External final evaluation of "Impact of air pollution on maternal and child health" project in Mongolia - 2018-2022

Air pollution in urban Mongolia has become a public health crisis where every child and pregnancy is at risk. In winter months, the levels of PM2.5 pollution in Ulaanbaatar city (UB) can reach 1,985 micrograms per cubic meter — nearly 80 times the level WHO recommends as safe1. The vast majority of that pollution is caused by the burning of coal for heating of the homes. Children in particular are suffering from a dramatic increase in morbidity and fatality rates due to increased exposure to air pollution during the cold season. Pneumonia is now the second leading cause of under-five child mortality. Children living in a highly-polluted district of central Ulaanbaatar were found to have 40% lower lung function than children living in a rural area. In Ulaanbaatar (UB), a 3.5-fold increase in foetal deaths in the winter months has been documented. Preliminary analysis shows that in the last 10 years, the incidence of res-piratory diseases in the country has increased alarmingly, including a 2.7-fold increase in flu, flu-like symptoms and asthma2. These harmful effects are likely to manifest throughout their lives - limiting their ability to learn and later to earn a living and fulfil their potential as adults - in turn fuelling intergenerational cycles of disadvantage.

The Swiss Agency for Development and Cooperation (SDC) at the Federal Department of Foreign Affairs (FDFA) commissioned UNICEF Mongolia to implement the four year project. At the impact level, the Project aims to contribute to: 1) reduced prevalence of pneumonia among children under 5; and 2) reduced incidence of pregnancy risks related to air pollution. In order to achieve the impact, it aims to achieve the following outcomes:
1. Improved capacity to generate and disseminate data, research, analysis and information on air pollution and maternal and child health (MCH).
2. Preschool children and pregnant women are at lower health risk from air pollution through community-level risk reduction measures.
3. MCH risk reduction measures are integrated in relevant national and local policies.

Swiss TPH was mandated to conduct the external final evaluation of the project entitled "Impact of air pollution on maternal and child health" in Mongolia. Our interdisciplinary and multi-national team will use a mixed-method approach including a document review, key-informant interviews (KIIs) and focus-group discussions (FGDs), followed by a joint analysis workshop with key stakeholders and a final report.

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