Վիճակագրական գրքույկ - 2020-ին ընդառաջ: Հետադարձ հաշվարկ by The Armenian EyeCare Project

2020-ÇÝ ÀÜ¸²è²æª Ðºî²¸²ðÒ Ð²Þì²ðÎ ²ÞÊ²î²ÜøÜºð ºì ìÆÖ²Î²¶ðàôÂÚàôÜ Ð²ÚÎ²Î²Ü ²ÎÜ²´àôÄàôÂÚ²Ü Ü²Ê²¶ÆÌ

COUNTDOWN TOWARDS 2020 ACTIVITIES AND STATISTICS THE ARMENIAN EYECARE PROJECT

ÈáõÛë Ñ³ÛÇ ³ãù»ñÇÝ

bringing sight to armenian eyes

2020-ÇÝ ÀÜ¸²è²æª Ðºî²¸²ðÒ Ð²Þì²ðÎ ²ÞÊ²î²ÜøÜºð ºì ìÆÖ²Î²¶ðàôÂÚàôÜ Ð²ÚÎ²Î²Ü ²ÎÜ²´àôÄàôÂÚ²Ü Ü²Ê²¶ÌÆ Æð²Î²Ü²òð²Ì ²ÞÊ²î²ÜøºðÀ Ð²Ú²êî²ÜÆ Ð²Üð²äºîàôÂÚàôÜàôØ ºì ÐÐ ´Ü²ÎâàôÂÚ²Ü ²ÎÜ²ÚÆÜ ²èàÔæàôÂÚ²Ü Æð²ìÆÖ²Î²ÚÆÜ ìºðÈàôÌàôÂÚàôÜÀ

COUNTDOWN TOWARDS 2020 ACTIVITIES AND STATISTICS ACTIVITIES CARRIED OUT BY THE ARMENIAN EYECARE PROJECT AND THE EYE HEALTH SITUATION ANALYSIS IN THE REPUBLIC OF ARMENIA êáõÛÝ Ññ³ï³ñ³ÏáõÃÛáõÝÁ ÑÝ³ñ³íáñ ¿ ¹³ñÓ»É ²Ù»ñÇÏÛ³Ý ÅáÕáíñ¹Ç ³ç³ÏóáõÃÛ³Ùμª ²ØÜ ØÇç³½·³ÛÇÝ ½³ñ·³óÙ³Ý ·áñÍ³Ï³ÉáõÃÛ³Ý (²ØÜ Ø¼¶) ¨ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ (Ð²Ü) ÙÇçáóáí: Ðñ³ï³ñ³ÏáõÃÛáõÝáõÙ ³ñï³Ñ³Ûïí³Í ï»ë³Ï»ïÝ»ñÁ å³ïÏ³ÝáõÙ »Ý Ñ»ÕÇÝ³ÏÝ»ñÇÝ, ¨ ÑÝ³ñ³íáñ ¿, áñ ãÑ³ÙÁÝÏÝ»Ý ²ØÜ Ø¼¶ Ï³Ù ²ØÜ Î³é³í³ñáõÃÛ³Ý ï»ë³Ï»ïÝ»ñÇ Ñ»ï: This publication was made possible with the support of the American People through the U.S. Agency for International Development (USAID) and the Armenian EyeCare Project (AECP). The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views of USAID or the U.S. Government.

ºðºì²Ü YEREVAN Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÇÍ The Armenian EyeCare Project

2010

Ðî¸ 617.7:31 ¶Øä 56.7+60.6 º899

Ð»ÕÇÝ³Ï³ÛÇÝ ËáõÙμ Ü³ÇñáõÑÇ æñμ³ßÛ³Ý èáç»ñ úÑ³Ý»ëÛ³Ý ²É»ùë³Ý¹ñ Ø³É³Û³Ý ÜáõÝ» ºÕÇ³½³ñÛ³Ý ì³ñí³ñ³ ø³É³ßÛ³Ý

îíÛ³ÉÝ»ñÇ í»ñÉáõÍáõÃÛáõÝÁª Ü³ÇñáõÑÇ æñμ³ßÛ³ÝÇ Ò¨³íáñáõÙÁª ØÇÝ³ë Ð³Ùμ³ñÓáõÙÛ³ÝÇ

Group of Authors Author Nairuhi Jrbashyan Roger Ohanesian Alexander Malayan Nune Yeghiazaryan Varvara Kalashyan

Data Analysis by Nairuhi Jrbashyan Design by Minas Hambardzumyan

º899 §2020-ÇÝ ÀÜ¸²è²æª Ðºî²¸²ðÒ Ð²Þì²ðÎ ²ÞÊ²î²ÜøÜºð ºì ìÆÖ²Î²¶ðàôÂÚàôÜ¦/ Ü³ÇñáõÑÇ æñμ³ßÛ³Ý, èáç»ñ úÑ³Ý»ëÛ³Ý, ²É»ùë³Ý¹ñ Ø³É³Û³Ý, ÜáõÝ» ºÕÇ³½³ñÛ³Ý, ì³ñí³ñ³ ø³É³ßÛ³Ý/: §Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÇÍ¦ ´³ñ»·áñÍ³Ï³Ý ÑÇÙÝ³¹ñ³Ù, 2010 Ã., 118 ¿ç

Ü»ñÏ³Û³óíáÕ ÝÛáõÃÁ ÝÏ³ñ³·ñáõÙ ¿ Ð²Ü-Ç ÏáÕÙÇó ÐÐ-áõÙ Çñ³Ï³Ý³óí³Í ³ßË³ï³ÝùÝ»ñÁ ¨ »ñÏñÇ μÝ³ÏãáõÃÛ³ÝÁ ïñ³Ù³¹ñí³Í ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÁ: ØÇ¨ÝáõÛÝ Å³Ù³Ý³Ï, ÝÛáõÃÁ å³ñáõÝ³ÏáõÙ ¿ ÐÐ μÝ³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛ³Ý áõ ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ ï³ñ³Íí³ÍáõÃÛ³Ý ·Çï³Ï³Ý ·Ý³Ñ³ï³Ï³ÝÝ»ñ, áñáÝù áñáßáõÙ ÁÝ¹áõÝáÕÝ»ñÇÝ ÑÝ³ñ³íáñáõÃÛáõÝ Ïï³Ý ·Ý³Ñ³ï»É ÇÝãå»ë μÝ³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛ³Ý íÇ×³ÏÁ, ³ÛÝå»ë ¿É ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÇ å³Ñ³Ýç³ñÏÁ »ñÏñáõÙ: This pubication presents the activities carried out by the Armenian EyeCare Project (AECP) in Armenia and services provided to the population. At the same time, it presents the estimates of main indicators of eye health and incidence of main eye diseases in Armenia. These indicators will serve as a basis for policy makers to analyze the eye health situation and estimate the demand of eye care services in the country. ISBN 978-99941-2-463-3

