The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #61345

Sona Oksuzyan, MD¹, Rebecca Kohler, MPH¹, and Leah Levin, MHS². (1) Intrah/Armenia, 31 Moskovyan Street, Apartment 76A, Yerevan, Armenia, 374-153-2697, dnelson@intrah.org, (2) Intrah/PRIME II, University of North Carolina at Chapel Hill, c/o David Nelson, 1700 Airport Rd., Suite 300, CB #8100, Chapel Hill, NC 27599-8100

Since Armenia’s independence in 1991, grim economic conditions have precipitated a decline in the use of reproductive health services, with growing trends toward delayed prenatal care, births at home and rising maternal mortality. As part of a process to strengthen the accessibility and quality of reproductive health care, the PRIME II Project conducted a qualitative assessment based on the perspectives of women and men regarding prenatal and maternity services in a provincial capital in northern Armenia. Suggesting overwhelming dissatisfaction with services, the findings outline a variety of obstacles women face in receiving quality care. By government decree, maternal health services should be free to all women. The assessment found that clients pay for every aspect of their care regardless of government policy and that quality is linked to social and economic status. The research also uncovered concerns about provider competence, facility cleanliness and client privacy. The assessment suggests that clients feel vulnerable to the vagaries of a health care system that does not meet their needs, are not well informed about the services they should receive, and have inadequate means of ensuring their reproductive and other rights. As a result of this and similar performance assessments, PRIME II is working with the Ministry of Health to strengthen the role of nurses and midwives in offering maternal health services at primary-level facilities. Interventions include training this cadre of provider in clinical and counseling skills and building strong partnerships between health facilities and the communities they serve.

Learning Objectives:

• • Articulate the overall health care situation and service delivery system in Armenia and its transition.
  • Describe the views of Armenian men and women on the weaknesses of the current reproductive health care delivery system.
  • List major recommendations to improve the quality and accessibility of reproductive health care in Armenia based on qualitative research.

Keywords: Access to Health Care, Quality of Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.