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Due to geographical and socioeconomic disparity stemming from Mongolia’s vast lands and low population, the rural population of Mongolia lacks access to quality health care, especially specialized care. This issue is exasperated by slow and expensive transportation, stemming from poor infrastructure capacity in rural areas. To improve access to quality health care for the rural population, especially mothers and newborns, the Telemedicine Support for maternal and newborn health project was carried out from 2007 to 2019 as a joint effort by the Government of Mongolia, the Government of Luxembourg and UNFPA. With the chief goal to improve health care for pregnant mothers and newborns in rural Mongolia through technological innovations, the project set up a nationwide network of consulting services, empowered physicians and specialists and sharing of knowledge and established a multi-disciplinary expert team for health consultation at the National Centre for Maternal and Child Health. At the tertiary level, the project supported the introduction of new services through the establishment of the Centre for advanced diagnosis in pregnancy, centre for minimally invasive surgery and women’s health, and the advanced centre for newborn care. At the national level, the Telemedicine project’s main activities focused on: - Revision of existing guides in line with international standards; - Policy advocacy on quality Maternal and Child Health Care; - Introduction of international Best Practices; - and Improvement of local case management through capacity development at all 21 provincial health centres. To build the capacity of maternal and newborn health care, the project focused on upgrading health facilities with new technology. The upgrade included: - Ultrasound with Doppler study to help make a correct evaluation of fetal growth. - Neo-natal incubators to ensure the survival of premature babies by keeping them in a controlled environment for observation and care. - Reproductive medicine unit – the first public advanced reproductive medicine centre to assist women who need infertility treatment, particularly those who cannot afford costly private services. - Minimal invasive surgery set to all doctors to operate with an endoscope, which provokes less pain and has a faster recovery rate. -Cardiotocography intrapartum continuous monitoring system to improve intrapartum case management and early detection of fetal and maternal distress during labour. - Nasal continuous positive airway pressure to encourage fetal respiratory recovery with minimal invasion. - Diagnostic and testing kit for biomedical engineers to help hospitals maintain maternal and child health equipment. As part of the project’s capacity-building efforts, a new methodology for training health professionals was introduced. This included: Hands-on surgical skill training for city and rural doctors to improve their skills in gynaecological and obstetrics surgeries. Simulation training to improve hands-on skills, clinical decision-making skills, case management skills, and team management skills in emergency situations, by setting up an artificial environment that mimics real clinical scenarios. This training is now provided at 22 drilling units and 2 advanced simulation centres. Establishment of a distance learning platform to allow doctors and midwives in rural areas to improve their medical knowledge without having to travel for required training. The newly adopted distance learning regulations provide online credits or Continuous Medical Education points to those who finish each course. The Telemedicine project established a teleconsultation system which allows the rural doctors and the expert team at the National Centre for Maternal and Child Health to work as a team. As of now all 21 provincial hospitals and the capital city of Ulaanbaatar are connected. Through telecommunication technology, health experts in the capital city can see patients in remote locations and provide specialist advice to those who seek a second opinion. By establishing a teleconsultation system, the Telemedicine Project created a stronger professional network. Communication and teamwork between the expert team and rural hospitals are greatly improved. Patients are directly benefiting from the enhanced team spirit. Since patient data and information is more easily shared and discussed when the patients are referred to the National Centre for Maternal and Child Health, the experts are more prepared to receive them and take prompt action. Thanks to the Telemedicine project, the overall quality of maternal and child health care in Mongolia improved significantly. This resulted in the reduction of Maternal and Neonatal Mortality. Mongolia became one of nine countries in the world that achieved the Millennium Development Goal 2015 target by reducing the maternal mortality ratio by 75%. In light of the success of the Telemedicine project, the government made revisions to its health policies and adopted new policies to ensure the sustainability of the project. The National Centre for Maternal and Child Health and the Ministry of Health introduced new regulations to support the Obstetrics software and emergency teleconsultation network. The regulations provide protection of patient information and encouraged communication between medical professionals at central and peripheral levels. In accordance with the International Confederation of Midwives, a new midwife Job Description was approved to strengthen the independence of midwives and their collaborative role with obstetricians. The scope of midwifery practices has been expanded to include reproductive health care, such as providing contraceptives and examining for early detection of STIs, and cervical and breast cancer. The role of midwives in helping adolescents was also emphasized. The National Centre for Maternal and Child Health became a distance learning center for midwifery and obstetrical services. The centre is responsible for ensuring smooth coordination of e-learning courses, while the Center for Health Development integrates them into the Continuous Medical Education system and provides online credit to those who participate in online classes. The Telemedicine Project received the prestigious United Nations Public Service Award garnering 1st place in the category of “Innovation and Excellence in Delivering Health Services.” This was the first United Nations Public Service Award any UNFPA office won in the past 15 years.