A woman stands next to her herd of goats on July 25th, 2016, in the Omnogovi (South Gobi) province in Mongolia.
(Photo: Joel Saget/AFP/Getty Images) Article excerpted from the Pacific Standard
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By Didem Tali
The least densely populated nation-state in the world, Mongolia has seen its urban population rise steadily since the collapse of communism in 1990s. Today, two million people out of the country's total population of three million live in urban centers, but a quarter of Mongolians still pursue a traditional nomadic lifestyle.
Many of the health issues in nomadic communities stem from how remote those communities are. In the Gobi Desert and around Mongolia, temperatures can plummet as low as -40C (-40F) in winter and soar to 45C (113F) in summer. Harsh weather conditions and a terrain that is often difficult to navigate pose significant challenges in getting reproductive health services to everyone who needs them.

To address those challenges, Mongolia's government launched a series of reforms, including increasing the number of maternity waiting homes in all districts, to make them more accessible to nomadic women. Waiting homes are places where women carrying high-risk pregnancies can stay until they give birth, to make sure they can be easily transferred to a nearby medical facility if complications arise before the delivery.
"We've managed to reduce the maternal mortality ratio by ensuring delivery in hospitals."

Health authorities also introduced a "two-week" rule, encouraging women in at-risk communities to attend a prenatal clinic two weeks before they are due to deliver, even if they haven't sought any medical support for their pregnancy before then.

"Now, women from nomadic families come to the provincial or district clinic two weeks before the due date. If there's a pregnancy-related complication, a skilled birth attendant is on hand to support them," Kitahara says.

The government has also tapped into the growing mobile and satellite phone networks to help reduce maternal mortality risks. Through a maternal and child health telemedicine network, established in 2008, women across the country can access reproductive health services, including family planning advice and information about cervical cancer.

The UNFPA estimates that around half of deliveries in Mongolia take place in the provinces. Overall, 99.6 percent of births now take place within health facilities that thousands of women didn't have access to in the 1990s.