Nose of dog, eye of elk, and wolf's liver: exploring the interconnectedness of Indigenous health and foraging among the Dukha reindeer herders of Mongolia.

Recent studies show that Traditional Ecological Knowledge (TEK) of Indigenous Peoples' food systems and the transfer of that knowledge to their children are critical to physical and mental health, promote the transfer of language and culture, and further resilience. The aim of this exploratory, medical ecological study was to document TEK about foraging and plant use among the Dukha, a small, semi-nomadic reindeer herding community in Northern Mongolia. Field research was conducted at multiple remote camps in 2019 and 2023. Methods included semi-structured, open-ended interviews (N = 16), photo identification, and participant observation (N = 34 families). Study Informants identified 27 foraged plants. Results placed Dukha foraging practices within a framework illustrating the interconnectedness of their worldview and cultural norms, including the physical and spiritual aspects of the landscape, with health, illness, and curing. Dukha curative knowledge of the flora aligns with both Traditional Mongolian Medicine (TMM) and scientific studies on healing and preventative care. Through foraging and plant use, the Dukha balance relationships with the land and spirits, benefit from better nutrition and physical activity, utilise healing qualities of indigenous flora, and foster the intergenerational transfer of language and traditional knowledge.

Historical background and current situation of pharmacy education in Mongolia.

In Mongolia, the medical education system with a long history has developed with its characteristics since ancient times. Modern medical education, including pharmacy education, began to grow in 1921. Before modern pharmaceutical science developed in Mongolia, pharmacy and pharmacy education were part of Traditional Mongolian Medicine and education. Medical knowledge and experience were transferred from generation to generation through simple teaching. From the sixteenth century, Manba Datsan was established in religious temples to teach Mongolian medicine through discipleship. Modern pharmacy education in Mongolia began in 1926 with the course training of pharmacy technicians, and pharmacist training started in 1961. Pharmacy technician training with a 3-year and pharmacist training with 5-year programs oriented on patient-centered pharmaceutical care are implemented in Mongolia. Pharmacy technicians can also study towards a B. degree in Pharmacy with an additional 3 years of training. As of 2023, seven state-owned and private higher education institutions offer pharmacy education and the number of institutions and students of pharmacy is expected to increase. The pharmacy education policy and the license examination type may be reformable, and the curricula should be regularly updated in line with international trends.

[Medicinal plant resources in Inner Mongolia autonomous region of China and Mongolia: a comparative study].

Inner Mongolia autonomous region of China and Mongolia are the primary regions where Chinese and Mongolian medicine and its medicinal plant resources are distributed. In this study, 133 families, 586 genera, and 1 497 species of medicinal plants in Inner Mongolia as well as 62 families, 261 genera, and 467 species of medicinal plants in Mongolia were collected through field investigation, specimen collection and identification, and literature research. And the species, geographic distribution, and influencing factors of the above medicinal plants were analyzed. The results revealed that there were more plant species utilized for medicinal reasons in Inner Mongolia than in Mongolia. Hotspots emerged in Hulunbuir, Chifeng, and Tongliao of Inner Mongolia, while there were several hotspots in Eastern province, Sukhbaatar province, Gobi Altai province, Bayankhongor province, Middle Gobi province, Kobdo province, South Gobi province, and Central province of Mongolia. The interplay of elevation and climate made a non-significant overall contribution to the diversity of plant types in Inner Mongolia and Mongolia. The contribution of each factor increased significantly when the vegetation types of Inner Mongolia and Mongolia were broadly divided into forest, grassland and desert. Thus, the distribution of medicinal plant resources and vegetation cover were jointly influenced by a variety of natural factors such as topography, climate and interactions between species, and these factors contributed to and constrained each other. This study provided reference for sustainable development and rational exploitation of medicinal plant resources in future.

Applied phosphorus is maintained in labile and moderately occluded fractions in a typical meadow steppe with the addition of multiple nutrients.

