Facilitators and barriers to compliance with a raw coal ban amongst pregnant women and mothers of young children in Ulaanbaatar, Mongolia: A mixed-methods study

Ulaanbaatar, Mongolia, is in the midst of a winter air pollution crisis driven by the combustion of solid fuels in the peri-urban Ger districts to which young children, fetuses and pregnant women are particularly vulnerable. To address this, the Mongolian government banned the sale and use of raw coal in May 2019 and has subsidized and promoted refined coal briquettes as an alternative fuel. This mixed-methods study utilized semi-structured interviews (n = 30) and a questionnaire survey (n = 369) to identify facilitators and barriers to compliance with the ban amongst Mongolian mothers living in Ulaanbaatar. Four main themes were identified that affected compliance: knowledge about air pollution, information sources, initial policy impacts and governance. Facilitators of participants' ban compliance included awareness of the severity of air pollution's health impacts, support for the policy and governmental enforcement. Concerns regarding fuel alternative safety and affordability, as well as uncertainty about the policy itself (inadequate information) were found to be barriers. Incorporation of these insights in future air pollution mitigation strategies could be beneficial for strengthening their effectiveness, both in Mongolia and settings that face similar challenges throughout the world, which in turn could be a crucial step in meeting the 2030 Sustainable Development Goals agenda.