NORTH MACEDONIA – Piloting medical abortion

Medical abortion is not available in North Macedonia as a method for termination of unplanned pregnancy, nor are medical abortion drugs registered in the country. The benefits of medical abortion is now more apparent than ever during the Covid-19 pandemic, since it reduces the need for physical contact with a healthcare worker and overcoming additional barriers to safe abortion care during a time when health systems are overwhelmed.

In March 2021, HERA in collaboration with the University Clinic of Obs & Gyn (in Skopje) started a pilot programme for medical abortion care. The project aims to initiate the the development of a service delivery model for medical abortion in the country following the Ministry of Health approval of the National Clinical Guidelines for safe abortion on 30 December 2020. The national guidelines, for the first time, provide clinical protocols for medical staff to provide medical abortion, which is in compliance with updated WHO standards. Furthermore, within the Preventive Programme for Mother and Child, the Ministry of Health has allocated US$ 10,000 for procurement of abortion pills in order to implement the pilot project in the University Clinic, thus demonstrating the political commitment to ensure medical abortion is integrated within comprehensive abortion care.

As of February, HERA has been supporting the clinic in its efforts to pilot medical abortion care. Together with the clinic staff, they have designed a pilot model for service delivery, done the renovation and refurbishment of clinic premises (where the services will be provided) and conducted the training of the ten medical staff with the support of the Karolinska Institute in Stockholm.

Information leaflets for patients on medical abortion have been also printed. The pilot project is expected to reach 150 women with medical abortion care by the end of October 2021. The pilot programme is intended to be an evaluation study, with the intention of documenting whether medical abortion is as acceptable and safe for women as the surgical procedure. Moreover, the results will enable the development of a national strategy for scaling up availability and accessibility of medical abortion throughout the entire country, especially in circumstances when the pills are not yet registered, the market is very small and give that healthcare providers as yet lack the competencies to deliver medical abortion services.

SOURCE: HERA from Astra CEE Bulletin on Sexual and Reproductive Health and Rights No. 3 (200) 2021, prepared by Antonina Lewandowska. HERA logo at CIDSR