Phosphorus (P) is a limiting nutrient second only to nitrogen (N) in the drylands of the world. Most previous studies have focused on N transformation processes in grassland ecosystems, particularly under artificial fertilization with N and atmospheric N deposition. However, P cycling processes under natural conditions and when P is applied as an inorganic P fertilizer have been understudied. Therefore, it is essential to examine the fate of applied P in grassland ecosystems that have experienced long-term grazing and, under certain circumstances, continuous hay harvest. We conducted a 3-year field experiment with the addition of multiple nutrient elements in a typical meadow steppe to investigate the fate of the applied P in various fractions of P pools in the top soil. We found that the addition of multiple nutrients significantly increased P concentrations in the labile inorganic P (Lab-Pi) and moderately occluded inorganic P (Mod-Pi) fractions but not in the recalcitrant inorganic P (Rec-Pi) fraction. An increase in the concentration of total inorganic P was found only when P and N were applied together. However, the addition of other nutrients did not change P concentrations in any fraction of the mineral soil. The addition of P and N significantly increased the total amount of P taken up by the aboveground plants but had no effect on the levels of organic and microbial P in the soil. Together, our results indicate that the P applied in this grassland ecosystem is taken up by plants, leaving most of the unutilized P as Lab-Pi and Mod-Pi rather than being immobilized in Rec-Pi or by microbial biomass. This implies that the grassland ecosystem that we studied has a relatively low P adsorption capacity, and the application of inorganic P to replenish soil P deficiency in degraded grasslands due to long-term grazing of livestock or continuous harvest of forage in the region could be a practical management strategy to maintain soil P fertility.

Investigation and analysis of the current usage status of OTC drug among Inner Mongolian residents / 中国药房

OBJECTIVE To investigate the current usage status of OTC drug among residents in Inner Mongolia Autonomous Region， and to provide evidence for the science popularization of rational drug use. METHODS By approximate random sampling， the questionnaire survey was conducted with the mini-apps Questionnaire Star among the residents aged 19 and above from 7 league or cities of Inner Mongolia Autonomous Region， in order to investigate the current situation of OTC drug use in the region. RESULTS A total of 611 people filled in the questionnaire， and 571 people filled in the questionnaire effectively， with an effective filling rate of 93.45%. According to the results， 18.7% of residents said they did not understand the concept of OTC drugs， 36.1% of residents said they did not know the OTC drug label， and 65.3% of residents did not know the difference between class A and B OTC drugs in terms of OTC drug awareness. And there were statistically significant differences in the scores of OTC drug awareness among different genders， education levels， monthly income and places of residence （P＜0.05）. When choosing OTC drugs， 23.5% of residents still believed in advertisements or friends’ recommendations； 14.5% of the residents did not read the drug instructions carefully before taking drugs. In terms of drug risk， 5.1% of residents had long-term use of OTC drugs； 8.6% of residents reported taking three or more OTC drugs； 2.1% of residents often added other drugs with the same effect or increased the dosage by themselves. They took traditional Chinese medicine， Mongolian medicine and other preparations while taking OTC drugs， accounting for 19.6%， 22.6% and 13.0% respectively. CONCLUSIONS Residents in Inner Mongolia have low awareness of OTC drugs， and their habits of drug use need to be improved. Repeated drug use and overdose drug use are serious， it is necessary to strengthen the publicity and popularization of rational use of OTC drugs.

Nursing policy and practice in Mongolia: Issues and the way forward.

