To participate in the Pilot Study training (06.05.23), organized by the Reproductive Health Training Center, Chisinau, Moldova –with the Minister of Health (MoH) of Transnistria and Family Planning and Reproductive Health Center from Tiraspol city, dedicated to the launch of the pilot study on Medical Abortion (MA) services via the Telemedicine platform.

Dr Rodica Comendant presented the latest WHO recommendations on the access to safe abortion services, including on MA via Telemedicine and regional perspectives and the prior experience with piloting the MA via Telemedicine, including from Moldova.

Dr Comendant announced the participants (8 stakeholders, amongst which managers of the PLC institutions, ob./gyns, MoH representatives and data collector specialists) about the upcoming start of the Pilot Study: MA via Telemedicine in Transnistria. She answered multiple questions participants had on this new initiative. All the participants expressed their support and were eager to start working on this new intervention in their region. Medical professionals, present at the training, talked about how limited is the access to MA in this region, due to how remote and separated from the rest of country their territory is, and expressed willingness and readiness to implement MA via Telemedicine as soon as possible in this former active conflict region.

To conduct the training of the Pilot Study teams, selected by the Family Planning and Reproductive Health Center in Tiraspol staff, the participants, who were carefully chosen, were introduced by name and their role explained, and then the training began. Conducting this training is an important step towards enhancing the knowledge and skills of the staff. By carefully selecting these participants, we wanted to ensure that the training will be effective and beneficial for everyone involved. We wanted to focus on communication skills, counseling techniques, and ethical considerations related to family planning and reproductive health services.

During the training, participants were instructed on how to correctly fill out the necessary forms, starting with the informed consent. We encouraged their active participation, and hope that we helped build practical skills to help reinforce learning. It was also emphasized the importance of providing client-centered care, respecting cultural diversity, and ensuring confidentiality and privacy.

A method of monitoring and evaluation was discussed and set in place in order to identify areas of improvement and ensure that the study data is collected and used in the best and the most accurate way. We had agreed that we will provide continuous support and mentorship following the training to contribute to the success of the Pilot Study team.

Overall, our comprehensive and well-structured training program  equiped the staff at the Family Planning and Reproductive Health Center in Tiraspol with the necessary knowledge, skills, and attitudes to provide quality care to individuals seeking their services.

The protocol of the study, the study forms, the informed consent, the patient instruction sheet were presented and discussed in depth with the participants. Training materials were printed in advance and distributed to the participants. We supplied them with 50 Medabon  boxes, purchased in advanced for this purpose. As a side note, we had to supply the medication ourselves because there is simply none in their pharmacies and there is no access to any in the entire region.

Moldova’s experience using Telemedicine for MA was presented, web site shared as an example of information – communication tool with the participants. The local website, developed in Transnistria was also presented, with detailed instructions on how to navigate it and what information can be found and where.

Closer to the end, participants were instructed how to fill out the study forms, with step-by-step progress notes, where we had an example study case, where we filled out the answer to each question in our forms, in a way that can be used for future references. We talked about patient safety and confidentiality with the accent on how important is for everyone involved to uphold that and set that as a main priority. A data entry tutorial, with step-by-step instructions was done as well.

The period that the pilot study is to take place was agree to be June-November 2023, with the hopes that they will be able to have the necessary numbers to satisfy the objective of 50 participants. It was also, decided that this period can be extended in case the nr of participants is way too small to have an objective determination on if the method of MA via telemedicine is a viable option to be implemented in the Transnistria region national safe abortion protocol.

Because of the delicate situation the Transnistia territory is in, we have to wear silk gloves so to speak, when interreacting with the MoH representatives, but what this pilot study will do is way more than supply us with some numbers – it will be a MoH approved activity that the local medical professionals can fall back on and justify why this is being done, that is backed up by real data and shown as a way to prove that such a method is needed and is a step forward in the development of any medical and health system.

It was agreed to have monthly monitoring checking’s, to discuss the progress and to clarify certain moments that need more attention than others. We will have an opportunity to track the progress of the work, address any concerns or questions, and ensure that everyone is on the same page. It’s also an opportunity to clarify any important details or moments that require more attention than others, helping to ensure a smooth and successful project.

Our team is very happy with this arrangement and is looking forward to starting the actual work. We will have clear communication and regular updates that will go a long way and help achieve our goal.

Dr Rodica Comendant, RHTC Director