Working on All Fronts to Counter COVID-19 in Mongolia

Challenge

When the COVID-19 pandemic struck Mongolia, the country faced a number of challenges in responding to the disease. Given the country’s low population density across a vast territory, delivery of essential health services was challenging. There was no comprehensive disease surveillance system, and laboratory capacities were weak. Since 2010, government spending on health has been low at between 6-8 percent of total government spending, which falls short of the 15 percent recommendation of the Abuja declaration. Healthcare facilities were aging, while allocations for maintenance and repairs were low. Frontline health workers, mostly women, faced extreme stress and required psychosocial support.

Approach

The World Bank emergency response project sought to strengthen Mongolia’s capacity to respond to the COVID-19 outbreak and strengthen national systems for public health preparedness. The project provided financing and cross-sectoral technical expertise, and promoted collaboration among different ministries, government agencies and local stakeholders. The project provided medical, laboratory, and personal protection equipment, medical supplies, and laboratory tests to selected hospitals and the World Bank proactively assisted the government to purchase these supplies, ensuring their delivery in time to help protect clinicians. The project financed vaccines used in the national vaccination campaign: this led to much earlier and higher population coverage compared to the rest of the region, averting considerable deaths in later waves. The project contracted the United Nations Children’s Fund (UNICEF) to design and construct a new, energy-efficient central vaccine storage facility with advisory support from the Energy Sector Management Assistance Program (ESMAP) in accordance with international standards.

Results

• Contributed to the objectives of the Country Partnership Framework through enhancing the quality of healthcare services.
• Supported the country’s commitment to address climate change through the new energy-efficient vaccine storage facility, which provides reliable and safe storage for life-saving vaccines while limiting greenhouse gases and local air pollution.
• Helped maintain Mongolia’s level of human capital through supporting the national COVID-19 vaccination campaign.
• The project financed sufficient vaccines to provide two doses to 1.16 million people, nearly half of the eligible population.  This high vaccination coverage averted many deaths in later waves of the pandemic. A new energy-efficient national vaccine storage facility was constructed in three months, which means that all COVID-19 and routine childhood vaccines can now be kept at the right temperature.
• The project provided more than 6,100 units of medical equipment to hospitals around the country so clinicians could prevent, diagnose, and treat COVID-19.
• The project provided 430 vaccination units with cold chain equipment such as fridges, meaning all vaccination units across the country can store vaccines safety and effectively.
• 1,700 healthcare professionals were trained on COVID-19 prevention, of which 85 percent were female. 

Bank Group Contribution

World Bank funding for the project consisted of $63.8 million from the International Development Association (IDA) and $13.8 million from the International Bank for Reconstruction and Development (IBRD). Funding was also provided by the Pandemic Emergency Financing Facility (PEF) in the amount  of one million dollars which purchased personal protective equipment, while ESMAP provided advisory services on energy efficiency to build the new national central vaccine storage facility.

The project contracted UNICEF to design and build a new central vaccine storage facility for the government, and to procure and deliver cold chain equipment around the country. The new building was constructed within three months, with technical support from ESMAP, which was important given the urgency of COVID-19 response. All vaccination units, even in remote areas, now have cold chain equipment to keep vaccines safe while the national vaccination campaign is underway.

Looking Ahead

Continued support would be required for strengthening primary health care providers and improving the capacity of their health staff and health volunteers.

Beneficiary Story

“I am truly grateful to have been fully vaccinated. When I was diagnosed with COVID-19 last summer, I stayed home and recovered without complications even though I have underlying risk factors and I believe this is all thanks to vaccines,” said Undraa Battuvshin, a 65-year-old woman.

“We are really blessed to have state-of-the-art equipment in our hospital. It is saving lives. It saved the life of Iderzaya and many other young and old men and women we treated at the hospital since the COVID-19 outbreak. We are glad to have this equipment at hand to help our treatment," said S. Narangerel, Vice Director, Third State Hospital of Mongolia.