Global inequality exists in the availability of a nursing workforce, supported evidentially by the ratio, in low-income countries, of only 9.1 nurses per 10 000 people versus 107.7 nurses per 10 000 people in high-income countries. Mongolia is no exception with 42.14 nurses per 10 000 people and a nursing shortage severe enough to endanger patient safety and well-being. This paper details both a policy analysis and contextually well-designed recommendations to strengthen Mongolia's nursing science and practice systems. Obstacles that significantly affect the successful development of nursing and midwifery professions in Mongolia include (1) a lack of strategic planning and regulation; (2) low status of nurses and midwives; (3) absence of professional representation for nurses and midwives; and (4) a dearth of strategic programs for postgraduate training of nurses and midwives. The suggested recommendations include the appointment of a chief nursing office within the government and a cohort of nurse leaders to work to establish a nursing and midwifery board as an independent, professional regulatory body in Mongolia to develop and implement standards to ensure best practice, higher standards of nurse education, and regulate the profession.

Nutrient budgets drive the changes in shoot N and P concentrations of plants in Inner Mongolia's grasslands over the past 40 years.

The nutrient budgets of grassland ecosystems have been extensively disturbed by human activity. The aims of this study were to quantify nitrogen (N) and phosphorus (P) budgets, and evaluate their contributions to changes in shoot nutrient concentrations of dominant plants in Inner Mongolia's grasslands over the past 40 years. N and P budgets were assessed using a nutrient budget model based on flowing intensity of nutrients in and out of the grassland. Meta-analysis was then conducted to quantify changes in shoot nutrient concentrations. The N budget remained positive and continued to increase throughout the study period, while enhanced N deposition and increased supplementary feeding dominated N input (76% of the total in 2017). In contrast, the P budget was negative until 2003, and became positive thereafter. The P input was mainly attributed to supplementary feeding (88% of the total in 2017). The mean shoot N concentration in 1979-1986 was 2.25%, while an increase to 2.53% was observed in 2006-2016. In contrast, the mean shoot P concentration was 0.17% in 1979-1991, subsequently leveling off at 0.17% in 2006-2016. The mean shoot N: P ratio basically remain unchanged over time from 16.72 to 15.85. The N surplus caused major increases in the shoot N concentration of the grassland plants; also, the increased P budget to compensate for past P deficiency resulted in no significant change of shoot P concentrations. Consequently, the grassland system had been in the joint N and P co-limitation over the past 40 years.

Chemical and Biological Characteristics of Oxytropis pseudoglandulosa Plant of Mongolian Origin.

Oxytropis pseudoglandulosa is used in Mongolian traditional medicine due to its numerous reported health-promoting effects. To date, there are very few scientific reports that describe this species. In this article, its volatile oil composition, lipid extract composition, total phenolic and flavonoid content, antibacterial and allergenic properties are elucidated for the first time. Hexadecanoic acid, fokienol and tricosane were determined as the most notable components of the volatile oil, at 13.13, 11.46 and 5.55%, respectively. Methyl benzoate was shown to be the most abundant component of lipid extract at 40.69, followed by (E)-prop-2-enoic acid, 3-phenyl- and benzenepropanoic acid, at 18.55 and 9.97%. With a TPC of 6.620 mg GAE g-1 and TFC of 10.316 mg QE g-1, the plant extract of O. pseudoglandulosa indicated good antioxidant activity measured by IC50 at 18.761 µg mL-1. Of the 12 tested microorganisms, B. subtilis and S. cerevisiae were the shown to be most susceptible to the plant extract, with MIC at 2.081 and 0.260% (v/v), respectively. Bet v 1-a major birch pollen allergen found in plant-based foods-was determined to be at 192.02 ng g-1 with ELISA. Such a wide spectrum of biological activity indicated by O. pseudoglandulosa lends credence for its application in food industry. Its exerted antioxidant and antimicrobial effects could improve preservation of low-processed food dedicated for consumers afflicted with allergies. Hexadecanoic acid supplemented in foods with dietary plant extracts could add to the potential anti-inflammatory impact. The analysis of lipid makeup suggests O. pseudoglandulosa extract could also be considered as natural pesticide in organic farming.

Chemical and Biological Profile and Allergenicity of Thymus baicalensis Plant of Mongolian Origin.

