Rotary members lead effort to transform childbirth care in Mongolia

The project’s second phase in 2015 involved Amarjargal Luvsandagva, a midwife at a hospital in Ulaanbaatar, visiting New Zealand for a month to observe pre- and postnatal health care practices. Luvsandagva shadowed Dockrill in hospitals and clinics. Since then, Luvsandagva has participated in trainings and seminars around the world and shares her knowledge with colleagues in Mongolia.

During the third phase in 2016, when the training team returned to Mongolia with updated materials, developed by Dunne, Dockrill, and others, the reach of the project became apparent. Upon arriving, Dockrill learned that at least a half dozen Mongolian TV news networks were covering the trip.

Dockrill credits the partnership with the Ulaanbaatar club and other clubs in Mongolia for the media attention and believes the project could not have been successful without Mongolian members who arranged transportation and translation and advocated for the curriculum to government authorities.

“Their connections throughout the country are why the project exceeded expectations,” Dockrill says.

In this third phase, the team trained more than 300 health care workers — including obstetricians and other doctors — through an expanded, three-day childbirth education course and a one-day emergency skills clinic. Participants discussed how they would incorporate what they’d learned into their practice, which Dockrill calls “a huge deal for the sustainability of the project.”

The team were also able to bring equipment — fetal monitors, hand-held Doppler scanners, syringe pumps, induction pumps, and more — to Mongolia and provide basic training to those using it.

During the fourth phase in 2018, follow-up trips expanded the program further into rural and hard-to-reach areas, making the training available to even more health care workers.

The updated 100-page training manual, created by Dunne and helped developed by Dockrill, was endorsed by the Mongolian Ministry of Health and is now adopted nationwide as the standard curriculum for maternal and infant care, covers topics such as immunization, breastfeeding, pain relief, diet, exercise, and when to call a doctor. The ministry has also made childbirth education mandatory for expectant mothers, who need to attend at least three classes to qualify for a new government payment program. In 2019, the training manual was even translated and adopted for use by the government of Nepal.

The success of the project contributed to the Mongolian government exceeding its 2011 goal of reducing the infant mortality rate to 15 out of every 1,000 live births. The latest data from 2019 puts the rate is 13.4, and it’s expected to keep declining.

Dunne, a member of the Rotary Club of Macedon Ranges, Australia, adds: “You can spend your life in health doing amazing, acute and critical work, maybe even being a busy fool, but nothing has the power to change a whole health care system like education, prevention is easier than cure.”

On World Health Day, 7 April, Rotary honored Dockrill as one of six People of Action: Champions of Health, an award that recognizes those who try to improve health outcomes at home and across the globe. “I never dreamed of this,” says Dockrill, who also credits her colleagues on the vocational training team and the sponsor Rotary clubs for the project’s success. “The dedication and tireless work from members like Samantha and Gary made this success a reality. It’s overwhelming to know that you may have played a small part in saving the lives of hundreds of mothers and babies.”