The new Constitution, adopted by referendum on June 5,1995, declares Armenia as a « sovereign, democratic state, based on social justice and the rule of law .
Administratively, the country is divided into 11 provinces, called Marz, including the capital of Armenia, Yerevan, which has the status of province. Governors, who are appointed by the President of the Republic and represent the Central Government, rule provinces. Elected local councils and mayors exercise decentralised local governance in all the communities.
Armenia was the first nation, which adopted Christianity as the countrys State religion in 301 AD the Holy See of the Catholics, the Supreme Patriarch of the Armenian Apostolic Church, is in Echmiatsin, a town 18 km west of Yerevan.
The official language of the country is Armenian. It is the only surviving member of the Thracian branch of the Indo-European group of languages. The Armenian alphabet was created in 405 AD and is remarkably well suited to the phonetic values of the language. From the earliest manuscripts to the latest computer fonts, the Armenian alphabet has undergone no alteration in form or structure.
1.1 Historical overview
The present-day Republic of Armenia occupies a small fraction of the territory of ancient Armenia, which extended from the lesser Caucasus Mountains south across the Armenian plateau to the Taurus Mountains. Archaeological studies trace back the history of Armenia to the 5th millennium BC.
Armenia is mentioned in the Bible as the Araratian Kingdom, historically known as Urartu. The geographic location played an essential role in the history and culture of Armenia. For many centuries, Armenians were in constant warfare with invaders and conquerorsAssyrians, Romans, Byzantines, Parathions, Arabs, and Turkswho ruled over their homeland, although not without meeting the most uncompromising resistance. Throughout these turbulent centuries, Armenians successfully asserted their historical identity and upheld their national heritage against great odds.
In the final part of this history, Armenia connected with USSR, and was one of the 15 Soviet Republics during more than 80 years.
The tumultuous changes throughout the Soviet Union from the late 1980s had inevitable repercussions in Armenia. In 1988, a movement of support began in Armenia for the constitutional struggle of Nagorno-Karabakh Armenians to exercise their right to self-determination. (This predominantly Armenian populated autonomous region had been placed under the jurisdiction of Azerbaijan in 1923). In the same year, Armenia was rocked by a severe earthquake that killed thousands, while the Azerbaijani Government fighting Armenians in Nagorno-Karabakh blocked supplies from both the Soviet Union and the West. These two issues have dominated Armenian politics since the first democratic elections in Armenia during the Soviet era. On September 21, 1991, the Armenian people voted overwhelmingly in favour of independence in a national referendum, and the independent Armenia came into being. The high level of public participation in these revolutionary events in Armenia can account for the stable political situation in the last years: people feel responsible towards society and the economy.
1.2 Diaspora
Armenia has a large Diaspora that is spread all over the world. The formation of the modern Armenian Diaspora is a result of the anti-Armenian policy of the Ottoman Empire that culminated in the first Genocide of the twentieth century. In 1915, about one million people were killed and more than 800,000 deported from their ancestral lands in Eastern Anatolia, Turkey. Currently, there are about 8 million Armenians living in the world, of which 60% live outside Armenia in more than sixty countries.
In recent years, the proportion of professionals, businessmen and civil servants in the Diaspora has grown more rapidly than other professional groups. Many Armenian organisations function in the Diaspora. They link communities of Armenians in the Diaspora.
The independence of Armenia created favourable conditions for the participation of Diaspora Armenians. They help solve the economic, technical, health, and social problems. They also contribute more generally in the creation of the new Armenian State. “Armenia“, “Aznavour for Armenia“, as well as other funds and organisations function successfully. The ties between Armenia and the Diaspora have evolved from the implementation of charitable projects and unilateral help, to the establishment of bilateral co-operation in different spheres.
1.3 Economic and social overview
Since declaring independence in 1991, Armenia has vigorously pursued free-market reforms within a democratic framework, facing acute political and economic difficulties that have beset the country in recent years. The major factors contributing to these difficulties are the devastating earthquake of 1988 that destroyed infrastructures and killed 25,000 persons, the economic blockade (the country has no access to the sea, which makes it economically dependent on neighbouring countries) imposed upon Armenia as a result of armed conflict between the Republic of Azerbaijan and the enclave of Nagorno-Karabakh, the choking off of Armenias major northern trade route due to civil conflict in Georgia, and the considerable economic dislocation associated with the disintegration of the Soviet Union. Economic decline has been reflected in sharp output reductions, falling incomes, reduced trade flows, severe energy shortages, and scarcity of food and other consumer goods.