Thymus baicalensis is a medicinal plant recognized as a traditional Mongolian therapeutic and health-promoting food supplement. The aim of the study was to check the suitability of the tested plant for supporting the treatment of certain diseases. The following study is the first one to showcase the versatile scope of characteristics of T. baicalensis, including its volatile oil composition, polyphenolic composition, lipid composition, phenolic and flavonoid contents, antioxidant activity, antimicrobial properties and ingestive allergenicity. Myrcene, at 26.15%, was shown to be the most abundant component of the volatile oil. Compounds known as inherent components of the Thymus genus: thymol and carvacrol made up only about 0.24% of the extracted oil. As much as 10.11 g kg-1 of polyphenol compounds were identified as derivatives of luteolin-7-O-glucuronide. The lipid extract was found to be rich in palmitic acid (31.05%), while unsaturated fatty acids were not reported. Spectrophotometric determination of the phenols and flavonoids indicated 7.541 mg of gallic acid g-1 and 4.345 mg of quercitin g-1, respectively. The free radical scavenging activity was determined by the 2,2-difenylo-1-pikrylohydrazyl method at IC50 = 206.97 µg mL-1. The extracts also had a strong inhibitory effect on M. flavus and P. fluorescenes bacteria, as well as S. cerevisiae yeasts. The Bet v 1 and profilin allergens in T. baicalensis were reported at 175.17 ng g-1 and 1.66 ng g-1, respectively.

Ethnobotanical profiles of wild edible plants recorded from Mongolia by Yunatov during 1940-1951.

Mongolian traditional botanical knowledge has been rarely researched concerning the ethnobotany theory and methodology in the last six decades (Pei in Acta Botanica Yunnanica 135-144, 1988, as reported (Martin in Ethnobotany: A methods manual, Chapman and Hall, 1995)). However, most of the known literature of indigenous knowledge and information regarding the use of local wild plants among Mongolian herders was first documented by several botanical research of Russian researchers in Mongolia through the 1940s and 1950s. One of the most comprehensive works was completed by A. A. Yunatov (1909-1967), which is known as "Fodder Plants of Pastures and Hayfields of the People's Republic of Mongolia" (FPM). Yunatov's research sampled forage plants in Mongolia from 1940 to 1951 and subsequently published a study in 1954. The original transcript of FPM was later translated into Chinese and Mongolian (Cyrillic alphabet) during 1958 and 1968. In addition to morphological characteristics, distribution, habitat, phenology, palatability, and nutrition of forage plants, Yunatov`s record collected local names, the folk understanding and evaluation of the forage, as well as other relevant cultural meanings and the use of local wild plants (collected from the wild as opposed to cultivated plants) in FPM through interviews. The book contains the most precious records created in the 1940s and 1950s on folk knowledge of the Mongolians' wild plants in Mongolia. It was composed of 8 chapters and 351 pages in total. The fifth chapter of FPM, entitled "The systematic overview of forage plants," making up 272 pages (77.49% of the total page counts). The order and content of the book-oriented along with profiles of specific plants. Yunatov collected detailed information on plants, such as the local name, morphology, distribution, habitats, ecological characteristics, and phenology. He also discussed the palatability of livestock, particular forage use, other usages, and chemical composition. Through careful reading and understanding of all three versions of the book (in Russian, Chinese, and Mongolian (Cyrillic alphabet)), the FPM-listed information of edible plants was categorized using ethnobotanical dependent analysis. The list of edible plants was ranked based on purposes and ethnobotanical inventories as per methodology and analysis used in the ethnobotany research. FPM listed 35 species are part of 15 families and 25 genera of wild edible plants. Most species belong to Liliaceae and Allium. Naturally grown grain and some food substitutes (plants that could be used as substitutions for typical food) come from the starchy organs, such as seeds, bulbs, roots, and rhizomes of 12, accounting for 34.28% of all species. Wild vegetables come from the parts of a young plant, tender leaves, young fruits, lower leg of stems, and bulbs of 9 species, accounting for 25.71% of all species. There are only three species of wild fruits, accounting for 8.57% of all edible plant species. Tea substitutes consist of leaves, roots, follicle, and aboveground parts of 8 wild plant species, accounting for 22.85% of all species. Seasonings from the wild were made of the elements such as seeds, rhizomes, tender leaves of 7 species, accounting for 20.00% of all species (Fig,8). Similarities and differences are noticeable in utilizing wild edible plants among Mongolian populations living in Mongolia and Inner Mongolia. Six species of wild edible plants listed in FPM have been proven to be collected and consumed by Mongolians from the Genghis Khan era in the twelfth century to the present day. This proved that the Mongolians have a tradition of recognizing and utilizing wild plants, demonstrating historical and theoretical value. Seven species of plants mentioned in this book were closely correlated to the locals' processing of traditional dairy products, meat, and milk food. Yunatov was not an ethnobotanist, but his accurate documentation of interviews and surveys with Mongolians represents valuable information about the collection and consumption of local wild plants during 1940-1951 in Mongolia. His research mission meant to focus on forage grass, the feed plant that sustained livestock, while he also recorded plants consumed by humans. His records on the edible parts and intake methods of some plants are incomplete. Still, it provided ethnobotanical materials of a remarkable scientific value and a living history of ethnobotany in Mongolian regions. Even by today`s standards, it will be challenging to obtain first-hand information of the richness and to the extent of Yunatov's research.