Ðî¸ 617.7:31 ¶Øä 56.7+60.6 º899

´àì²Ü¸²ÎàôÂÚàôÜ Üºð²ÌàôÂÚàôÜ................................................................................................... 66 1. Ð²ÚÎ²Î²Ü ²ÎÜ²´àôÄàôÂÚ²Ü Ü²Ê²¶ÆÌ Ìð²¶ðÆ Üä²î²ÎÜ àô ÜºðÎ²ÚÆê Üì²ÖàôØÜºðÀ.................................................................................. 88 1.1. Ìð²¶ðÆ Üä²î²ÎÀ, ¾àôÂÚàôÜÀ ºì ¶àðÌÀÜÎºðÜºðÀ............................. 88 1.2. Ìð²¶ðÆ ÐÆØÜ²Î²Ü Üì²ÖàôØÜºðÀ............................................................. 99 2. Ð²Ü-Æ §ÈàôÚê Ð²ÚÆ ²âøºðÆÜ¦ Ü²Ê²ÒºèÜàôÂÚàôÜÀ, ¸ð² ´²Ô²¸ðÆâÜºðÜ àô ²ð¸ÚàôÜøÜºðÀ........................................................... 10 10 2.1. Ü²Ê²ÒºèÜàôÂÚ²Ü ¾àôÂÚàôÜÜ àô ÐÆØÜ²Î²Ü ²ð¸ÚàôÜøÜºðÀ................ 10 10 2.2. Ü²Ê²ÒºèÜàôÂÚ²Ü ´²Ô²¸ðÆâÜºðÆ ÀÜ¸Ð²Üàôð ÜÎ²ð²¶ÆðÀ................. 12 12 - ´Ý³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ É³ÛÝ³ï³ñ³Í ½ÝÝáõÙÝ»ñ ¨ μáõÅû·ÝáõÃÛáõÝ............... 12 12 - îíÛ³ÉÝ»ñÇ í»ñÉáõÍáõÃÛáõÝ ¨ ·Çï³·áñÍÝ³Ï³Ý ³ßË³ï³ÝùÝ»ñ.................... 12 12 - ´ÅßÏ³Ï³Ý áõëáõóáõÙ ¨ í»ñ³å³ïñ³ëïáõÙ.................................................... 14 13 - Ð³Ýñ³ÛÇÝ áõëáõóáõÙ......................................................................................... 14 14 - Î³ñáÕáõÃÛáõÝÝ»ñÇ ½³ñ·³óáõÙ........................................................................ 15 15 3. 2003-2009 ÃÃ. ÐÐ ´Ü²ÎâàôÂÚ²ÜÀ Ð²Ü-Ç Ø²îàôò²Ì ²ÎÜ²´àôÄ²Î²Ü Ì²è²ÚàôÂÚàôÜÜºðÆ êºÔØ ÜÎ²ð²¶ÆðÀ............................................................ 20 20 3.1. 2003-2009 ÃÃ. ºðºø Þðæ²ÚòºðÆ ÀÜÂ²òøàôØ Ð²Ü-Æ îð²Ø²¸ð²Ì ²ÎÜ²´àôÄ²Î²Ü Ì²è²ÚàôÂÚàôÜÜºðÆ ²Øöàö ÜÎ²ð²¶ÆðÀ.............................20 20 3.2. 2007-2009 ÃÃ. Ð²Ü-Ç ºððàð¸ Þðæ²ÚòÆ ÀÜÂ²òøàôØ Æð²Î²Ü²òì²Ì ²ÞÊ²î²ÜøÜºðÆ êºÔØ ÜÎ²ð²¶ÆðÀ....................................................................25 25 4. Ð²Ü-Ç îìÚ²ÈÜºðÆ ÞîºØ²ð²ÜÆ ìºðÈàôÌàôÂÚ²Ü ²ð¸ÚàôÜøÜºðÆ ²ØöàöàôØÀ.............................................................................. 27 27 4.1. Ð²Ü-Ç ÎàÔØÆò ¼ÜÜì²Ì ´Ü²ÎâàôÂÚ²Ü ²ÎÜ²ÚÆÜ ²èàÔæàôÂÚ²Ü Ø²êÆÜ îìÚ²ÈÜºðÆ Ð²ì²øØ²Ü àô ØÞ²ÎØ²Ü ØºÂà¸²´²ÜàôÂÚàôÜÀ.............. 27 4.2. Ð²Ü-Ç 2003-2009 ÃÃ. ºðºø Þðæ²ÚòºðÆ ÀÜÂ²òøàôØ ÐÐ ´Ü²ÎâàôÂÚ²Ü Þðæ²ÜàôØ ¶ð²Üòì²Ì ²ÎÜ²ÚÆÜ ÐÆì²Ü¸àôÂÚàôÜÜºðÀ.................................. 29 29 4.3. ÐÐ ´Ü²ÎâàôÂÚ²Ü Þðæ²ÜàôØ ²ÎÜ²ÚÆÜ ÐÆì²Ü¸àôÂÚàôÜÜºðÆ î²ð²Ìì²ÌàôÂÚ²Ü ¶Ü²Ð²î²Î²ÜÜºðÀ` Àêî Ð²Ü-Ç îìÚ²ÈÜºðÆ.................... 34 34 5. 2003-2009 ÃÃ. Ð²Ü-Ç ºðºø Þðæ²ÚòÜºðÆ ÀÜÂ²òøàôØ ÐÐ ´Ü²ÎâàôÂÚ²ÜÀ îð²Ø²¸ð²Ì ²ÎÜ²´àôÄ²Î²Ü Ì²è²ÚàôÂÚàôÜÜºðÀ` Ø²ð¼²ÚÆÜ Îîðì²Ìàì......................................................................................... 39 39 5.1. ²ð²¶²ÌàîÜÆ Ø²ð¼....................................................................................... 39 39 5.2. ²ð²ð²îÆ Ø²ð¼............................................................................................. 41 41 5.3. ²ðØ²ìÆðÆ Ø²ð¼........................................................................................... 42 42 5.4. Îàî²ÚøÆ Ø²ð¼..............................................................................................43 43 5.5. Èàèàô Ø²ð¼ ................................................................................................... 44 44 5.6. ÞÆð²ÎÆ Ø²ð¼.................................................................................................45 45 5.7. êÚàôÜÆøÆ Ø²ð¼............................................................................................ 46 46 5.8. î²ìàôÞÆ Ø²ð¼.............................................................................................. 47 47 5.9. ì²Úàò ÒàðÆ Ø²ð¼....................................................................................... 48 48 Ð²ìºÈì²ÌÜºð....................................................................................................... 50 50

ENGLISH VERSION OF THE BROCHURE................................................................................65 65

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1. §Ð²ÚÎ²Î²Ü ²ÎÜ²´àôÄàôÂÚ²Ü Ü²Ê²¶ÆÌ¦ Ìð²¶ðÆ Üä²î²ÎÜ àô ÜºðÎ²ÚÆê Üì²ÖàôØÜºðÀ 1.1.

Ìð²¶ðÆ Üä²î²ÎÀ, ¾àôÂÚàôÜÀ ºì ¶àðÌÀÜÎºðÜºðÀ

Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÇÍÁ (³ÛëáõÑ»ï` Ð²Ü) μ³ñ»·áñÍ³Ï³Ý Ï³½Ù³Ï»ñåáõÃÛáõÝ ¿, áñ 1992 Ã. ²ØÜ-áõÙ ÑÇÙÝ³¹ñ»É ¿ ³Ù»ñÇÏ³Ñ³Û ³ÏÝ³μáõÛÅ èáç»ñ úÑ³Ý»ëÛ³ÝÁ: Î³½Ù³Ï»ñåáõÃÛ³Ý ³é³ù»ÉáõÃÛáõÝÝ ¿ Ï³ÝË³ñ·»É»É Ð³Û³ëï³ÝáõÙ Ó»éùμ»ñáíÇ ÏáõñáõÃÛáõÝÁ: ²Û¹ Ýå³ï³Ïáí Çñ»Ýó ÷áñÓÁ Ñ³Õáñ¹»Éáõ ¨ ÑÇí³Ý¹Ý»ñÇÝ μáõÅ»Éáõ ³é³ù»ÉáõÃÛ³Ùμ ²ØÜ-Çó Ð³Û³ëï³Ý »Ý ³Ûó»É»É μ³½Ù³ÃÇí μ³ñÓñ³Ï³ñ· ³ÏÝ³μáõÛÅÝ»ñ: ê÷ÛáõéùÇ Ù»ñ Ñ³Ûñ»Ý³ÏÇóÝ»ñÇ ¨ ³ÛÉ Ñ³Ý·³Ý³ÏáõÃÛáõÝÝ»ñÇ ßÝáñÑÇí Ð³Û³ëï³Ý »Ý μ»ñí»É μ³½Ù³ÃÇí Ã³ÝÏ³ñÅ»ù ³ÏÝ³μáõÅ³Ï³Ý μáõÅå³ñ³·³Ý»ñ, ë³ñù³íáñáõÙÝ»ñ ¨ ¹»Õáñ³Ûù: Ð²Ü-Ý Çñ ³é³ù»ÉáõÃÛáõÝÁ ÐÐ-áõÙ Çñ³Ï³Ý³óÝáõÙ ¿ »ñÏñáõÙ áõ ¹ñ³ÝÇó ¹áõñë ·ïÝíáÕ Çñ ·áñÍÁÝÏ»ñÝ»ñÇ Ñ»ï ë»ñï Ñ³Ù³·áñÍ³ÏóáõÃÛ³Ùμ: Ð²Ü-Ç ÑÇÙÝ³Ï³Ý ·áñÍÁÝÏ»ñÝ»ñÝ »Ý` - ÐÐ ³éáÕç³å³ÑáõÃÛ³Ý Ý³Ë³ñ³ñáõÃÛáõÝÁ, - ÐÐ ³ßË³ï³ÝùÇ ¨ ëáóÇ³É³Ï³Ý Ñ³ñó»ñÇ Ý³Ë³ñ³ñáõÃÛáõÝÁ, - ÐÐ μáÉáñ Ù³ñ½»ñÇ Ù³ñ½å»ï³ñ³ÝÝ»ñÁ, ºñ¨³ÝÇ ù³Õ³ù³å»ï³ñ³ÝÁ, ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝù³å»ï³ñ³ÝÝ»ñÁ - ê. Ø³É³Û³ÝÇ ³Ýí³Ý ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÁ, - ø³Ý³ù»é-¼»ÛÃáõÝ μÅßÏ³Ï³Ý Ï»ÝïñáÝÁ, - ºñ¨³ÝÇ å»ï³Ï³Ý μÅßÏ³Ï³Ý Ñ³Ù³Éë³ñ³ÝÇ ÃÇí 1 ÐÎÐ ³ÏÝ³μáõÅ³Ï³Ý ÏÉÇÝÇÏ³Ý, - Ø³ñ½³ÛÇÝ μÅßÏ³Ï³Ý Ï»ÝïñáÝÝ»ñÁ, ³éáÕçáõÃÛ³Ý Ï»ÝïñáÝÝ»ñÝ áõ ´ØÎ-Ý»ñÁ, - ²ØÜ ØÇç³½·³ÛÇÝ ½³ñ·³óÙ³Ý ·áñÍ³Ï³ÉáõÃÛáõÝÁ (²ØÜ Ø¼¶) ¨ Ñ³ñ³ÏÇó ³éáÕç³å³Ñ³Ï³Ý ¨ ÏñÃ³Ï³Ý Íñ³·ñ»ñ, - ´³½Ù³ÃÇí Ï³½Ù³Ï»ñåáõÃÛáõÝÝ»ñ áõ ³ÝÑ³ïÝ»ñ ê÷ÛáõéùáõÙ, - ØÇ ß³ñù »ñÏñÝ»ñÇ ¹»ëå³ÝáõÃÛáõÝÝ»ñ, - ´³½Ù³ÃÇí Ñ³ë³ñ³Ï³Ï³Ý ¨ ÙÇç³½·³ÛÇÝ Ï³½Ù³Ï»ñåáõÃÛáõÝÝ»ñ: Ð²Ü-Ç ·áñÍáõÝ»áõÃÛáõÝÁ Ù»Í³å»ë Ýå³ëï»É ¿ Ð³Û³ëï³ÝáõÙ §ÎáõñáõÃÛ³Ý Ï³ÝË³ñ·»ÉÙ³Ý é³½Ù³í³ñ³Ï³Ý Íñ³·ñÇ¦ Çñ³Ï³Ý³óÙ³ÝÁ: (î»°ë Ñ³í»Éí³Í 2, ÐÐ Ï³é³í³ñáõÃÛ³Ý 02/11/2006 Ãí³Ï³ÝÇ N-43-Ü áñáßÙ³Ý Ï³ï³ñÙ³Ý í»ñ³μ»ñÛ³É ï»Õ»Ï³ÝùÁ:) 8

1.2.

