Medical abortion (MA) is one of the options for pregnancy termination for women in Eastern Europe and Central Asia (EECA); however, MA services are significantly underutilized. Inconvenience and costs associated with two or more mandatory in-person visits for MA likely contribute to reduced uptake. Telemedicine MA (TMA) is uniquely positioned to address barriers to the service. Recent analyses have shown MA via telemedicine services to be highly effective, safe, and acceptable in Moldova (Comendant R, et al. RFCH 2022) and Georgia (Tsereteli N, et al. EJCRHC 2023), and given similar findings in other countries where telemedicine MA is available (Aiken A. et all. BJOG, 2021; Porter Erlank C, et al. BMJ SRH 2021; Chong E. et al. Contraception 2021) the service is expected to be equally successful across the EECA region.
We conducted formative research to assess the feasibility of medical abortion service via telemedicine in five EECA countries: Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, and Uzbekistan. Our goal was to collect data from relevant stakeholders related to MA service delivery barriers and the potential for MA via telemedicine provision. This study aimed at collecting information that could be used to guide a comprehensive initiative leading to the introduction of telemedicine medical abortion in the EECA region.
Structured questionnaires for women, providers, pharmacists/drug distributors, NGOs and policy makers were developed in English and translated into local languages in early 2022. Data collection was started after pre-testing and revision of the instruments. Interviewers were recruited and trained in each country to administer the questionnaire. Formative research participants who were interested and who consented participated in a face-to-face structured interview. Interviews took approximately 30 minutes to complete, and were conducted in local languages in each country. Interviewers asked participants about their knowledge on MA, MA service delivery barriers and the potential for MA via telemedicine provision in their respective countries. All participants were assigned an identification number, and no names or other identifying information were recorded. Data from completed questionnaires were entered into Excel.