Bridging Gaps between Education and Practice: Challenges of the Health Social Workers in Mongolia

Background and Purpose: The social work profession began in Mongolia about a quarter century ago, and the Mongolian National University of Medical Sciences (MNUMS) started an undergraduate social work program in 2003. As of 2024, 343 social workers had graduated from the program, of whom 71% work in the health sector. Although they provide essential services, their roles are often ill defined - in part due to discrepancies in education and healthcare policies. The current study aimed to identify core functions and common challenges faced by social workers in the health sector and to draw implications for social work education in Mongolia.

Methods: We sent an online survey with four open-ended questions containing 13 subtopics to 130 graduates with healthcare experience, of whom 46 responded. The questions were designed to clarify their current roles, challenges, and future improvement. We used Nvivo-14 to manage, code and analyse the data.

Results: MNUMS has made three significant changes in the social work undergraduate program since 2003 and 61% of the participants graduated with a second (2012-2019), 10% with the first (2007-2011) and 29% with the current curriculum (since 2020). Regarding work characteristics, 82% of the participants work in the capital city and 18% work in the countryside. 45% of participants were currently working as health social workers, whereas 55% were in public health positions. Just over one quarter (27.82%) were in direct services, 39.07% were in community practice, and 33.11% in administration. Participants in social work positions were more likely to provide individual, group, and community service, while those in public health tended to engage in administrative work, such as writing reports and implementing programs. Direct social work practice is more common at primary healthcare institutions, central hospitals, and specialised centers, whereas community practice is more prominent in primary care. Forty-three percent of graduates identified lack of clarity about their professional roles in the healthcare sector as a pressing challenge. One in five (20.85%) reported feeling undervalued and 17% reported that colleagues and supervisors do not differentiate public health professionals and health social workers. Participants recommendations included developing medical (24.86%) and public health (21.6%) social work, improving the policy environment concerning health social work (24.11), increasing post-graduate training (17.38%), and promoting health social work (10.23%).

Conclusions: Public health is a priority in Mongolia and health social workers are the main workforce in public health service delivery. However, a general lack of awareness about social work in the health sector and the growing need for public health services leads to role confusion. Policy level improvements, alignment between education and healthcare policies, and post-graduate training are suggested solutions.