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15 Ñ³Ù³·áñÍ³ÏóáõÃÛ³Ùμ Ð²Ü-Á ³ÝóÏ³óÝáõÙ ¿ Ñ³Ý¹ÇåáõÙÝ»ñ Ý³¨ Ñ³Ù³ÛÝù³ÛÇÝ ³ÏïÇí ËÙμ»ñÇ ¨ μáõÅ³ßË³ïáÕÝ»ñÇ Ñ»ï, áñáÝù ëï³ó³Í ·Çï»ÉÇùÝ»ñÁ ÷áË³ÝóáõÙ »Ý μÝ³ÏãáõÃÛ³ÝÁ` ï»Õ»Ï³ïíáõÃÛáõÝÁ Ñ³ë³Ý»ÉÇ ¹³ñÓÝ»Éáí ³é³í»É Ù»Í Ãíáí Ù³ñ¹Ï³Ýó:

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3. 2003-2009 ÃÃ. ÐÐ ´Ü²ÎâàôÂÚ²ÜÀ Ð²Ü-Ç Ø²îàôò²Ì ²ÎÜ²´àôÄ²Î²Ü Ì²è²ÚàôÂÚàôÜÜºðÆ êºÔØ ÜÎ²ð²¶ÆðÀ ÜÏ³ïÇ áõÝ»Ý³Éáí, áñ μÝ³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ É³ÛÝ³Í³í³É ½ÝÝáõÙÝ»ñÇ ¨ μáõÅû·ÝáõÃÛ³Ý μ³Õ³¹ñÇãÁ Ð²Ü-Ç §ÈáõÛë Ñ³ÛÇ ³ãù»ñÇÝ¦ Ý³Ë³Ó»éÝáõÃÛ³Ý ³é³í»É É³ÛÝ³ï³ñ³Í áõ Ù³ëë³Û³Ï³Ý μ³Õ³¹ñÇãÝ ¿, áñÇ Çñ³Ï³Ý³óáõÙÁ ÑÝ³ñ³íáñáõÃÛáõÝ ¿ ïí»É Ý³¨ Ï³ï³ñ»Éáõ í»ñÉáõÍáõÃÛáõÝÝ»ñ áõ ëï³Ý³Éáõ »ñÏñÇ μÝ³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛáõÝÁ μÝáõÃ³·ñáÕ Ï³ñ¨áñ óáõó³ÝÇßÝ»ñ, ëïáñ¨ Ý»ñÏ³Û³óÝáõÙ »Ýù ³Û¹ μ³Õ³¹ñÇãÇ ßñç³Ý³ÏáõÙ Ð²Ü-Ç` 2003-2009 ÃÃ. Ð³Û³ëï³ÝÇ Ù³ñ½»ñáõÙ Ï³ï³ñ³Í »ñ»ù ßñç³Ûó»ñÇ ÁÝÃ³óùáõÙ Çñ³Ï³Ý³óñ³Í ³ßË³ï³ÝùÝ»ñÇ ë»ÕÙ ÝÏ³ñ³·ÇñÁ: Ð²Ü-Ç í»ñçÝ³Ï³Ý Ýå³ï³ÏÁ ÏáõñáõÃÛ³Ý ¹»Ù å³Ûù³ñÁ ¨ Ð³Û³ëï³ÝÇ Ûáõñ³ù³ÝãÛáõñ μÝ³ÏãÇ Ñ³Ù³ñ Å³Ù³Ý³Ï³ÏÇó ³ÏÝ³μáõÅáõÃÛáõÝÁ Ñ³ë³Ý»ÉÇ áõ Ù³ïã»ÉÇ ¹³ñÓÝ»ÉÝ ¿: ²Û¹ Ýå³ï³ÏÇÝ Ñ³ëÝ»Éáõ Ñ³Ù³ñ Ð²Ü-Á, Ù³ëÝ³íáñ³å»ë, 2003 Ã, Ç í»ñ Çñ³Ï³Ý³óÝáõÙ ¿ §ÈáõÛë Ñ³ÛÇ ³ãù»ñÇÝ¦ Íñ³·ÇñÁ: ì»ñçÇÝë Ð³Û³ëï³ÝÇ ·ÛáõÕ³Ï³Ý áõ ù³Õ³ù³ÛÇÝ Ñ³Ù³ÛÝùÝ»ñÇ μÝ³ÏÇãÝ»ñÇ ßñç³ÝáõÙ ÁÝ¹Ñ³Ýáõñ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ, Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝ, íÇñ³Ñ³ïáõÃÛáõÝ Ï³Ù É³½»ñ³ÛÇÝ μáõÅáõÙ ³ÝóÏ³óÝ»Éáõ ÙÇçáóáí Ýñ³Ýó Ñ³Ù³ñ Ñ³ë³Ý»ÉÇ ¿ ¹³ñÓÝáõÙ μ³ñÓñáñ³Ï ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÁ: §ÈáõÛë Ñ³ÛÇ ³ãù»ñÇÝ¦ Íñ³·ñÇ ßñç³Ý³ÏÝ»ñáõÙ 2003-2009 ÃÃ. Ð²Ü-Ç ÏáÕÙÇó ÐÐ Ù³ñ½»ñáõÙ Çñ³Ï³Ý³óí³Í ³ßË³ï³ÝùÝ»ñÇ ³Ù÷á÷ ÝÏ³ñ³·ÇñÁ, Ñ³ïÏ³å»ë Í³Ýñ³Ý³Éáí 2007-2009 ÃÃ. Ð²Ü-Ç Ï³ï³ñ³Í í»ñçÇÝ ßñç³ÛóÇ ³ñ¹ÛáõÝùÝ»ñÇ íñ³, μ»ñíáõÙ ¿ ëïáñ¨:

3.1. 2003-2009 ÃÃ. ºðºø Þðæ²ÚòºðÆ ÀÜÂ²òøàôØ Ð²Ü-Æ Ø²îàôò²Ì ²ÎÜ²´àôÄ²Î²Ü Ì²è²ÚàôÂÚàôÜÜºðÆ ²Øöàö ÜÎ²ð²¶ÆðÀ ´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2003-2009 ÃÃ. ÁÝÃ³óùáõÙ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ (²ÞÐ) »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É ÐÐ 9 Ù³ñ½»ñáõÙ, ÁÝ¹·ñÏ»Éáí ¹ñ³Ýó ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñÇ μÝ³ÏãáõÃÛ³Ý Ù»Í Ù³ëÁ1: âÝ³Û³Í áñáß ï³ñμ»ñáõÃÛáõÝÝ»ñÇÝ, μáÉáñ ßñç³Ûó»ñÇ Ï³½Ù³Ï»ñåã³Ï³Ý 1 ²Ûë μ³ÅÝáõÙ í»ñÉáõÍí»Éáõ »Ý ÙÇ³ÛÝ ÐÐ 9 Ù³ñ½»ñáõÙ (μ³óÇ ¶»Õ³ñùáõÝÇùÇó ¨ ºñ¨³Ý ù³Õ³ùÇó) 2003-2009 ÃÃ. Ð²Ü-Ç Ï³ï³ñ³Í ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñÇ ³ñ¹ÛáõÝùÝ»ñÁ:

21 ·áñÍ»É³Ï»ñåÁ, μÅßÏ³Ï³Ý Ùáï»óáõÙÝ»ñÁ ¨ áõÕÕí³ÍáõÃÛáõÝÁ ÑÇÙÝ³Ï³ÝáõÙ ÝáõÛÝÝ »Ý: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÇ ËÙμ»ñÁ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ ³Ûó»É»É »Ý »ñÏñÇ 841 ·ÛáõÕ³Ï³Ý áõ ù³Õ³ù³ÛÇÝ Ñ³Ù³ÛÝùÝ»ñ (ÐÐ Ñ³Ù³ÛÝùÝ»ñÇ ßáõñç 90%-Á): Úáõñ³ù³ÝãÛáõñ Ù³ñ½áõÙ Ý³Ëù³Ý Ð²Ü-Ç ³ßË³ï³ÝùÝ»ñÁ ëÏë»ÉÁ ï»ÕÇ »Ý áõÝ»ó»É Ñ³Ý¹ÇåáõÙÝ»ñ Ù³ñ½Ç Õ»Ï³í³ñáõÃÛ³Ý Ñ»ï` Íñ³·ñÇ Çñ³Ï³Ý³óÙ³Ý ÑÇÙÝ³Ï³Ý ËÝ¹ÇñÝ»ñÁ Ñ³Ù³Ï³ñ·»Éáõ Ýå³ï³Ïáí: ´Ý³ÏãáõÃÛáõÝÁ É³ÛÝáñ»Ý ï»Õ»Ï³óí»É ¿ Ð²Ü-Ç ³Ýí×³ñ ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÇ í»ñ³μ»ñÛ³É. Ñ³Ù³å³ï³ëË³Ý Ñ³Ûï³ñ³ñáõÃÛáõÝÝ»ñ »Ý ïåí»É ï»Õ³Ï³Ý Ã»ñÃ»ñáõÙ, Ñ»é³ñÓ³Ïí»É »Ý ï»Õ³Ï³Ý é³¹Çá- ¨ Ñ»éáõëï³Ï³Û³ÝÝ»ñáí, ÇÝãå»ë Ý³¨ ÷³Ïóí»É »Ý μáÉáñ Ñ³ë³ñ³Ï³Ï³Ý í³Ûñ»ñáõÙ (åáÉÇÏÉÇÝÇÏ³Ý»ñ, Ë³ÝáõÃÝ»ñ, ù³Õ³ù³å»ï³ñ³Ý, μ³ÝÏ»ñ, ¨ ³ÛÉÝ): Ø³ñ½Ç μáõÅ³ßË³ïáÕÝ»ñÝ áõ ëáóÇ³É³Ï³Ý ³ßË³ïáÕÝ»ñÁ Ã»° ³ãùÇ ËÝ¹ÇñÝ»ñ áõÝ»óáÕ ÑÇí³Ý¹Ý»ñÇÝ, Ã»° ÁÝ¹Ñ³Ýáõñ μÝ³ÏãáõÃÛ³ÝÁ Ñáñ¹áñ»É »Ý ³Ûó»É»É Ð²Ü-Ç μÅÇßÏÝ»ñÇÝ: ²ÏÝ³μáõÅ³Ï³Ý ½ÝÝáõÙÝ»ñÝ Çñ³Ï³Ý³óÝáÕ μÅÇßÏÝ»ñÇ ËÙμ»ñÁ ï»Õ³Ï³Ûí»É »Ý ï»ÕÇ åáÉÇÏÉÇÝÇÏ³Ý»ñáõÙ, ³ÙμáõÉ³ïáñÇ³Ý»ñáõÙ ¨ ´ØÎ-Ý»ñáõÙ, ¨ μáÉáñ ó³ÝÏ³óáÕÝ»ñÝ ³Ýó»É »Ý ³Ýí×³ñ ³ÏÝ³μáõÅ³Ï³Ý ½ÝÝáõÙ: Ð²Ü-Ç ÏáÕÙÇó μÝ³ÏãáõÃÛ³ÝÁ ïñ³Ù³¹ñíáÕ Í³é³ÛáõÃÛáõÝÝ»ñÝ ³Ýí×³ñ »Ý μáÉáñÇ Ñ³Ù³ñ (Ý»ñ³éÛ³É ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñÁ, ³ÏÝáóÇ ¹áõñë·ñáõÙÝ áõ ÙÇç³ÙïáõÃÛáõÝÝ»ñÁ ²ÞÐ-áõÙ): ²ÏÝ³ÛÇÝ íÇñ³Ñ³ïáõÃÛáõÝÝ»ñ ³ñíáõÙ »Ý ÙÇ³ÛÝ μÝ³ÏãáõÃÛ³Ý ³Ù»Ý³³Õù³ï áõ Ëáó»ÉÇ Ë³í»ñÇÝ (Ý³Ë³å»ë ×ßï»Éáí ³Û¹ ÷³ëïÁ` ÐÐ ³ßË³ï³ÝùÇ áõ ëáóÇ³É³Ï³Ý Ñ³ñó»ñÇ Ý³Ë³ñ³ñáõÃÛ³Ý ïñ³Ù³¹ñ³Í ó³ÝÏ»ñÇ ÙÇçáóáí): ²Û¹ ËÙμ»ñÇÝ ãå³ïÏ³ÝáÕ ³ÝÓÇÝù, áñáÝù íÇñ³Ñ³ïáõÃÛ³Ý Ï³ñÇù áõÝ»Ý, áõÕ»·ñíáõÙ »Ý ³ÏÝ³μáõÅ³Ï³Ý ÏÉÇÝÇÏ³Ý»ñ: ²ãùÇ ½ÝÝáõÙÝ»ñÝ Çñ³Ï³Ý³óí»É »Ý ºñ¨³ÝÇ »ññáñ¹³ÛÇÝ ûÕ³ÏÇ ³ÏÝ³μáõÅ³Ï³Ý Ñ³ëï³ïáõÃÛáõÝÝ»ñÇ ³ÏÝ³μáõÛÅÝ»ñÇó, μáõÅùáõÛñ»ñÇó ¨ ÏÉÇÝÇÏ³Ï³Ý ûñ¹ÇÝ³ïáñÝ»ñÇó μ³ÕÏ³ó³Í ¨ Ñ³ïáõÏ ³Û¹ Ýå³ï³Ïáí í»ñ³å³ïñ³ëïí³Í ËÙμ»ñÇ ÏáÕÙÇó` û·ï³·áñÍ»Éáí ³ãùÇ ½ÝÝÙ³Ý ÙÇç³½·³ÛÝáñ»Ý ÁÝ¹áõÝí³Í ã³÷³ÝÇßÝ»ñÝ áõ ·áñÍÇùÝ»ñÁ: ¼ÝÝáõÙÁ Ý»ñ³é»É ¿ ÑÇí³Ý¹Ý»ñÇ ï»ëáÕáõÃÛ³Ý ëñáõÃÛ³Ý ëïáõ·áõÙÁ È³Ý¹áÉïÇ ¨ êÇíó¨-¶áÉáíÇÝÇ ³ÕÛáõë³ÏÝ»ñÇ û·ÝáõÃÛ³Ùμ: î»ëáÕáõÃÛ³Ý ó³Íñ ëñáõÃÛ³Ý ¹»åù»ñáõÙ, ¹ñ³ å³ï×³éÁ áñáß»Éáõ Ýå³ï³Ïáí, ½ÝÝáõÙÝ»ñÁ ß³ñáõÝ³ÏíáõÙ ¿ÇÝ ×»Õù³ÛÇÝ É³ÙåÇ ¨ ûýÃ³ÉÙáëÏáåÇ ÏÇñ³éÙ³Ùμ: â³÷í»É ¿ Ý»ñ³ÏÝ³ÛÇÝ ×ÝßáõÙÁ Ñ³Ù³å³ï³ëË³Ý ·áñÍÇùÇ` ïáÝáå»ÝÇ Ï³Ù Ø³ÏÉ³ÏáíÇ ÙÇçáóáí: ²ÝÑñ³Å»ßïáõÃÛ³Ý ¹»åùáõÙ ¹áõñë »Ý ·ñí»É ³ÏÝáóÝ»ñ:

²é³í»É μ³ñ¹ ¹»åù»ñáõÙ, »ñμ ÑÇí³Ý¹ÇÝ ³ÝÑñ³Å»ßï ¿ñ ³í»ÉÇ Ù³Ýñ³½ÝÝÇÝ Ñ»ï³½áïáõÙ Ï³Ù Ñ»ï³·³ μáõÅáõÙ (íÇñ³Ñ³ï³Ï³Ý Ï³Ù É³½»ñ³ÛÇÝ), Ý³ áõÕ»·ñíáõÙ ¿ñ ²ÞÐ` ³í»ÉÇ Ëáñ³óí³Í Ñ»ï³½áïáõÃÛáõÝÝ»ñÇ ¨ Ñ»ï³·³ μáõÅÙ³Ý ¨ áõÕ»·ñÙ³Ý Ýå³ï³Ïáí: ºñ»Ë³Ý»ñÝ ³Û¹åÇëÇ ¹»åù»ñáõÙ áõÕ»·ñíáõÙ ¿ÇÝ ºñ¨³ÝÇ ³ÏÝ³μáõÅ³Ï³Ý ÏÉÇÝÇÏ³Ý»ñ: ²ÛÝ ÑÇí³Ý¹Ý»ñÁ, áñáÝù ÙÇ³ÛÝ ß³ñáõÝ³Ï³Ï³Ý μáõÅáõÙ Ï³Ù ËÝ³ÙùÇ Ï³ñÇù áõÝ»ÇÝ, áõÕ»·ñíáõÙ ¿ÇÝ ï»ÕÇ ³ÏÝ³μáõÛÅÇ Ùáï: ²Ûë É³ÛÝ³Í³í³É ³ßË³ï³ÝùÝ»ñÇ ³ñ¹ÛáõÝùáõÙ 2003-2009 ÃÃ. ÁÝÃ³óùáõÙ Ð³Û³ëï³ÝáõÙ ³Ýí×³ñ ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñ ëï³Ý³Éáõ Ýå³ï³Ïáí Íñ³·ñÇÝ ¹ÇÙ»É ¨ ³ÏÝ³μáõÅ³Ï³Ý ½ÝÝáõÙ ¿ ³Ýó»É »ñÏñÇ 156,688 μÝ³ÏÇã (»ñÏñÇ μÝ³ÏãáõÃÛ³Ý ßáõñç 5%-Á), áñáÝó Ù»Í Ù³ëÁ` 61%-Á, Ù»Í³Ñ³ë³Ï μÝ³ÏãáõÃÛáõÝ ¿ (16 ¨ ³í»ÉÇ ï³ñ»Ï³Ý), ÇëÏ 39%-Á` »ñ»Ë³ (ÙÇÝã¨ 16 ï³ñ»Ï³Ý): ÀÝ¹ áñáõÙ, Ï³Ý³Ûù Ñ³Ýñ³å»ïáõÃÛáõÝáõÙ ½ÝÝí³Í μÝ³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ·»ñ³ÏßéáõÙ »Ý. Ýñ³Ýù Ï³½ÙáõÙ »Ý Ñ»ï³½áïí³ÍÝ»ñÇ ßáõñç 57%-Á: ºñ»Ë³Ý»ñÇ ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ Ñ³ÛïÝ³μ»ñáõÙÝ áõ Å³Ù³Ý³ÏÇÝ Ï³ÝË³ñ·»ÉáõÙÁ Ù»Í³å»ë Ýå³ëïáõÙ ¿ μÝ³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ÏáõñáõÃÛ³Ý áõ ÃáõÛÉ ï»ëáÕáõÃÛ³Ý Ï³ÝË³ñ·»ÉÙ³ÝÁ, ³Û¹ ÇëÏ å³ï×³éáí Ð²Ü-Á Çñ »ñÏñáñ¹ ßñç³ÛóÇ Å³Ù³Ý³Ï ³í»ÉÇ Ù»Í áõß³¹ñáõÃÛáõÝ ¿ ¹³ñÓñ»É ¹åñáóÝ»ñáõÙ Ï³ï³ñíáÕ ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñÇÝ: Æñ »ñÏñáñ¹ ßñç³ÛóÇ ÁÝÃ³óùáõÙ ÐÐ-áõÙ Ð²Ü-Ç ÏáÕÙÇó ½ÝÝí³Í μÝ³ÏãáõÃÛ³Ý Ï»ëÇó ³í»ÉÇÝ` 55%-Á ÑÇÙÝ³Ï³ÝáõÙ ·ÛáõÕ³Ï³Ý 245 Ñ³Ù³ÛÝùÝ»ñÇ 320 ¹åñáóÝ»ñÇ ³ß³Ï»ñïÝ»ñÝ »Ý »Õ»É: ÐÇÙÝ³Ï³ÝáõÙ ¹ñ³Ýáí ¿ å³ÛÙ³Ý³íáñí³Í Ð²Ü-Ç ÏáÕÙÇó Ñ»ï³½áïí³Í μÝ³ÏãáõÃÛ³Ý ßñç³ÝáõÙ »ñ»Ë³Ý»ñÇ μ³ñÓñ Ý»ñÏ³Û³óí³ÍáõÃÛáõÝÁ (39%)` »ñÏñÇ μÝ³ÏãáõÃÛ³Ý ÅáÕáíñ¹³·ñ³Ï³Ý Ï³éáõóí³ÍùÇ Ñ³Ù»Ù³ï (ßáõñç 24%): Ð³ßíÇ ³éÝ»Éáí ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñÇ μÝ³ÏãáõÃÛ³Ý Ñ³Ù³ñ ³ÏÝ³μáõÅ³Ï³Ý ³é³çÝ³ÛÇÝ áõ »ñÏñáñ¹³ÛÇÝ Í³é³ÛáõÃÛáõÝÝ»ñÇ ³é³í»É ¹Åí³ñ³Ù³ïã»ÉÇáõÃÛáõÝÁ` Ð²Ü-Ç ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñÁ Ù»Í³å»ë áõÕÕí³Í »Ý »Õ»É ¹»åÇ ·ÛáõÕ³Ï³Ý μÝ³ÏãáõÃÛáõÝÁ. Ñ»ï³½áïí³ÍÝ»ñÇ ßáõñç 58%-Á ·ÛáõÕ³Ï³Ý μÝ³ÏãáõÃÛáõÝ ¿: êáóÇ³É³å»ë ³Ý³å³Ñáí áõ Ëáó»ÉÇ ¨ ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ½ÝÝí³Í μÝ³ÏãáõÃÛ³Ý Ñ³Ù³ñ Ð²Ü-Á å³ïñ³ëï»É áõ ³Ýí×³ñ ïñ³Ù³¹ñ»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ 29,546 ³ÏÝáó:

¼ÝÝáõÙÝ»ñ ³Ýó³Í μÝ³ÏãáõÃÛ³Ý Ù³ñ½³ÛÇÝ μ³ßËáõÙÁ íÏ³ÛáõÙ ¿, áñ ¹ñ³ ÁÝ¹Ñ³Ýáõñ ÃíáõÙ ³é³í»É Ù»Í Ý»ñÏ³Û³óí³ÍáõÃÛáõÝ áõÝ»Ý ²ñ³ñ³ïÇ, ²ñÙ³íÇñÇ, Îáï³ÛùÇ áõ Èáéáõ Ù³ñ½»ñÇ μÝ³ÏÇãÝ»ñÁ:

Ð²Ü-Ç ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ (²ÞÐ) 2003-2009 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ 16,518 μÝ³ÏÇã (½ÝÝí³Í Ù»Í³Ñ³ë³ÏÝ»ñÇ 17.3%-Á), áñáÝóÇó 7,939-Á (½ÝÝí³Í Ù»Í³Ñ³ë³ÏÝ»ñÇ 8.3%-Á) ³ÛÝáõÑ»ï¨ ²ÞÐ-áõÙ íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

ÀÝ¹Ñ³Ýáõñ ³éÙ³Ùμ 2003-2009 ÃÃ. ²ÞÐ-áõÙ ³ÝóÏ³óí»É ¿ 8,394 íÇñ³Ñ³ïáõÃÛáõÝ áõ É³½»ñ³ÛÇÝ ÙÇç³ÙïáõÃÛáõÝ, áñáÝó Ù»Í Ù³ëÁ (ßáõñç 70%-Á) Ï³ï³ñ³ÏïÇ ï³ñμ»ñ íÇñ³Ñ³ïáõÃÛáõÝÝ»ñÝ »Ý »Õ»É:

ÐÐ Ûáõñ³ù³ÝãÛáõñ Ù³ñ½áõÙ Ð²Ü-Ç Ù³ïáõó³Í ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÇ ÝÏ³ñ³·ÇñÁ μ»ñí³Í ¿ μ³ÅÇÝ 5-áõÙ: 24

3.2. 2007-2009 ÃÃ. Ð²Ü-Ç ºððàð¸ Þðæ²ÚòÆ ÀÜÂ²òøàôØ Æð²Î²Ü²òì²Ì ²ÞÊ²î²ÜøÜºðÆ êºÔØ ÜÎ²ð²¶ÆðÀ Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ 2007-2009 ÃÃ. ÁÝÃ³óùáõÙ »ññáñ¹ ßñç³ÛóÝ »Ý Ï³ï³ñ»É ÐÐ 9 Ù³ñ½»ñáõÙ (μ³ó³éáõÃÛ³Ùμ ºñ¨³ÝÇ, áñï»Õ ½ÝÝáõÙÝ»ñÁ Ï»ÝïñáÝ³óí³Í »Ý »Õ»É μÝ³ÏãáõÃÛ³Ý ³é³ÝÓÇÝ, Ñ³ïáõÏ ËÙμ»ñÇ ßñç³ÝáõÙ áõ ¹åñáóÝ»ñáõÙ, áõ ¶»Õ³ñùáõÝÇùÇ Ù³ñ½Ç)1: ºññáñ¹ ßñç³ÛóÇ ÁÝÃ³óùáõÙ Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ »Ý ³ÝóÏ³óñ»É Ð³Û³ëï³ÝÇ 490 Ñ³Ù³ÛÝùÝ»ñáõÙ Ï³Ù »ñÏñÇ Ñ³Ù³ÛÝùÝ»ñÇ ßáõñç 54%-áõÙ: ¼ÝÝáõÙÝ»ñÇ Ý»ñÏ³Û³ó»É »Ý »ñÏñÇ 615 ï³ñμ»ñ Ñ³Ù³ÛÝùÝ»ñÇ μÝ³ÏÇãÝ»ñ` ÑÇÙÝ³Ï³ÝáõÙ ·ÛáõÕ³Ï³Ý μÝ³Ï³í³Ûñ»ñÇó: ÀÝ¹Ñ³Ýáõñ ³éÙ³Ùμ, ½ÝÝí³ÍÝ»ñÇ ·»ñ³ÏßÇé Ù³ëÁ` 68%-Á, ·ÛáõÕ³Ï³Ý μÝ³ÏãáõÃÛáõÝÝ ¿, áñáÝó Ñ³Ù³ñ ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÝ ³í»ÉÇ ¹Åí³ñ³Ù³ïã»ÉÇ »Ý: Ð²Ü-Ç ÏáÕÙÇó ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñÇ ¿ »ÝÃ³ñÏí»É Ð³Û³ëï³ÝÇ 26,711 μÝ³ÏÇã (Ï³Ù »ñÏñÇ μÝ³ÏãáõÃÛ³Ý ßáõñç 0.9%-Á), áñáÝóÇó 16,837-Á Ï³Ù 63%-Á` Ï³Ý³Ûù, ÇëÏ 1,195-Á` »ñ»Ë³ (ÙÇÝã¨ 16 ï³ñ»Ï³Ý): Ð²Ü-Ç ÏáÕÙÇó ½ÝÝí³ÍÝ»ñÇ Ï»ëÇó ³í»ÉÇÝ` 52%-Á ëáóÇ³É³å»ë ³Ý³å³Ñáí ¨ ³é³ÝÓÇÝ (Ñ³ïáõÏ) Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ ³ÝÓÇÝù »Ý »Õ»É:

1 ՀԱՆ-ը իր աշխատանքները սահմանափակել է Գեղարքունիքի մարզում, քանի որ այնտեղ գործում է Հայաստանի ամերիկյան համալսարանի Կարո Մեղրիկյանի աչքի հիվանդությունների կանխարգելման կենտրոնի և “Արարատ-1 Լայոնս Քլաբ ինտերնեյշնլ” բարեգործական հասարական կազմակերպության և ՀՀ առողջապահության նախարարության համատեղ ջանքերով ստեղծված Սևանի ակնաբուժական կենտրոնը:

Ð²Ü-Ç ÏáÕÙÇó ³ÏÝ³ÛÇÝ ½ÝÝáõÙ ³Ýó³ÍÝ»ñÇ Ù»Í Ù³ëÁ (72.3%) í»ñ³ñï³¹ñáÕ³Ï³Ý ï³ñÇùÇó μ³ñÓñ ï³ñÇùÇ μÝ³ÏãáõÃÛáõÝÝ ¿` 49Çó μ³ñÓñ ï³ñÇù áõÝ»óáÕÝ»ñÁ: 70 ¨ ³í»ÉÇ ï³ñ»Ï³ÝÝ»ñÁ Ï³½ÙáõÙ »Ý ½ÝÝí³Í μÝ³ÏãáõÃÛ³Ý Ù»Ï »ññáñ¹Çó ùÇã ³í»ÉÇÝ` 31%-Á: ¼ÝÝí³Í μÝ³ÏãáõÃÛ³Ý ï³ñÇù³ÛÇÝ μ³ßËáõÙÁ μ»ñí³Í ¿ ·Í³å³ïÏ»ñ 2-áõÙ:

²ÞÐ-Ý ÁÝ¹áõÝ»É, Ëáñ³óí³Í Ñ»ï³½áïÙ³Ý ¿ »ÝÃ³ñÏ»É ¨ ³Ëïáñáß»É ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ 3,943 ½ÝÝí³ÍÝ»ñÇ (½ÝÝí³Í Ù»Í³Ñ³ë³ÏÝ»ñÇ 15.5%-Á)` ³ßË³ï»Éáí ÑÇÙÝ³Ï³ÝáõÙ ÐÐ ÷áùñ áõ ÙÇçÇÝ ù³Õ³ùÝ»ñáõÙ ¨ ÁÝ¹áõÝ»Éáí Ý³¨ Ñ³ñ³ÏÇó ·ÛáõÕ»ñÇ μÝ³ÏãáõÃÛ³ÝÁ: ²Û¹ μÝ³ÏãáõÃÛ³Ý ßáõñç Ï»ëÁ` 48%-Á (Ï³Ù ½ÝÝí³Í Ù»Í³Ñ³ë³ÏÝ»ñÇ 7.4%-Á)` 1,893 Ù³ñ¹, ²ÞÐ-áõÙ íÇñ³Ñ³ïí»É Ï³Ù É³½»ñ³ÛÇÝ ÙÇç³ÙïáõÃÛ³Ý ¿ »ÝÃ³ñÏí»É: Ð²Ü-Á ³ÏÝáó ¿ å³ïñ³ëï»É áõ ïñ³Ù³¹ñ»É ¹ñ³Ýó Ï³ñÇùÝ áõÝ»óáÕ ëáóÇ³É³å»ë ³Ý³å³Ñáí 9,793 Ù³ñ¹áõ Ñ³Ù³ñ:

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29 ²Ûë Ñ»ï³½áïáõÃÛ³Ý ßñç³Ý³ÏÝ»ñáõÙ ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛ³Ý ·Ý³Ñ³ï³Ï³ÝÝ»ñÝ áõ óáõó³ÝÇßÝ»ñÁ Ñ³ßí³ñÏí»É »Ý ÑÇÙÝ³Ï³ÝáõÙ Ù»Í³Ñ³ë³Ï (16 ¨ ³í»ÉÇ ï³ñ»Ï³Ý) ¨ Ù³ëÝ³íáñ³å»ë 50-Çó μ³ñÓñ ï³ñÇùÇ μÝ³ÏãáõÃÛ³Ý Ñ³Ù³ñ` Ñ³ßíÇ ³éÝ»Éáí í»ñçÇÝÝ»ñÇë ³é³í»É μ³ñÓñ éÇëÏ³ÛÇÝ ·áñÍáÝÁ ÑÝ³ñ³íáñ ÏáõñáõÃÛ³Ý ³éáõÙáí: ´³óÇ ³Û¹, ßï»Ù³ñ³ÝÁ å³ñáõÝ³ÏáõÙ ¿ ¹ÇÝ³ÙÇÏ ß³ñù»ñ, áñáÝù Ñ³Ù³å³ï³ëË³ÝáõÙ »Ý »ñÏáõ ï³ñí³ ÁÝÃ³óùáõÙ ÐÐ 9 Ù³ñ½»ñáõÙ Ð²Ü-Ç Çñ³Ï³Ý³óñ³Í »ñ»ù ßñç³Ûó»ñÇÝ` 20032005, 2005-2007 ¨ 2007-2009 Ãí³Ï³ÝÝ»ñÇÝ: àõëïÇ, ëï³óí³Í ³ñ¹ÛáõÝùÝ»ñÇ Ñ³Ù»Ù³ïáõÃÛáõÝÝ»ñÁ ¹ÇÝ³ÙÇÏ³ÛáõÙ áõÝ»Ý áñáß³ÏÇ ³é³ÝÓÝ³Ñ³ïÏáõÃÛáõÝÝ»ñ, áñáÝó ÁÝÃ»ñóáÕÁ å»ïù ¿ áñáß í»ñ³å³ÑáõÙáí Ùáï»Ý³:

4.2. Ð²Ü-Ç 2003-2009 ÃÃ. ºðºø Þðæ²ÚòºðÆ ÀÜÂ²òøàôØ ÐÐ ´Ü²ÎâàôÂÚ²Ü Þðæ²ÜàôØ ¶ð²Üòì²Ì ²ÎÜ²ÚÆÜ ÐÆì²Ü¸àôÂÚàôÜÜºðÀ ÐÐ ²éáÕç³å³ÑáõÃÛ³Ý Ý³Ë³ñ³ñáõÃÛáõÝÝ Çñ íÇ×³Ï³·ñ³Ï³Ý ï³ñ»·ñù»ñáõÙ å³ßïáÝ³å»ë Ññ³å³ñ³ÏáõÙ ¿ »ñÏñÇ μÝ³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛáõÝÁ μÝáõÃ³·ñáÕ »ñÏáõ ÑÇÙÝ³Ï³Ý óáõó³ÝÇß` ³ãùÇ ¨ Ýñ³ Ñ³í»ÉÛ³É ³å³ñ³ïÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ áõ ·É³áõÏáÙ³ÛÇ ³é³çÇÝ ³Ý·³Ù ³Ëïáñáßí³Í ¹»åù»ñÇ ù³Ý³ÏÁ ¨ μÝ³ÏãáõÃÛ³Ý ÁÝ¹Ñ³Ýáõñ ÑÇí³Ý¹³óáõÃÛáõÝÝ ³Û¹ ÑÇí³Ý¹áõÃÛáõÝÝ»ñáí: Àëï áñáõÙ, μÝ³ÏãáõÃÛ³Ý ÑÇí³Ý¹³óáõÃÛ³Ý ¹»åù»ñÁ ·ñ³ÝóíáõÙ »Ý μáõÅû·ÝáõÃÛáõÝ ëï³Ý³Éáõ Ñ³Ù³ñ ¹ÇÙ»ÉÇë ¨ å³ñï³¹Çñ Ï³ÝË³ñ·»ÉÇã ùÝÝáõÃÛáõÝÝ»ñ ³ÝóÝ»ÉÇë1: ²Û¹ óáõó³ÝÇßÝ»ñÇ ¹ÇÝ³ÙÇÏ³Ý íÏ³ÛáõÙ ¿, áñ ³ãùÇ áõ Ýñ³ Ñ³í»ÉÛ³É ³å³ñ³ïÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñáí ·ñ³Ýóí³Í μÝ³ÏãáõÃÛ³Ý ÃÇíÁ Ù»ñ »ñÏñáõÙ 2004-2008 ÃÃ. ³×»É ¿ ßáõñç »ñÏáõ ³Ý·³Ù` 2008Ã-ÇÝ Ï³½Ù»Éáí 2,610 Ù³ñ¹` 100,000 μÝ³ÏãÇ Ñ³ßíáí (Ï³Ù ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ 68,544 Ù³ñ¹): ÀÝ¹ áñáõÙ, 2005 Ã-Çó ëÏë³Í, Ýßí³Í ÑÇí³Ý¹áõÃÛáõÝÝ»ñáí ÑÇí³Ý¹Ý»ñÇ ÁÝ¹Ñ³Ýáõñ ÃíÇ ßáõñç 47%-Á, ³Ëïáñáßí»É ¿ Çñ ÏÛ³ÝùáõÙ ³é³çÇÝ ³Ý·³Ù: ²ãùÇ áõ Ýñ³ Ñ³í»ÉÛ³É ³å³ñ³ïÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ ÃíáõÙ, ë³Ï³ÛÝ, å³ßïáÝ³Ï³Ý íÇ×³Ï³·ñáõÃÛáõÝÁ Ù³Ýñ³Ù³ëÝáõÙ ¿ ÙÇ³ÛÝ ·É³áõÏáÙ³ÛÇ ¹»åù»ñÁ: Àëï ÐÐ ³éáÕç³å³ÑáõÃÛ³Ý Ý³Ë³ñ³ñáõÃÛ³Ý ïíÛ³ÉÝ»ñÇ` 2008 Ã. ¹ñáõÃÛ³Ùμ Ù»ñ »ñÏñáõÙ ·ñ³Ýóí³Í ¿ »Õ»É ·É³áõÏáÙ³Ûáí ³Ëïáñáßí³Í 5,320 Ù³ñ¹, áñáÝóÇó 1,274-Á 2008 Ã. ³Ëïáñáßí»É ¿ ÏÛ³ÝùáõÙ ³é³çÇÝ 1 î»°ë ÐÐ ²Ü ²²Æ ï»Õ»Ï³ïí³Ï³Ý í»ñÉáõÍ³Ï³Ý Ñ³Ýñ³å»ï³Ï³Ý Ï»ÝïñáÝ. ìÇ×³Ï³·ñ³Ï³Ý ï»Õ»Ï³·Çñù 2008:

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ÎáõñáõÃÛ³Ý Ñ³Ý·»óÝáÕ ³é³ÝÓÇÝ ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ ï³ñ³Íí³ÍáõÃÛ³Ý ·Ý³Ñ³ï³Ï³ÝÝ»ñÇ Ù³ñ½³ÛÇÝ Ñ³Ù»Ù³ï³Ï³Ý å³ïÏ»ñÁ μ»ñí³Í ¿ ³ÕÛáõë³Ï 7-áõÙ:

é»ïÇÝáå³ÃÇ³

ÆÝãå»ë Ñ³ÛïÝÇ ¿, 50 ¨ ³í»ÉÇ ï³ñ»Ï³Ý μÝ³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÁ ³í»ÉÇ ï³ñ³Íí³Í »Ý: ÆÝãå»ë »ñ¨áõÙ ¿ ²ÕÛáõë³Ï 8-Çó, ÏáõñáõÃÛ³Ý Ñ³Ý·»óÝáÕ ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ ï³ñ³Íí³ÍáõÃÛáõÝÁ ÐÐ 50 ¨ ³í»ÉÇ ï³ñ»Ï³Ý μÝ³ÏãáõÃÛ³Ý ÃíáõÙ ¿³å»ë ³í»ÉÇ μ³ñÓñ ¿ ù³Ý ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ μÝ³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ¨ Ï³½ÙáõÙ ¿ 37% (μÝ³ÏãáõÃÛ³Ý` 13.3%-Ç ¹ÇÙ³ó):

ÑÇí³Ý¹áõÃÛáõÝÝ»ñ

é»ïÇÝáå³ÃÇ³

Ð²Ü-Ç ÏáÕÙÇó Ùß³Ïí»É áõ Ñ³ßí³ñÏí»É ¿ ½ÝÝí³Í 50 ¨ ³í»ÉÇ ï³ñ»Ï³Ý μÝ³ÏãáõÃÛ³Ý ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛ³Ý Ëáó»ÉÇáõÃÛ³Ý Ñ³Ù³ÃÇíÁ (²²ÊÐ): Ð²Ü-Ç ÏáÕÙÇó ½ÝÝí³Í 50 ¨ ³í»ÉÇ ï³ñ»Ï³Ý ³ÛÝ Ù³ñ¹ÇÏ, áñáÝù ³Ëïáñáßí»É »Ý ÏáõñáõÃÛ³Ý Ñ³Ý·»óÝáÕ ³éÝí³½Ý Ù»Ï ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛ³Ùμ (·É³áõÏáÙ³, Ï³ï³ñ³Ïï, »Õç»ñ³Ã³Õ³ÝÃÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñ, ¹Ç³μ»ïÇÏ é»ïÇÝáå³ïÇ³ ¨ Ù³ÏáõÉÛ³ñ ¹»·»Ý»ñ³óÇ³), Ñ³Ù³ñí»É »Ý Ëáó»ÉÇ` ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛ³Ý ï»ë³ÝÏÛáõÝÇó: ²²ÊÐ-Ý ³Û¹åÇëÇ μÝ³ÏãáõÃÛ³Ý ï»ë³Ï³ñ³ñ ÏßÇéÝ ¿ 50 ¨ ³í»ÉÇ ï³ñ»Ï³Ý μÝ³ÏãáõÃÛ³Ý ÁÝ¹Ñ³Ýáõñ ÃíáõÙ: Ð²Ü-Ç ïíÛ³ÉÝ»ñÁ íÏ³ÛáõÙ »Ý, áñ ÐÐ 50 ¨ ³í»ÉÇ ï³ñ»Ï³ÝÝ»ñÇ 37%-Ý áõÝÇ Ëáó»ÉÇ ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛáõÝ: ê³ Ýß³Ý³ÏáõÙ ¿, áñ ÐÐ-Ç ³Û¹ ï³ñÇùÇ Ñ³Ù³ñÛ³ Ûáõñ³ù³ÝãÛáõñ ãáññáñ¹ μÝ³ÏÇã ÏáõñáõÃÛ³Ý Ñ³Ý·»óÝáÕ ³éÝí³½Ý Ù»Ï ³ÏÝ³ÛÇÝ ÑÇí³Ý¹áõÃÛáõÝ áõÝÇ: ÀÝ¹ áñáõÙ, ÐÐ Ù³ñ½³ÛÇÝ Ïïñí³Íùáí ³Ù»Ý³μ³ñÓñ ³ÏÝ³ÛÇÝ ³éáÕçáõÃÛ³Ý Ëáó»ÉÇáõÃÛ³Ý Ñ³Ù³Ãí»ñÁ ëï³óí»É »Ý ²ñ³ñ³ïÇ, ²ñÙ³íÇñÇ áõ ²ñ³·³ÍáïÝÇ Ù³ñ½»ñáõÙ (ï»°ë ù³ñï»½ 7): 38

5. 2003-2009 ÃÃ. Ð²Ü-Ç ºðºø Þðæ²ÚòºðÆ ÀÜÂ²òøàôØ ÐÐ ´Ü²ÎâàôÂÚ²ÜÀ îð²Ø²¸ð²Ì ²ÎÜ²´àôÄ²Î²Ü Ì²è²ÚàôÂÚàôÜÜºðÀ` Ø²ð¼²ÚÆÜ Îîðì²Ìàì ²Ûë μ³ÅÇÝÁ Ý»ñÏ³Û³óÝáõÙ ¿ Ð²Ü-Ç §ÈáõÛë Ñ³ÛÇ ³ãù»ñÇÝ¦ Ý³Ë³Ó»éÝáõÃÛ³Ý ßñç³Ý³ÏÝ»ñáõÙ 2003-2009 ÃÃ ÐÐ Ù³ñ½»ñáõÙ Çñ³Ï³Ý³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñÇ áõ μáõÅû·ÝáõÃÛ³Ý ³ßË³ï³ÝùÝ»ñÇ ³Ù÷á÷ å³ïÏ»ñÁ` Ûáõñ³ù³ÝãÛáõñ Ù³ñ½Ç Ïïñí³Íùáí:

5.1.

²ð²¶²ÌàîÜÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2003, 2005 ¨ 2007 Ãí³Ï³ÝÝ»ñÇÝ §Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ¦ ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É ²ñ³·³ÍáïÝÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ñ»ï³½áï»É ¿ Ù³ñ½Ç 20,750 μÝ³ÏãÇ, áñáÝó Ï»ëÇó ùÇã ³í»ÉÇÝ` 52.8%-Á, ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 47.2%-Á` »ñ»Ë³:

Ð²Ü-Ç ³ßË³ï³ÝùÝ»ñÝ áõ Ù³ïáõó³Í Í³é³ÛáõÃÛáõÝÝ»ñÁ áõÕÕí³Í »Ý »Õ»É ·ÛáõÕ³Ï³Ý μÝ³ÏãáõÃÛ³ÝÁ, áñÇ Ñ³Ù³ñ ³ÏÝ³μáõÅ³Ï³Ý ËáñÁ Ñ»ï³½áïáõÃÛáõÝÝ»ñÝ ³é³í»É³å»ë ¹Åí³ñ Ñ³ë³Ý»ÉÇ »Ý: ¶ÛáõÕ³μÝ³ÏÝ»ñÁ Ï³½ÙáõÙ »Ý Ù³ñ½áõÙ ½ÝÝí³Í μÝ³ÏãáõÃÛ³Ý 68.2%-Á:

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2003-2007 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É Ù³ñ½Ç 1,319 μÝ³ÏÇã, áñáÝóÇó 552-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

Ð²Ü-Á 1,924 ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É Ù³ñ½Ç` ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ μÝ³ÏãáõÃÛ³ÝÁ:

5.2.

²ð²ð²îÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2004, 2006 ¨ 2008 ÃÃ. Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É ²ñ³ñ³ïÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á Ñ»ï³½áï»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ù³ñ½Ç 23,870 μÝ³ÏãÇ, áñáÝó ßáõñç 51%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 49%-Á` »ñ»Ë³:

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2004-2008 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É Ù³ñ½Ç 2,504 μÝ³ÏÇã, áñáÝóÇó 865-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

Ð²Ü-Á 2,732 ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É Ù³ñ½Ç` ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ μÝ³ÏãáõÃÛ³ÝÁ:

5.3.

²ðØ²ìÆðÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2003, 2006 ¨ 2008 ÃÃ, Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É ²ñÙ³íÇñÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á Ñ»ï³½áï»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ù³ñ½Ç 25,115 μÝ³ÏãÇ, áñáÝó ßáõñç 53%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 47%-Á` »ñ»Ë³:

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2003-2008 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿³Ýó»É Ù³ñ½Ç 2,405 μÝ³ÏÇã, áñáÝóÇó 1,084-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

Ð²Ü-Á 1,518 ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É Ù³ñ½Ç` ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ μÝ³ÏãáõÃÛ³ÝÁ: 42

5.4.

Îàî²ÚøÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2005, 2007 ¨ 2009 ÃÃ. Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É Îáï³ÛùÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á Ñ»ï³½áï»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ù³ñ½Ç 18,949 μÝ³ÏãÇ, áñáÝó ßáõñç 50%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É:

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2005-2009 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É Ù³ñ½Ç 2,051 μÝ³ÏÇã, áñáÝóÇó 893-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

Ð²Ü-Á 2,270 ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É Ù³ñ½Ç` ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ μÝ³ÏãáõÃÛ³ÝÁ:

5.5.

