When is it necessary to refer a patient to inpatient care, in which cases can treatment be continued at home, what medications should be prescribed, which examinations are mandatory... These and many other similar questions are depicted in the clinical guidelines, which aim to assist doctors and improve the quality of care in the field of maternal and reproductive health.
Obstetrician-gynecologist Edita Gharibyan, who has also authored a number of these guidelines, emphasizes their importance as a helpful, supportive tool for the doctor:
"It's true, we shouldn't forget that this is medicine, and there will, of course, be cases requiring an individual approach, and there may be deviations from certain points of the guidelines, but the majority of our work will be performed based on these documents, which will greatly simplify our job, as the doctor will know exactly how to work, how to proceed in specific cases."
Within the framework of close cooperation with the Ministry of Health and the Armenian Association of Obstetricians-Gynecologists, UNFPA initiated the development of clinical guidelines in the field of sexual and reproductive health starting in 2015. Based on these, training courses, including credited simulation training, have been conducted. Since 2023, UNFPA has also been supporting the work on clinical protocols, taking as a basis the special format approved by the Ministry of Health of the Republic of Armenia. To date, 21 clinical guidelines have already been developed, based on the existing clinical guidelines.
Soon, the series of 21 clinical guidelines will be supplemented by four more. A conference dedicated to the discussion and validation of these new guidelines was attended by specialists from the field, obstetricians-gynecologists from Yerevan and the regions.
The new guidelines were developed by obstetricians-gynecologists Rusudan Vardanyan and Edita Gharibyan with the support of UNFPA, in collaboration with the Ministry of Health of the Republic of Armenia.
The guidelines address the following topics: "Management of miscarriages in the first trimester of pregnancy"; "Management of amniotic fluid volume disorders: oligohydramnios and polyhydramnios"; "Management of endometrial hyperplasia and endometrial polyps"; "Management of Rhesus (Rh) isoimmunized pregnancies and fetal hemolytic disease".
In her welcoming speech at the event, Lusine Sargsyan, Head of the UNFPA Armenia Country Office, highlighted the importance of this meeting and noted that the UNFPA is readily assisting the Ministry of Health in its efforts to improve the quality of healthcare services provided in the field of sexual and reproductive health:
"Clinical guidelines and protocols play a crucial role in this process, as they are based on international best practices and evidence-based medicine approaches. We are confident that through joint work and professional cooperation, we can create clinical guidelines that will elevate healthcare services to a higher quality."
The presentation of the guidelines was followed by an active discussion with specialists, during which suggestions and additions were made, and concerns and reservations were also voiced.
"Many questions arose; there were issues that were controversial for us as well, and for the participants, and these needs to be discussed so that we can reach a golden mean," noted Rusudan Vardanyan, adding that a group of specialists worked on these documents, involving clinical residents and young doctors: "The topics of these four new guidelines are very relevant: problems related to miscarriages, indications for hospitalization. These are the issues that the practicing doctor deals with very frequently."
Ani Babelyan, Obstetrician-Gynecologist:
"I can honestly say that the necessity of these guidelines, which will be approved in the future, are very, very important in our lives, in our daily work. I believe all obstetricians-gynecologists will confirm this, because previously we did not have any protocol regarding such topics and there are no specific guiding documents for the doctor on how to proceed, what to do. Of course, our knowledge and experience allow us to make decisions, but being protected in the form of such a guideline is a priority for me."
The agreed-upon proposals resulting from the workshop will be included in the documents and will then be submitted to the Ministry of Health to start the official approval process.
"The validation process is one of the most important components, as it ensures the involvement of the professional community and provides an opportunity to receive feedback and suggestions from specialists in the field, which in turn helps to make the document more comprehensive," notes Narine Beglaryan, Sexual and Reproductive Health Programs Analyst at the UNFPA Armenia CO, adding that the ultimate goal of this initiative is for these guidelines to be effectively implemented in healthcare institutions and have a real impact on the quality of medical care.