Characterization of metabolites in Saposhnikovia divaricata root from Mongolia.

Saposhnikoviae Radix (SR), derived from the dried root and rhizome of Saposhnikovia divaricata, is a popular crude drug used in traditional Chinese and Japanese medicine. To evaluate the metabolites of S. divaricata roots from Mongolia and to investigate their geographical variation, we developed the HPLC method, determined the contents of 9 chromones and 4 coumarins, and conducted multivariate statistical analysis. All Mongolian specimens contained prim-O-glucosylcimifugin (1) and 4'-O-ß-D-glucosyl-5-O-methylvisamminol (3), and their total amount (5.04-25.06 mg/g) exceeded the criterion assigned in the Chinese Pharmacopoeia. Moreover, the content of 1 (3.98-20.79 mg/g) was significantly higher in the Mongolian specimens than in Chinese SR samples. The specimens from Norovlin showed the highest contents of 1 and 3. The total levels of dihydropyranochromones were higher in the specimens from Bayan-Uul. The orthogonal partial least squares-discriminant analysis revealed that the Mongolian specimens tended to be separated into three groups based on growing regions, in which several chromones contributed to each distribution. Furthermore, 1H NMR analysis revealed that Mongolian specimens had less amount of sucrose and a substantial amount of polyacetylenes. Thus, in this study, the chemical characteristics of Mongolian S. divaricata specimens were clarified and it was found that the specimens from the northeast part of Mongolia, including Norovlin, had the superior properties due to higher amounts of major chromones.

A review of an ancient book of Mongolian medicine translated from Russian / Монголын Анагаах Ухаан