The social situation in the country and the living conditions remain rather difficult. With respect to poverty, the World Bank estimates that in 1994, 28% of the population had incomes below 40% of average household expenditures, and is classified as either poor or very poor. The most vulnerable peoplesingle/disabled pensioners, orphans, institutionalised children and the elderly, expectant/nursing women and destitute people needing regular social assistanceare identified through PAROS, a government-operated vulnerability assessment system. They constitute 12.5% of the population and can be considered to be living in extreme poverty. Pensioners and others living on fixed incomes account for 40% of the countrys population. The main coping mechanism has been through emigration, humanitarian aid, and the high level of social solidarity, including remittances from the Armenian Diaspora. Elements of a poverty alleviation strategy have been identified in the World Banks poverty assessment for Armenia as well as in the National Human Development Report 1996, promoted by UNDP.
2. Womens Activities in the New Situation
2.0 Legal status of women
Women around the world are seeking empowerment and human rights, including the right to reproductive health and self-determination.
In a country which was rarely independent, the Armenian people considered the family as the main factor for keeping the fabric of society together. The Armenian women played a crucial role in the survival of the nation.
The peculiarity of the social conditions of women in Armenia is in the fact that their constitutional rights are in no way inferior to those of men; legislation now as before recognises equal rights for all regardless of gender, age or ethnic origin. This sets Armenia and the other former socialist states aside from developing countries and even some Western nations. Moreover, the Armenian Constitution in some instances grants women certain advantages and privileges. This has led to women surpassing men in several social indices. Among these are educational level, social benefits, medical coverage, and preferential parenthood rights.
2.1. Real status of women
In social practice, women remain subordinate to men in a number of issues. The Armenian woman traditionally had an accessory role in the family and in society. The way of life, popular rites, social norms and common mentality have presumed a woman’s subordinate role in the family and to her husband. These traditions have not lost their substance even today. For example, the possibilities for promotion are not the same for women as they are for men and women often remain economically dependent upon men. The overall average salary for women is less than two thirds of that of men because of the low involvement of women in high-paid activity. Social mobility for women is lower than for men. Women’s representation in senior civil service positions is as low as 3 to 5%. And, women bear the burden of the so-called informal sector of the economy, which includes assuring the functioning of the family, educating and caring for the children, and the household.
2.2 Violence against women
There is little information about sexual, physical and psychological violence against children and women. In general, national mentality and moral prevent women and children from reporting about violence. There is a telephone counselling service «Trust » for children to report any kind of physical or mental abuse.
2.3 Women in the transition period
The predicament of the development of market relations during the transition period resulted in apparent changes in the condition of women. There seem to be two general tendencies. In 1993 women accounted for 49% of Armenia’s labour force and unemployment among them the same year reached 64%, whereas the same index among men was 36%. Women’s employment in the newly formed private sector was not high, only 45 out of every 1,000 working women were involved in registered small businesses, whereas for men this index was 75. Men take out the majority of bank loans. All sorts of deposits and bequests are also usually made in the name of men. As a result of the privatisation of land in 1991 and 1992, 304,000 individual farms emerged. These lots were registered to women only when there were no men in the family or when a woman was the elder of the family. By rough estimates, the GDI should have declined since 1993 because registered unemployment among women had reached 79% by 1994, thus affecting income levels.
On the other hand, compared with the past more and more Armenian women are attaining active economic positions as opposed to men, who are confused with loss of their jobs in the state sector because of low wages. Women have started to make serious contributions to family budgets, sometimes becoming the sole bread providers. Mostly their activity is in unregistered self-employment (cooking for sale, working as housekeepers, engaging in trade outside of Armenia, etc.). Their social and political activity has also increased: there are three political and 25 women’s social organisations currently registered. A women’s party was rated second by party ballots in recent parliamentary elections, increasing women’s representation from 3.6 to 6.3% in the National Assembly. Women’s educational attainment levels are continuing to increase. Their enrolment in higher education exceeds that of men (54% in 1995).
In 1995 women accounted for 85% of schoolteachers and there is similar evidence in respect to medical, journalistic, judicial and other professions. The overwhelming majority of NGO members are women. Of course, this increase is a partially passive process, because of men leaving these positions. Nevertheless, it gives women a lever for influencing current economic, social, and political processes.
