvshin
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Parchaa, Tsetsegmaa
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Yamazaki, Chiho
;
Koyama, Hiroshi
INTRODUCTION: Midwives are at the core of strengthening the health system, especially in the crucial period around pregnancy, childbirth, and the early weeks of life. In 2016, the national-level maternal mortality ratio in Mongolia was 48.6 deaths per 100,000 live births, but this was much higher (up to 212.9 deaths/100,000) in some rural provinces of the country. The wide variation in maternal mortality between urban and rural areas of Mongolia might be related to the distribution of midwives and equity of access to maternity care. OBJECTIVES: In the present study, we aimed to determine the distribution of midwives in each province of Mongolia and to examine inequality in the distribution of midwives nationwide. DESIGN: A secondary data analysis. METHODS: Data from the Centre of Health Development and the National Statistical Office of Mongolia were obtained and analysed. First, we assessed the distribution of midwives at provincial and regional levels, along with the association between these distributions and the maternal mortality ratio in 2016. We then calculated the inequality of these distributions using the Gini coefficient and examined trends for the years 2010-2016. We compared results for urban, suburban, and rural provinces. Rural areas are sparsely populated and enormous in size, so it may be difficult access to basic healthcare services. It was considered important, therefore, to assess the number of midwives per 1000 km2 as well as the commonly used indicator of per 10,000 population. RESULTS: When the land area in each province was taken into consideration rather than only the population, wider variations between urban, suburban, and rural provinces became apparent. Provinces varied according to the number of midwives per 10,000 population by a factor of three (range 2.0-6.2/midwives); while provinces varied according to the number of midwives per 1000 km2 by a factor of approximately 300 (range 0.2-61.2/midwives). The Gini coefficient for the number of midwives per 10,000 population in 2016, R = 0.201, revealed "relative" equality. This was slightly reduced from R = 0.305 in 2010 and indicated a shift toward equality. However, the Gini coefficient for the number of midwives per 1000 km2 area indicated "severe" inequality of R = 0.524 in 2016. This was increased from R = 0.466 in 2010, indicating that no improvement has been seen over these years. CONCLUSIONS: Our study suggests that two different measures of midwifery distribution should be used as indicators: number of midwives "per 10,000 population" and "per 1000 km2 area". In rural areas such as parts of Mongolia, geographical features and population density are important features of the local context. To deliver healthcare services in a timely manner and within a reasonable distance for pregnant women who need care, the indicator of per 1000 km2 area would be more suitable for rural and sparsely populated areas than the indicator of per 10,000 population, which is commonly used for urban and settled areas. Based on our findings, to reduce the wide gap in MMR between rural and urban areas, we recommend at least one midwife per 1000 km2 area in rural regions of Mongolia.
Scopus© Citations 4

Erdenee, Oyunchimeg

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