@#In our research article published in journal of Mongolian Medical Science, 2018 №1 (183), we made the following conclusion. These include: </br> 1. Activities of religious envoys from Europe to Qing dynasty (Manchu) and Mongolia, the Imperial Russian Consular office, which was opened in Ikh Khuree (The ancient capital of Mongolia), and documents related to infectious diseases, European medical knowledge and information on medical care are historical facts that European medicine was first “imported” to Mongolia. Based on these facts, the knowledge of European medicine in Mongolia began to spread in the 1720s. </br> 2. It was concluded that the knowledge of European medicine in Mongolia had previously been concentrated in the Ikh Khuree through Qing dynasty (Manchu), Inner Mongolia, and Buryatia in the north, and had gradually spread to some provinces of Mongolia to prevent communicable diseases. </br> Over the next three years, many evidences were found that enriched the history of Mongolian medicine. Among these facts, a book called in Oirat dialect “Ahr surhl” is of great interest as the book provides an opportunity to further confirm that European medicine has begun to spread in Mongolia, as we noted in a previous article. The Russian title of the book is “ Краткое наставление о лечении болезней простыми средствами” and the Mongolian translation in English is “A Brief treatise” (A Brief Instruction on Treating Diseases with Simple Methods). The book is called “Ahr surhl” when translated from Russian into Oirat dialects in Todo Bichig (Clear Script). </br> The first volume was compiled by Professor Osip Kirillovich Kamenetsky, the first Russian physician and member of the Academy of Medicine and Surgery, and the second volume was compiled by Yakov Osipovich Sapolovich and published in St. Petersburg in 1803. Later, with the help of Princess Tseveg Tundutova of Kalmykia, Nikolay Alekseevich Lebedev translated the Oirat dialect into Todo Bichig (Clear Script). </br> The book is one of the historical sources that clarifies on how European medicine spread through Russia in the late 18th and early 19th centuries, and how European medicine and traditional medicine coexisted and developed. It is a brief book compiled by a Russian scholar on the medical knowledge, methods, pharmacology in European medicine. </br> It is important to note that the translation of this book in the Oirat dialect into Todo Bichig (Clear Script) opened the door for the Mongolian people to use European medicine. Therefore, it is true that the knowledge of Western medicine began to spread among the Mongols as early as the 19th century. The only book currently preserved in Mongolia was found in Khuvsgul province in north, not in the Oirat-speaking western provinces of Mongolia. This is a testament to the book’s widespread popularity in Mongolia.

A Dynamic 6,000-Year Genetic History of Eurasia's Eastern Steppe.

The Eastern Eurasian Steppe was home to historic empires of nomadic pastoralists, including the Xiongnu and the Mongols. However, little is known about the region's population history. Here, we reveal its dynamic genetic history by analyzing new genome-wide data for 214 ancient individuals spanning 6,000 years. We identify a pastoralist expansion into Mongolia ca. 3000 BCE, and by the Late Bronze Age, Mongolian populations were biogeographically structured into three distinct groups, all practicing dairy pastoralism regardless of ancestry. The Xiongnu emerged from the mixing of these populations and those from surrounding regions. By comparison, the Mongols exhibit much higher eastern Eurasian ancestry, resembling present-day Mongolic-speaking populations. Our results illuminate the complex interplay between genetic, sociopolitical, and cultural changes on the Eastern Steppe.

Complementary feeding practices and associated factors among Mongolian children 6-23 months of age.

Little is known about factors influencing children's dietary intake in Mongolia, a country undergoing rapid nutrition transition. Using nationally representative data from the 2017 Mongolia National Nutrition Survey, we assessed the nutritional status of children aged <2 years and examined household, maternal, and child factors associated with feeding practices among children aged 6-23 months (n = 938). Multivariable logistic regression models were used to identify predictors of minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). The prevalence of child stunting (length/height-for-age Z-score < -2 SD) was 6.3%, and the prevalence of overweight (weight-for-height Z-score > +2 SD) was 16.8%. The prevalence of anaemia and iron deficiency was 39.0% and 32.2%, respectively, and 73.5% and 85.5% of children had inadequate vitamin A and vitamin D status, respectively. Of children aged 6-23 months, 92.1% (n = 864) had MMF, 49.6% (n = 465) had MDD, and 43.8% (n = 411) achieved MAD. Increased household wealth was positively associated with all three indicators, whereas severe food insecurity was not associated with MMF, MDD, or MAD. Older child age (odds ratio, 95% CI: 1.09 [1.06, 1.12]; p < .001) and maternal dietary diversity (odds ratio, 95% CI: 2.36 [1.67, 3.34]; p < .001) were positively associated with child MDD. Nutrition-specific and nutrition-sensitive efforts are needed to improve the dietary quality of infants and young children in Mongolia and reduce the high burdens of child micronutrient deficiency and overweight in the country.

