Community involvement in health in Mongolia: hospital boards and other participatory structures

Abstract

Under the Soviet central planning model that operated until 1990,the Mongolian population had little or no involvement in decision-making about health care. As part of overall health sector reform in Mongolia, hospital boards have been established, with significant community representation, to guide strategic and financial management and to assist in developing services according to community needs and expectations. We discuss experiences, and steps taken to resolve initial problems. We also describe other more recent participatory models including the family group practice initiative which involves the community choosing their doctor, community management of revolving drug funds, establishment of community health volunteer networks,and the government's information campaign strategy on the reforms. The community participation models in Mongolia are part of an ongoing process of openness and emphasise the commitment to change in that country. We argue that these experiences have the potential to guide and inform similar measures in other transitional countries.