Maternity hospitals to be closed en masse in regions of Armenia

The Armenian Ministry of Health has shut down nine maternity hospitals located in various regions in Armenia.

Throughout 2019, the clinics had less than 150 births, however in many cases, they are the only maternity hospitals within reach for residents of several areas of Armenia.

In the city of Yevghard in the Kotayk region of Armenia, medical workers are holding a protest against the closure of the hospital for the second day in a row.

They object to the ministry’s decision, noting that despite the  poor conditions, serious operations are carried out in the hospital, and all the necessary equipment is in place. Moreover, they say not a singular case of maternal or child death was registered in the past year.

Why, then, is the Ministry of Health shutting down maternity hospitals in the regions?

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Protests against the decision

A protest rally in the city of Yeghvard began on January 13. At first, only employees of the hospital participated in it, then other residents of the city joined them.

“They tell us that the number of births is small. Compared to 2018, in 2019 the indicator increased by 18 to 136. But who said that there should be an even 150 births per year in the districts? If we had proper facilities, then we could handle up to 250 births”, says one of the doctors at Yeghvard Maternity Hospital.

Some local residents and medical workers say the small number of births in the hospital is explained by the fact that the hospital moved to a new place, and many residents of the region were uninformed.

Yeghvard doctors say that the Ministry of Health is cutting down expenses in order to support larger medical centers, and say that the minister of health has never once in the past two years visited the medical center, learned about its problems and has instead ignored the opinion of the local population.

Workers at other maternity hospitals also unhappy

The recently repaired maternity ward of the village of Achajur in the Tavush region is also closing. From January 1, it has stopped receiving state funding. But the doctors continued to work, and in the very first days after the New Year, three women already gave birth here.

Local doctor Nune Nersisyan is worried that the “initiative” of Achajur doctors may have legal consequences – that is, they can still be punished for this:

“But the doctor takes the oath of Hippocrates and cannot refuse help. In addition, doctors only learned on television three days ago that they would no longer receive funding. That is, even if a legal step is followed, they can say that they did not receive a written notice, although the ministry should have provided it two months ago.”

Nune Nersisyan also commented on the obligatory minimum of births, which must be performed by the hospital in order to continue work:

“I don’t know on the basis of what calculations they calculated 150 births, since in Achajur with a population of 5,500 people, the number of births was approximately 90. But last year, the maternity hospital did not work in the first three months, because they said that it would be closed.”

The maternity hospital of the city of Maralik, which serves 17 nearby villages, will no longer work, and 12 people have lost their jobs here.

As for the inhabitants of Maralik and the 17 settlements in the neighborhood, now they will have to go to the city of Gyumri or Artik if necessary, which is a distance of between 12-27 kilometers.

The minister’s response

“Maternity hospitals in Armenia are being closed only so that medical care becomes better,” said Minister of Health Arsen Torosyan.

He believes that the hospitals can guarantee the quality of the services provided only at a certain load. According to him, in a hospital where a thousand operations are performed a year, the level is higher than in one where 100 are performed.

“In medicine, this is an axiom,” said Torosyan.

This is the logic according to which a threshold of 150 deliveries per year was set for maternity hospitals.

However, there are exceptions. The changes will not affect hard-to-reach regions – in particular, the cities of Byrd, Chambarak and Meghri. From here to the nearest maternity hospitals, one has to travels several dozen kilometers.

“In all other cases, it is better to transport the patient 20-30 kilometers, but to provide reliable assistance than to risk the life of the mother and child,” the minister said.

Response on social media

Armenian Facebook users have responded negatively to the decision:

“Dear Mr. Torosyan, if all the necessary conditions are created, none of Tsakhkaovit will come to Yerevan to give birth. As a resident of the village of Tsakhkaovit, I ask you to reconsider your decision.”

“You can’t do anything – starting from some meaningless advanced training courses to closing maternity hospitals.”

“Instead of sending qualified personnel to the regions, you close local hospitals? What are the advantages of this decision?”

“Before making decisions, you need to take into account the opinion of residents!”