Thus, the market is revealing the economic potential of women, so far unrecognised. Economic crisis and liberalisation processes create favourable conditions for many women to attain economic independence. This appears to be a gain that they will not give away easily.
Equality is the main principle of the international movement for women’s rights. Equal opportunities require laws and opportunities to be gender sensitive. Armenia’s Parliament has ratified most of the conventions protecting women’s rights. The rights of women to vote and to run for office, the right to citizenship and participation in government are guaranteed in the draft constitution. An important objective is to eliminate gender discrimination in employment and compensation as well as to stipulate a number of privileges connected with maternity.
The Parliament of the Republic of Armenia ratified the International Convention on Womens Rights on 9 June 1993.
In October 1994 in Yerevan was conference « Armenian Women on the Verge of the 21st Century », where issues of equal rights for women, social security, health protection and family planning were discussed.
More that twenty Women’s Non-governmental Organisations are registered in Armenia. Women’s opportunities to participate in public activities has increased in the process of democratic reforms.
3. Lifestyles
Health and wellbeing are inextricably linked to the overall conditions of life. The prerequisites for both health and healthy living include feeling free from lifes threats, and having meaningful roles and functions in society, proper education, a decent home, and the necessary earnings to meet basic needs.
The supremacy of health in the concept of human development is indisputable. In social policy there are four ways by which the government can contribute to the improvement of the health status of the population. These are medical and biological research, assuring the availability and quality of medical services, control over the quality of the environment and food along with regulation of hazardous impacts, and, finally, promotion of healthy lifestyles.
3.0 Nutrition
The issue of food has reached crucial dimensions for the 80% of the population of Armenia that lives in absolute or relative poverty or impoverishment. The quantitative and qualitative inadequacy of food negatively affects public health.
There is a programme financed by the Government of the United States and implemented through the Ministry of Health, for nutrition of pregnant and breastfeeding women, and 0-5 year-old children. All pregnant women receive iron and vitamin supplements.
Specialists from National Institute of Nutrition of Rome, Italy visited Armenia in 1998 at the invitation of UNICEF, to assist the Ministry of Health in developing a nutrition surveillance system and designing a national nutrition survey. The survey will focus on the nutritional status of children and women with a particular attention to micronutrient deficiencies.
Nutrition and health policy in women and children:Report on a WHO workshop, Yerevan,Armenia.
A childs right to adequate nourishment, and the duty of society to ensure that a pregnant woman has access to good nutrition, have been matters of concern for over a century. Yet even in the 1990s,babies are still at risk of undernutrition before birth. Recent years have seen increasing evidence of the importance of nutrition for a satisfactory birth outcome. The Workshop was designed for health facility administrators, policy- makers and clinicians interested in nutrition and how food affects the health of women and infants, and was attended by gynaecologists/obstetricians, paediatricians and hygienists working in the saneped system. On the first day a short course for administrators and policy- makers on « Promoting breastfeeding in sanitary facilities » was held, and during the following three days the WHO/UNICEF training module on « Healthy eating in pregnancy and lactation » was pilot tested. Participants gained knowledge on providing health advice for women during pregnancy, birth and the postpartum period with a view to promoting WHO guidelines on healthy eating. The Workshop contributed to developing a national plan of action for Armenia to implement national dietary guidelines for pregnant and lactating women and their families.
Copenhagen WHO Regional Office for Europe 1998
3.1 Healthy behaviour
Armenia has a lowest number of registered cases of alcoholism among former Soviet Republics.
There is no significant data about the consumption of psychotropic drugs. However, cases of death caused by drug abuse increased from 3 in 1988 to 32 in 1994.
The tendency toward tobacco smoking among teenagers in urban areas is especially alarming.
Among adolescent girls (14 to 16 years old) 21% of girls questioned smoked and of these 98% smoked 1 to 5 cigarettes a day, 48% started smoking from the age of 16, 24% from the age of 15 and 20% from the age of 14.
4. Health Care Potential
During the Soviet time the public health care system in Armenia was based upon the principles of social justice and health-care was free of charge. The law on “Health Care and Services” which was signed by the President on April 1996 has started reforms in Health Care system. The health system is presently involved in the transition to a market economy.