Diet and Nutrition Status of Mongolian Adults.

(1) Background: Aspects of the Mongolian food supply, including high availability of animal-source foods and few plant foods, are plausibly associated with disease in the population. Data on Mongolian diets are lacking, and these risks are poorly quantified. The purpose of this study was to provide a multifaceted nutritional analysis of the modern Mongolian diet. (2) Methods: The study population consisted of 167 male and 167 female healthy non-pregnant urban and nomadic adults (22-55 years) randomly selected from lists of residents in 8 regions. From 2011-2016, 3-day weighed diet records and serum were collected twice from each participant in summer and winter; anthropometry was collected once from each participant. Serum was analyzed for biomarkers, and nutrient intake computed using purpose-built food composition data and adjusted for within-person variation. Exploratory dietary patterns were derived and analyzed for associations with diet and nutrition measurements. (3) Results: We collected 1838 of an expected 1986 diet records (92.5%), 610/658 serum samples (92.7%), and 315/334 height and weight measurements (94.3%). Sixty-one percent of men and 51% of women were overweight or obese. Consumption of red meat, refined grains, and whole-fat dairy was high, while that of fruits, non-tuberous vegetables, eggs, nuts and seeds, fish and poultry, and whole grains was low. Dairy and red meat were more consumed in summer and winter, respectively. Dietary inadequacy of 10 of 21 assessed nutrients, including fiber, folate, and vitamin D were >50% prevalent, while protein, zinc, and vitamin B12 inadequacy were low. Biochemical evidence of iron and vitamin A deficiency was also low. Three dietary patterns (Urban, Transitional, Nomadic) explained 41% of variation in food consumption. The Urban pattern was positively associated with BMI in multivariate analysis. (4) Conclusions: Results indicate a high prevalence of key dietary inadequacies and overweight among Mongolian adults. Prior studies by our group have suggested that expanded supplementation and food fortification would be effective in addressing micronutrient inadequacies; these strategies should be coupled with measures to mitigate the growing burden of chronic disease.

Distribution of midwives in Mongolia: A secondary data analysis.

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.

Metabolomic profiling of Saposhnikoviae Radix from Mongolia by LC-IT-TOF-MS/MS and multivariate statistical analysis.

Saposhnikoviae Radix (SR) is a commonly used crude drug that is obtained from the root and rhizome of Saposhnikovia divaricata which is distributed throughout China, Korea, Mongolia, and Russia. To evaluate the quality of Mongolian S. divaricata, metabolomic profiling of 43 plant specimens from different regions of Mongolia, as well as 8 SR samples and 2 plant specimens from China, were conducted by liquid chromatography-ion-trap-time-of-flight-mass spectrometer (LC-IT-TOF-MS). LC-MS profiles of the specimens showed uniformity and 30 compounds were tentatively identified, including 13 chromones and 17 coumarins. Among them, 16 compounds were isolated and unambiguously verified by comparing them with the spectroscopic data of standard compounds. Orthogonal partial least squares-discriminant analysis (OPLS-DA) based on LC-MS data from 7 Mongolian specimens and 8 Chinese SR samples as well as 2 plant specimens revealed that these 2 groups were clearly distinguishable and that Mongolian specimens were characterized by an abundance of prim-O-glucosylcimifugin (1). Moreover, the OPLS-DA of the Mongolian specimens showed that they can be discriminated by their growing regions based on the content of 8 chromones. The total content of dihydrofurochromones 1-3 was relatively higher in the specimens from Khalkhgol in the far eastern part of Mongolia, while contents of 10, 11, 15, and 16 were higher in those from Holonbuir in the eastern part. Based on this research, the roots of S. divaricata from Mongolia have potential as a new resource of SR in Kampo medicine.

The transnational Sowa Rigpa industry in Asia: New perspectives on an emerging economy.

