Phase III: March 01, 2010 – March 31, 2011
Women’s Rights Center together with Gynuity Health Projects has launched an activity on “Feasibility and acceptability of expanding abortion services in Armenia” starting as early as 2006. The main task was to get support and permission of the Ministry of Health of Armenia for the start of the work on promotion and utilization of the medical abortion in the country, as well as registration of appropriate preparations, used in the given method and raise awareness on the method.

During recent years, WRC has succeeded in receiving permission from the Ministry of Health of the Republic of Armenia for the start of the study in three clinics in Yerevan, implementing the task of promoting and utilizing the method of medical abortion in the country; registering the medicaments and raising awareness on the method of medical abortion by conducting trainings in Yerevan and Gyumri for relevant specialists.

The activities envisaged for the implementation for 2010 are the establishment of a Working Group for drafting recommendations for MA national guidelines; organization of trainings and refreshing training, liaising with pharmaceutical companies, key policymakers, NGOs and other important decision makers on drug availability in the country and legislation issues during a round-table meeting; disseminating patient education material on medical abortion in the regions of Armenia.


Phase II: January 01, 2009 - December 31, 2009
As a consecutive continuation of the project “Feasibility and acceptability of expanding abortion services in Armenia”, a number of activities have been carried out by Women’s Rights Center starting from January 2009 to ensure the best and effective implementation of the project’s goal to improve the quality of women’s reproductive health in Armenia.

According to the project, several major events were planned, including dissemination meeting on study findings “Acceptability and feasibility of medical abortion in Armenia”, 2 trainings on medical abortion for obstetrician-gynecologists in both Yerevan and one of the regions of Armenia, as well as a conduct of a TV show to raise public awareness and knowledge on the method of medical abortion.

On May 28-30, 2009 Dr. Susanna Vardanyan, Project Manager participated in the Second International Conference on “Early Terms of Pregnancy: problems, solutions and challenges” held in Moscow.

The date of the dissemination meeting was negotiated and agreed by Ms. Vardanyan and Ms. Tsereteli and settled on July 9, 2009.
On the next day, July 10, 2009 training on medical abortion for doctors of maternity hospitals and clinics from Yerevan city was to be held in the framework of the project.

During the whole period of its activity, WRC was working in close contact with Dr. Tamar Tsereteli, Senior Consulting Associate from Tbilisi, Georgia, G. Avagyan, Leading Specialist of the Ministry of Health and Dr. R. Abrahamyan, Director of the Center of Perinatology as well as with other doctor-investigators.


Phase I: 2006 – 2008
Millions of women every year seek to terminate their pregnancies – the estimates based on figures for the year 2000 indicate that of 210 million pregnancies worldwide, approximately 46 million ended in induced abortion. Nearly half of these abortions were considered to be unsafe (performed by unskilled providers or under unhygienic conditions or both) and resulted in 67,900 deaths.

Armenia has one of the highest abortion rates in the region (2.6 abortions per woman). One factor contributing to high abortion rate is the low use of modern contraception. Expanding choice of abortion services is one important step in improving the quality of women’s reproductive health care. In Armenia, like many of its neighboring countries, abortion is a major method of birth control and an alternative (medical abortion) to surgical abortion was important to be introduced and offered to women.

For almost two decades now, medical abortion using mifepristone and misoprostol has been shown to be a safe, effective, and acceptable option for terminating pregnancies. Research focusing on dosage, route of administration, timing of mifepristone and misoprostol administration, gestational age limits, and location of misoprostol administration seeks to improve treatment regimens even further so that they empower women, minimize side effects, maximize efficacy, and are simple enough to administer in rural areas where health services may be poorly equipped.

Women’s Rights Center together with Gynuity Health Projects has launched a project “Feasibility and acceptability of expanding abortion services in Armenia” starting as early as 2006. The main task was to get support and permission of the Ministry of Health of Armenia for the start of our work on promotion and utilization of the medical abortion in the country, as well as registration of appropriate preparations, used in the given method.