The Ministry of Health has focused on decentralisation of the Health Care and introduction of Health Insurance. Also planned is decentralisation of the health care system and privatisation of premises, as well as design of a mechanism for providing low cost treatment to poor patients. However, Maternity, Child Health and some other services are free of charge.
There are 517 outpatient clinics, 182 hospitals with 30,068 hospital beds. Eleven sanatoriums for children and three orphanages are also operational. In 1993, the Health Ministry employed 13,578 physicians. The health-care network is sufficiently developed and there are an adequate number of professionals .
There are innovative programmes for the effective use of human resources, including the computer information centre of the Ministry of Health (help programme management and decision- making) and Diagnostica (a private firm undertaking diagnostic studies and continuing medical education).
5. Obstetrical and Gynaecological Services
There are many Obstetrical and Gynaecological Services in Armenia:
Armenian Research Centre for Maternal and Child Health Protection in Yerevan ;Republican Centre of Perinatology, Obstetrics and Gynaecology in Yerevan ;Centre for Family Planning and Sexual Health in Yerevan ;five independent maternity centres in Yerevan, five in other cities, and regional centres (Gumri,Vanadzor, Hrazdan, Kotaik, Armavir) ;eight obstetric/gynaecological departments in clinical and city hospitals ;33 obstetric/gynaecological departments in central regional hospitals ;22 rural district hospitals with obstetrical beds,
36 independent maternal consultations and 64 obstetrical and gynaecological consulting rooms ;636 feldsher/obstetrical posts.
There is a specialised Centre on Womens Reproductive Health in Yerevan.
The country has 5019 hospital beds in the obstetric/gynaecological departments and institutions and 835 obstetricians and gynaecologists. There is roughly one gynaecologist for every 100 births.
5.0.1 External assistance in reproductive health and family planning
The Ministry of Health has developed the special national programme on human reproduction, which includes the development of a network of Family Planning/Health centres in all administrative districts of the country (Table 3, Table 4, Table 5).
5.0.2 Major institutions in maternal and child health/family planning
National Institute of Reproductive Health
Government MCH/FP services and womens polyclinics at all levels of health care
6. Health Status and Its Trends
6.0. Population general mortality and growth rate
The location of the total population has changed significantly. In 1960 the urban and rural populations were split evenly between urban and rural areas. In 1994 this gap widened, with 67.7% of the population living in urban areas and 32.3% in rural areas. In 1994 two thirds of the population lived in urban areas, and nearly one half the population lived in the capital of Yerevan .
The natural growth rate of Armenia has steadily declined since 1940 from 27.4 per 1000 to 16.3 in 1990.Between 1991 and 1993 the natural growth rate dropped from 15.1 to 8.4%. This may be a consequence of the economic crisis.
In the early sixties, women constituted 52.4% of the total population. Because of the considerable mobility of the population (60% of them being men), the distribution of sexes later became nearly equal. The early nineties reduced the proportion of women reduced to 51.5%.
In the last few years, the population general mortality rate has increased from 6 per 1000 of population in 1990 to 7.36 in 1993 (Table 17, Table 18). The absolute number of deaths within these three years has increased by 5500 (from 22,000 to 27,500) or by 24%. Circulatory diseases are the leading cause of death (3.9 per 1000). Over the last five years, this indicator has significantly increased. It stood at 2.97 in 1989 and reached 3.9 in 1994. Malignant diseases are the second most frequent cause of death. That rate was 0.96 per 1000 in 1993. Deaths due to injuries and poisoning are in third place and equal 0.62 per 1000 . The death rate due to respiratory diseases was 0.51 in 1993.
The available statistics on mortality do not classify the number of deaths according to the initial causes of death (cold, malnutrition, and stress). Furthermore, some causes of death may be related to the prevailing socio-economic situation in the country. In fact, according to some estimates, no less than half of the increase in the number of deaths may be attributed to this particular situation.
6.1 Life expectancy
At the beginning of the 1980s, life expectancy in Armenia was the highest of all the former Soviet republics and higher than the European average. Estimates in 1990 show that it is still one of the highest, but some three years below the European average .
The dramatic decline in life expectancy in 1988 was attributable to the 1988 earthquake. Life expectancy reverted to its previous level in 1989. However, while all other republics show a slight improvement in life expectancy, Armenia is experiencing a decline: male life expectancy declined from 70.4 years in 1981 to 68.5 in 1990, while female life expectancy declined from 76.8 years to 75.4 years.
