Otgonbayar LUVSANNOROV, Aynur ÖZGE, Derya ULUDÜZ, Semih TASDELEN, Sarkhan AMIRGULIYEV, Tayyar ŞAŞMAZ, Rami BURSTEIN
Neurological Sciences and Neurophysiology - 2026;43(3):107-116
Background: Headache disorders are a significant but underrecognized public health burden, especially in low-and middle-income countries (LMICs) where access to specialized care and effective treatments is limited. Mongolia presents a unique case due to its vast geography, rural population distribution, and underdeveloped headache care infrastructure. This study offers the first nationwide assessment of Mongolia's headache care landscape, highlighting patient burden, medication accessibility, healthcare provider preparedness, and systemic barriers to treatment. Methods: As part of the International Headache Society and MENAA Headache Group initiative, a cross-sectional survey was conducted using a modified version of the HARDSHIP questionnaire. Data on patient demographics, medication access, affordability, provider training, and regional care disparities were analyzed. Results: Providers managed an average of 20.9 patients with headache per week, with 63% of cases involving women and 57.1% of patients aged over 25 years. A significant proportion of patients (45.0%) could not afford medication, and only a minority had access to triptans or migraine-specific therapies. Only 43.4% of providers had received formal training in headache care. Neurologists were significantly more likely to have received headache training and to treat adult patients, whereas non-specialists reported a higher proportion of pediatric patients. Conclusions: This study identifies critical shortcomings in Mongolia's headache care system and highlights urgent needs for reform. Recommended actions include establishing structured headache care pathways, expanding access to medications through national formularies and insurance, enhancing provider training, and utilizing telemedicine to reach underserved regions.