In autumn of 2006 a meeting of the representatives of Gynuity Health Projects with high-ranking officials of the Ministry of Health was organized. As a result, of the negotiations an agreement was reached on the start of our activity. Because of cooperation with the Ministry of Health and Drug Agency of Armenia, in spring 2007 one of the necessary drugs – mifepristone was registered.

A meeting of Dr. Tamar Tsereteli, Senior Consulting Associate and Susanna Vardanyan, the Project Manager with the Leading Specialist of the Ministry of Health G. Avagyan and Director of the Center of Perinatology Dr. R. Abrahamyan was organized in May 2007. During the meeting parties reached an arrangement on conducting the experimental part of the study with the use of mifepristone and training for doctors in 3 clinics of Yerevan, headed by Dr. R. Abrahamyan, in September 2007. Appropriate materials were translated from English into Armenian for acquaintance with the topic and study, responsibilities of the participating parties were settled, and presented by the Director of the Center of Perinatology Dr. R. Abrahamyan, along with the findings of women’s and medical worker’s data surveys.

Since September-October 2007, certain changes took place at RA Ministry of Health: a new minister was appointed. In this connection WRC prepared a new explanatory letter with necessary documents attached and forwarded it to the Minister H. Kushkyan for consideration. When an approval was received from RA Ministry of Health, the last phase - method introduction has launched. The phase included several activities. Simultaneously with these activities, WRC project staff continued keeping in touch with representatives from the Gynuity Health Projects Dr. Tamar Tsereteli, Senior Consulting Associate and Erica Chong, Resident Physician from Baylor College of Medicine. General opinion that participants shared about the training was that it was very helpful and shall affect the doctors’ work in conducting clinical study on mifepristone-misoprostol medical abortion.

During March – April 2008 preparation work on developing IEC material was done. A pamphlet was prepared on medical abortion that contained detailed information about the method. The draft version was forwarded to Ms. Avagyan to proofread and made it more understandable for Armenian women and adjusted its content to our reality. The final versions of both Armenian and English versions of IEC material were sent for design.

At the beginning of May WRC project staff organized a monitoring visit of Dr. Tsereteli to Yerevan. Meetings with research coordinators from all three clinics Ms. Armine Harutunyan, Anna Aghajanyan and Ruzanna Abrahamyan were arranged. All completed study forms were collected and provided to Dr. Tsereteli’s consideration to check and give comments/suggestions.

In June 2008, WRC received a material from Gynuity titled “Expanding choice in abortion services in Armenia” for translation in order to put it in MA bulletin. Material was translated and forwarded to Gynuity Health Projects. In September, published booklets were disseminated among Armenian women for familiarizing on medical abortion method of termination of pregnancy.

Instead of the planned TV Show at the end of 2008, it was decided to have a round table with progressive gynecologists working in the given field and find out their opinions and attitudes on medical abortion, and receive their suggestions and recommendations.

To organize and conduct the round table on medical abortion, WRC had prepared a letter of permission to RA Ministry of Health. All necessary preparation works were undertaken; gynecologists were invited to participate to the round table. Supporting materials were also prepared. The round table was held on October 23, 2008 at Marriott-Armenia hotel.

During various activities undertaken by our organization, every opportunity was used to spread information on medical abortion and the perspectives and advantages of the new method that became available in the country with high contribution of Gynuity Health Projects.

The overall outputs of the project are promising and the goals settled at the start have been reached. Though a new Minister of Health was appointed in October 2007, WRC managed to take appropriate steps to keep the project activities according to the schedule. In spite of certain difficulties, mifepristone was successfully registered in 2007 and imported to Armenia in 2008.

Activities of raising public awareness were considered necessary to carry out in the regions of Armenia as well. A significant importance was given to informing women on safe abortion, on possibilities to acquire knowledgeable consultation of drug usage as well as opportunity to apply for safe and efficient medical abortion method that would improve the quality of women’s reproductive health care in Armenia.
Succeeding monitoring visits were made by Dr, Tsreteli to Yerevan on regular basis in the course of the project implementation.