An incomplete account of the migration caused by the earthquake and conflicts with neighbouring countries may also give rise to some bias in mortality and life expectancy.
6.2 Marriage and divorce practices
A radical change in the reproductive behaviour of Armenia’s population took place within the span of one generation. This was a natural transition from a traditional family type to one that was modern and urban.
Marriage practices have changed during last years. Marriage rates remained fairly constant from 1960 until 1988 when marriages per 1000 population fell below 10 and have not returned to that level. In 1993 the marriage rate was 5.8. The divorce rate was around 1 to 1.4 over the last 20 years, but has dipped to 0.8 in 1993. Low marriage rate may be also connected with the fact, that some couples may not officially register their marriage, to receive Government financial support for single mothers.
Traditionally, the choice of spouse was highly dependent from parents. Now there is a tendency to premarital relations, choice of spouse is less dependent from parents.
In 1993, the average age of marriage was 21.7 for women and 25.8 for men. In 1989-94, the average age at the first marriage for women was 22.2 years.
6.3 Fertility
The fertility rate in Armenia declines. In 1959, it was 4.7; in 1969-70, it declined to 3.2 children per woman; and in 1979-80, it dropped to 2.4. For 1990, the total fertility rate (TFR) increased to 2.7. The projection for TFR for 2010 is 2.3 children per woman.
The rural fertility rate is higher. In 1993 it was 2.5 to the urban rate of 1.7; however, it is also steadily declining.
6.4 Perinatal care
As a result of socio-economical difficulties, the number of women attending prenatal clinics has dropped, especially in the rural areas, and the number of complications during pregnancy and birth has risen. The percentage of pregnant women under the supervision of prenatal clinics in 1993 was 17.6% lower than in 1992. As a result of the difficulty to organise preventive examinations of the « high risk groups » of pregnant women, the incidence of pre-eclampsia and eclampsia cases increased significantly from 2.3% in 1980 to 3.8% in 1990 and to 7.1% in 1993.
Low-iron and low-protein diets have increased the incidence of anaemia among pregnant women.
The number of births at home and under the supervision of not trained personnel has increased. Due to difficulties with transportation, women often arrive very late at the maternity hospitals, in many cases in the placental period of labour.
6.5 Birth rate
After the legalisation of abortion and the introduction of contraception during the 1960s, the birth rate declined.
The 1990 birth rate of 24 has remained stable since 1980. The birth rates among the countrys 37 districts vary from 19 (Yerevan) to 40 (Spitak, hit by the 1988 earthquake).
One of the main characteristics of the birth rate in Armenia, during the period of 1990-95, is the decline of the total number of births in about 39% of women. In multiparas, it declined in 41% and in primiparas in 35% . The recent decline of the birth rate may be explained by the current economic crisis in Armenia.
The most important structural factors of the traditional Armenian family model were the effective absence of births among women over the age of 40, the largest proportion of births (75%) occurs in the relatively narrow age-range of 20 to 29 years, the steady increase (45%) in the proportion of middle-sized families (families with two to three children make up 80% of the total).
The number of pregnancies in women under 19 have increased, while pregnancies those aged 20-29 have decreased. Fertility is especially high in those 15-19 (in 1990 there were 80 live birth per 1000).
During the period 1990-1995, there was a high rate of elderly primiparas. In the age group of primiparas 30 years and over, the birth rate increased from 3,64% in 1990 to 4,5% in 1995; and the rate of primiparas 45 years and over, increased twice, which is very uncommon for a traditional Armenian family.
6.6 Abortion
Abortion has been legally permitted in Armenia since 1955. It is available upon request up to 12 weeks of pregnancy. As modern contraceptive methods have not, and are yet not generally available, abortion rates are very high in Armenia. In 1990, the abortion rate was 29.6 per 1000 women of fertile age. In 1992, the abortion: live birth ratio was 1/2.5 . A WHO survey in 1991 showed, that 63% of married women of reproductive age had at least one abortion and 6% had 10 or more.
6.7 Female mortality and cancer
The leading causes of female mortality are diseases of the circulatory system, malignant neoplasms , diseases of the respiratory system (1992).