This article advances the hypothesis that "traditional" Asian pharmaceutical industries are rapidly growing in size and prominence in contemporary Asia, and identifies a lack of empirical data on the phenomenon. Addressing this gap, the article provides a quantitative outline and analysis of the Sowa Rigpa (Tibetan, Mongolian and Himalayan medicine) pharmaceutical industry in China, India, Mongolia and Bhutan. Using original data gathered through multi-sited ethnographic and textual research between 2014 and 2019, involving 232 industry representatives, policy makers, researchers, pharmacists and physicians, it assembles a bigger picture on this industry's structure, size and dynamics. Revealing a tenfold growth of the Sowa Rigpa pharmaceutical industry in Asia between 2000 and 2017, the study supports its initial hypothesis. In 2017, the industry had a total sales value of 677.5 million USD, and constituted an important economic and public health resource in Tibetan, Mongolian and Himalayan regions of Asia. China generates almost 98 percent of the total sales value, which is explained by significant state intervention on the one hand, and historical and sociocultural reasons on the other. India has the second largest Sowa Rigpa pharmaceutical industry with an annual sales value of about 11 million USD, while sales values in Mongolia and Bhutan are very low, despite Sowa Rigpa's domestic importance for the two nations. The article concludes with a number of broader observations emerging from the presented data, arguing that the Sowa Rigpa pharmaceutical industry has become big enough to exert complex transformative effects on Tibetan, Mongolian and Himalayan medicine more generally. The quantitative and qualitative data presented here provide crucial foundations for further scholarly, regulatory, and professional engagement with contemporary Sowa Rigpa.

A Survey Report on Ikki-Ryo : A Moxibustion Clinic Affiliated with the Uchihara Training Camp (1938-1945) for the Japanese Youth Volunteer Brigade for Reclamation of Manchuria and Mongolia / 日本東洋医学雑誌

Ikki-Ryo was a moxibustion clinic established as part of a national project facility that belonged to the Uchihara Training Camp (1938-1945) for the Japanese Youth Volunteer Brigade for Reclamation of Manchuria and Mongolia. Since such a case is extremely rare in the modern medical history of Japan, this article summarizes the information on Ikki-Ryo obtained through documents collection and analysis, interviews, and fieldwork investigation. Ikki-Ryo was proposed by acupuncturists Bunshi Shirota and Kyohei Tanaka, and was established under the directorship of Kanji Kato. It played a role in the clinical practice and training of moxibustion techniques. The data suggests that Ikki-Ryo provided advantageous clinical effects in the promotion of good health and in the treatment of some diseases (e.g. enuresis, suspected tuberculosis) for the trainees, while it is indicated that this clinic had a certain geographical, organizational, and emotional distance from other medical or healthcare departments at the camp. Although the role of moxibustion has changed throughout history, the concept and activities of Ikki-Ryo are still thought-provoking from the perspective of the diversity, versatility, complementarity, and sustainability of healthcare tools.

Folk nomenclature of plants in Cistanche deserticola-associated community in South Gobi, Mongolia.

Cistanche deserticola is an important medicinal plant in Mongolia. Despite its significant role in local healing systems, little traditional knowledge had been reported. The present study investigated folk names of C. deserticola and other species of the same community in Umnugobi Province, South Gobi region of Mongolia, based on ethnobotanical approaches. The high correspondence between folk names and scientific names of plant species occurring in Cistanche-associated community shows the scientific meaning of folk nomenclature and classification in Mongolia. The Mongolian and folk names of plants were formed on the basis of observations and understanding of wild plants including their morphology, phenology and traditional uses as well. Results from this study will support the conservation of C. deserticola itself, a rare and endangered plant species listed in the Monglian Red Data Book. Our documentation of folk nomenclature based on 96 plant species in the Cistanche community, as a part of traditional knowledge associated with biodiversity, will be very helpful for making strategy of plant biodiversity conservation in Mongolia.