Ulaanbaatar 2013

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Mongolia Compact Gender Summary Report: Best Practices And Lessons Learned7 HEALTH PROJECTCase study: Interventions Targeting MalesIn the course of collecting and analysis data on beneficiaries, the health project discovered that thecoverage of men aged 40 and above in its activities was low, especially in urban areas in the screeningand early detection of non-communicable diseases (i.e., diabetes and arterial hypertension). A numberof focus group discussions were conducted to explore and determine menthe reasons for their lowparticipation. The qualitative assessment also explored overall public understanding, awareness andattitudes towards non-communicable diseases and accessibility of information delivered by the MCA-Mongolia Heath project.As the study findings show, men had some information about the non-communicable diseases(NCDs), as three out of four respondents noted they had heard of diabetes and arterial hypertension.The majority of respondents said that they visit a doctor only in case they have pain or symptoms, buthave never visited a medical practitioner as a way of prevention or early detection. Although the datareveals that around 70% of the respondents had heard about the ongoing screening campaign, theawareness raising did not really improve the attendance rate among men in screening and earlydetection of NCDs due to:‐ Lack of information in regards to particular services‐ Lack of own responsibility for health among men‐ Lack of communication and relations between government organizations‐ Physicians and other health care professionals‟ disrespectful, rude, and unfair attitudes towardspublic or their social status‐ Physicians and other health care professionals‟ unfavorable attitudes towards patients.As a result of the survey and focus group discussion, a number of modifications were made to projectoutreach activities, as described in the section that follows below.7.1 IntroductionThe main goal of the project is to decrease mortality and disability due to Non-CommunicableDiseases and Injuries (NCDI) and to increase the length and quality of life ofMongolians. To reach this goal, the following objectives were defined as priorities:‣ Increase awareness of population on NCDI prevention‣ Prevention and early detection of NCD‣ Provision of an effective, affordable and longtime treatment of NCD;‣ Prevention and improved response to road traffic injuries;‣ Introduction of international best practices in the field of NCD diagnosis and treatmentand road traffic injuries;‣ Improvement of quality and access to NCD health care.7.2 Key Issues identified in the 2011 GIPThe following issues and recommended entry points were identified during the 2011 GIP:‣ Issues of access and awareness of preventative health practices across groups, rural/urbandisparities‣ The need to better understand differences in men and women‟s knowledge, attitude and practicewith regard to health‣ Women‟s primary role in healthcare, both in the home and in staffing of health care systems‣ Advocacy: BCC/IEC strategies to target men and women through differentiated messages andchannels (already underway)28Page 28 of 80
Mongolia Compact Gender Summary Report: Best Practices And Lessons Learned‣ Ensure that materials do not reinforce the stereotype of women as the de facto health careprovider and in fact present an image of men as equally responsible for their own and theirfamilies‟ health‣ Data Collection / M&E: Adjustment to KAP follow up studies, including road traffic study, toensure that they can include gender analysis.7.3 Issues identified during 2012 GIP ReviewDuring the GIP 2012 review it was revealed that there is a need to stress the importance ofconsidering benefits going to men as well as women. For example, diabetes and hypertensionscreening for 40-64 year olds had low participation rates among men and needed to be strengthened.The project committed to addressing this concern through its public outreach efforts; namely, morefocus was given to targeting men via aimag health departments and district health centers.Additionally, the following priorities were identified as needed:‣ Small scale (rapid) research to evaluate men‟s likely participation in diabetes and hypertensionscreening, and what would be likely to increase their participation, followed by an effort toincorporate this into the screening process and possible targeted outreach to men to encouragetheir participation‣ Seek ways – perhaps through small-scale parallel research – to ensure that the second KAP studymay be more gender-responsive‣ Successor should be targeted for awareness raising and capacity building on gender integrationand the best practices of the health project.7.4 Key accomplishments in integrating genderThe health project covers the entire country and has had high levels of participation of women. Thegeneral understanding of diabetes and of its preventability has improved among the rural population,men and younger populations. Significant percentages of women believe that signs of breast cancercan be detected at an early stage and 53.9% of rural women were covered by the health professional‟scheck-up of breast cancer. The awareness of the recommended frequency of participation in cervicalcancer screening increased by 28% and of the possibility of cervical cancer prevention by HPVvaccination increased by 30% during the recent years. 3 Some of the reasons for the high participationof women have been due to the nature of the activities – e.g. targeted interventions re: cervical andbreast cancer – which target female health issues.The project also focused on gender-specific roles and behavior as they relate to health, includingmale-targeted interventions and those benefitting the disabled. As of April 2013 more than 300,000people were screened for hypertension and diabetes mellitus type II. Unfortunately, sex-disaggregateddata on overall screening coverage is not available. Data for screening coverage of disabled peoplewas collected only in Ulaanbaatar, the capital city. According to this information 12,976 out of total16,822 disabled people aged 30-60 who live in UB city were not involved in NCD screening. As aresult of the screening campaign initiated by MCA-Mongolia targeting at people with disabilities, anestimated 10,362 of them went through preventive health check-up.In activities with broad targets, such as access to information, education and communication (IEC)and behavior change communication (BCC), the Health project has included gender analysis in orderto best target its messages. For example, research on health seeking behavior for breast and cervicalcancer revealed that women are unwilling to communicate their cancer concerns with husbands.Therefore, posters were developed targeting men with messages such as “Please, encourage your3 “Knowledge, Attitude and Practice of General Public on NCDI” survey report by the National Center for Public Health andMCA-Mongolia, 2013Page 29 of 8029
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