Annually, females in Armenia lose a total of 28 902 years of potential life (YPLL) per 100 000 population due to various causes of death. Injuries are the most common, accounting for 15 334 YPLL; circulatory conditions account for 4 816 YPLL; respiratory conditions total 2 140 YPLL; neoplasms 2 744 YPLL; and residual causes account for 3 868 YPLL.
Armenia had a general screening programme for women. However, this programme was closed in 1991 as a result of the economic crisis. Consequently, the detection of malignant neoplasms has decreased and the mortality has increased.
6.8 Maternal mortality
The maternal mortality rate in Armenia is about three times higher than the WHO target for Europe . The primary causes of this high mortality ratio are haemorrhaging, abortions and hypertensive complications. The high rate of post-abortion mortality in the country has been attributed to lack of sanitary supplies, short supply of drugs, and poor skills of health care personnel.
6.9 Infant mortality
Infant mortality is just below the former USSR average . The main causes are conditions in the perinatal period (33%), respiratory diseases (26%) and infectious and parasitic diseases (20%). The actual rates may by underreported because the definition of infant mortality rate as used in Armenia (which is based on that used in the former USSR) differs from that which is recognised by the WHO.
There is a significant difference in infant mortality between urban and rural areas. The infant mortality rate is higher in the rural areas (Table 23), but 70% of all cases of infant mortality is in urban areas, because of the transfer of the severe patients from the rural areas to the hospitals in urban areas.
6.10 Contraception
There are not many official studies on the contraceptive prevalence in Armenia. Available data is very controversial.
Data from the Ministry of Health for 1991 showed that the contraceptive prevalence rate in Armenia is 56%. In the document from WHO Regional Office for Europe, however, it is estimated to be under 10%. From hospital-based studies, data from 1992 showed that 1,6% of women used IUD and 0,06% used OC.
A study in 1991 on contraceptive prevalence and use pattern in Yerevan of 4349 married women, aged 15-44 years showed: 56% currently used contraception; 11% used contraception at some point in the past, but are not current users; 33% never used contraception.
The same study showed, that couples, who currently used contraception (56%), mainly used withdrawal (32%), traditional methods (23%), and condom (28%). The use of IUD was14% and pills 3%.
Modern oral and injectable contraceptives are available since a couple of years in special family planning services and have been received through humanitarian aid as external assistance in Reproductive Health and Family Planning or as free research samples.
Contraceptives are available in private pharmacies in Yerevan, but costs are very high. Outside Yerevan, contraceptives are generally not available.
6.11 Infertility
Data available for 1992 showed a high prevalence of infertility in Yerevan. 21.4% of the women in the study had secondary and 3.2% had experienced primary infertility.
During the last years, as a result of high prevalence of STDs, malnutrition, stress, cold and other causes, the incidence of infertility is very high.
6.12 Sexually transmitted diseases
The incidence of STDs has consistently increased in the early 1990s as a consequence of low socio-economic conditions, poor state of maintenance of basic water supply and sanitation infrastructure, malnutrition, the unavailability of drugs, frequent migration of the male part of the population to different countries for temporary job finding.
Many women, especially in rural areas, do not seek specialised medical care, because of financial problems and because of the shame to have a STD. There is a high practise of treatment without attending the clinic.
Armenia has a Republican Centre for Combating and Prevention of AIDS since 1984. In 1994, it became part of the Republican Centre for Population Health Observation.
AIDS tests are performed for pregnant women in maternity or prenatal clinics, for donors in the blood transfusion service, and for patients at the Infectious Disease Hospital No.1 in Yerevan, where there are specialists in HIV/AIDS treatment.
6.13 Breastfeeding
From 1988 to 1992, the rate of breastfeeding during the first four months decreased from 64% to 37%, the cause of which may be womens opinion, that mothers malnutrition can affect milk quality; and the abundance of child nutrition by humanitarian aid during the first years after the earthquake.
During 1995-97 the National Government, with external assistance, carried out a programme for early and continuous breastfeeding during the first four months of the baby’s life.
In rural areas, 80%- 90% of the women breastfeed their infants for the first six months.
Credits:Dr. Karine Martirosyan in collaboration with the
Geneva WHO Collaborating Centre for Research in Human Reproduction
More Information:http://www.gfmer.ch/Endo/Reprod_health/
Reprod_Health_Eastern_Europe/armenia/Armenia_Martirosyan.html