Èàèàô Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2005-2009 ÃÃ. ÁÝÃ³óùáõÙ §Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ¦ ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É Èáéáõ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á Ñ»ï³½áï»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ù³ñ½Ç 18,569 μÝ³ÏãÇ, áñáÝó ßáõñç 68%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 32%-Á` »ñ»Ë³:

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2005-2009 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É Ù³ñ½Ç 2,815 μÝ³ÏÇã, áñáÝóÇó 1,165-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

Ð²Ü-Á 4,653 ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É Ù³ñ½Ç` ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ μÝ³ÏãáõÃÛ³ÝÁ: 44

5.6.

ÞÆð²ÎÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2005-2009 ÃÃ. ÁÝÃ³óùáõÙ §Ð³ÛÏ³Ï³Ý ²ÏÝ³μáõÅáõÃÛ³Ý Ü³Ë³·ÍÇ ³ÏÝ³μáõÛÅÝ»ñÝ áõ ²ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É ÞÇñ³ÏÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ñ»ï³½áï»É ¿ Ù³ñ½Ç 16,834 μÝ³ÏãÇ, áñáÝó ßáõñç 86%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 14%-Á` »ñ»Ë³Ý»ñ: âÝ³Û³Í Ýñ³Ý, áñ Ù³ñ½Ç μÝ³ÏãáõÃÛáõÝÁ ÑÇÙÝ³Ï³ÝáõÙ ù³Õ³ù³μÝ³Ï ¿, Ð²Ü-Ç ³ßË³ï³ÝùÝ»ñÝ áõ Ù³ïáõó³Í Í³é³ÛáõÃÛáõÝÝ»ñÁ Ù»Í³å»ë áõÕÕí³Í »Ý »Õ»É ¹»åÇ ·ÛáõÕ³Ï³Ý μÝ³ÏãáõÃÛáõÝÁ, áñÇ Ñ³Ù³ñ ³ÏÝ³μáõÅ³Ï³Ý ËáñÁ Ñ»ï³½áïáõÃÛáõÝÝ»ñÝ ³é³í»É³å»ë ¹Åí³ñ Ñ³ë³Ý»ÉÇ »Ý: Ð³ßíÇ ³éÝ»Éáí, áñ ¶ÛáõÙñÇáõÙ Ã»° ³é³çÝ³ÛÇÝ ¨ Ã»° »ñÏñáñ¹³ÛÇÝ Ù³Ï³ñ¹³ÏÇ ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÝ ³éÏ³ »Ý, Ð²Ü-Ç »ññáñ¹ ßñç³ÛóÇ ÁÝÃ³óùáõÙ ¶ÛáõÙñÇ ù³Õ³ùÁ ÁÝ¹·ñÏí³Í ãÇ »Õ»É: ²ÛëåÇëáí, Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý μÝ³ÏãáõÃÛ³Ý ÁÝ¹·ñÏí³ÍáõÃÛáõÝÁ Ð²Ü-Ç ïñ³Ù³¹ñ³Í ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñáí ß³ï ãÇ ï³ñμ»ñíáõÙ` Ñ³Ù³å³ï³ëË³Ý³μ³ñ Ùáï 53 ¨ 47% (ÙÇÝã¹»é Áëï ²ìÌ ïíÛ³ÉÝ»ñÇ` Ù³ñ½Ç ù³Õ³ù³μÝ³Ï μÝ³ÏãáõÃÛ³Ý Ù³ëÝ³μ³ÅÇÝÁ Ï³½ÙáõÙ ¿ ßáõñç 63%):

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2005-2009 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É Ù³ñ½Ç 2,724 μÝ³ÏÇã, áñáÝóÇó 1,153-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É:

Æñ »ñÏñáñ¹ ¨ »ññáñ¹ ßñç³Ûó»ñÇ ÁÝÃ³óùáõÙ Ð²Ü-Á ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ 3,948 Ù³ñ¹áõ:

5.7.

êÚàôÜÆøÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2004, 2006 ¨ 2008 ÃÃ. ÁÝÃ³óùáõÙ Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É êÛáõÝÇùÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á Ñ»ï³½áï»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ù³ñ½Ç 12,928 μÝ³ÏãÇ, áñáÝó ßáõñç 56%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 44%-Á` »ñ»Ë³:

Ð²Ü-Ç ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóáõÙ 2004-2008 ÃÃ. ÁÝÃ³óùáõÙ Ëáñ³óí³Í ³ÏÝ³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¿ ³Ýó»É Ù³ñ½Ç 1,264 μÝ³ÏÇã, áñáÝóÇó 502-Á íÇñ³Ñ³ïí»É áõ É³½»ñ³ÛÇÝ μáõÅáõÙ »Ý ëï³ó»É: 46

Ð²Ü-Á 1,739 ³Ýí×³ñ ³ÏÝáó ¿ ïñ³Ù³¹ñ»É Ù³ñ½Ç` ¹ñ³ Ï³ñÇùÝ áõÝ»óáÕ ¨ ëáóÇ³É³å»ë Ëáó»ÉÇ ËÙμ»ñÇÝ å³ïÏ³ÝáÕ μÝ³ÏãáõÃÛ³ÝÁ:

5.8.

î²ìàôÞÆ Ø²ð¼

´Ý³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ³ÏÝ³ÛÇÝ ½ÝÝáõÙÝ»ñ Çñ³Ï³Ý³óÝ»Éáõ Ýå³ï³Ïáí 2004, 2007 ¨ 2009 ÃÃ. ÁÝÃ³óùáõÙ Ð²Ü-Ç ³ÏÝ³μáõÛÅÝ»ñÝ áõ ³ãùÇ ß³ñÅ³Ï³Ý ÑÇí³Ý¹³ÝáóÁ »ñ»ù ßñç³Ûó »Ý Ï³ï³ñ»É î³íáõßÇ Ù³ñ½Ç ù³Õ³ù³ÛÇÝ áõ ·ÛáõÕ³Ï³Ý Ñ³Ù³ÛÝùÝ»ñáõÙ: ²Û¹ ÁÝÃ³óùáõÙ Ð²Ü-Á Ñ»ï³½áï»É ¿ ÁÝ¹Ñ³Ýáõñ ³éÙ³Ùμ Ù³ñ½Ç 14,210 μÝ³ÏãÇ, áñáÝó ßáõñç 65%-Á ã³÷³Ñ³ë μÝ³ÏãáõÃÛáõÝ ¿ »Õ»É, ÇëÏ 35%-Á` »ñ»Ë³:

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- Ստեղծվել է վիրահատական հմտությունների զարգացման կենտրոն (Վետ-լաբ): - Պատրաստվել և հրատարակվել է ուսումնական ձեռնարկներ և կլինիկական ուղեցույցեր ակնաբույժների, ընտանեկան բժիշկների և համայնքային բուժքույրերի համար: - Իրականացվել է կատարակտի վիրահատության մոնիտորինգ Աչքի շարժական հիվանդանոցում: Կատարակտի վիրահատության մոնիտորինգի փորձնական ծրագիր ներդրվում է Մալայանի անվան ակնաբուժական կենտրոնում:

Ըստ ՀՀ կառավարության որոշմամբ սահմանված նպատակների կատարված աշխատանքներն են. Üå³ï³Ï I. 50-Çó μ³ñÓñ ï³ñÇùÇ μÝ³ÏãáõÃÛ³Ý Ùáï »ñÏÏáÕÙ³ÝÇ ÏáõñáõÃÛ³Ý ï³ñ³Íí³ÍáõÃÛáõÝÁ 0.5%-Çó Ñ³ëóÝ»É 0.2 %-Ç: ºÝÃ³Ýå³ï³ÏÝ»ñ: Î³ï³ñ³Ïï: Ð³Û³ëï³ÝÇ Ð³Ýñ³å»ïáõÃÛáõÝáõÙ Ï³ï³ñ³ÏïÇ íÇñ³Ñ³ï³Ï³Ý óáõó³ÝÇßÁ 1000-Çó μ³ñÓñ³óÝ»É ÙÇÝã¨ 3000-Ç` Ù»Ï ÙÇÉÇáÝ μÝ³ÏãáõÃÛ³Ý Ñ³ßíáí Ø³ñ½³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñáõÙ Ý»ñ³ÏÝ³ÛÇÝ áëåÝÛ³ÏÇ ï»Õ³¹ñÙ³Ùμ Ï³ï³ñ³ÏïÇ ¿ùëïñ³Ï³åëáõÉÛ³ñ íÇñ³Ñ³ïáõÃÛáõÝÝ»ñÇ ÁÝ¹Ñ³Ýáõñ ÃÇíÁ 0.03%-Çó Ñ³ëóÝ»É 80%-Ç: Àëï ²éáÕç³å³ÑáõÃÛ³Ý Ð³Ù³ßË³ñÑ³ÛÇÝ Î³½Ù³Ï»ñåáõÃÛ³Ý ÎáõñáõÃÛ³Ý Ï³ÝË³ñ·»ÉÙ³Ý ÏáÙÇï»Ç ã³÷áñáßÇãÝ»ñÇ, μáõÅÙ³Ý ³ÝÑ³çáÕ »Éù»ñÇ ÃÇíÁ 23% -Çó Ñ³ëóÝ»É 5%-Ç: ¶É³áõÏáÙ³: ÎñÏÝ³å³ïÏ»É ÑÇí³Ý¹áõÃÛ³Ý í³Õ ÷áõÉ»ñáõÙ Ñ³ÛïÝ³μ»ñí³Í ·É³áõÏáÙ³Ûáí ÑÇí³Ý¹Ý»ñÇ ã³÷³μ³ÅÇÝÁ: ¶É³áõÏáÙ³ÛÇ ï³ñ»Ï³Ý íÇñ³Ñ³ïáõÃÛáõÝÝ»ñÇ ÃÇíÁ ³í»É³óÝ»É 30%-áí ¸Ç³μ»ïÇÏ é»ïÇÝáå³ïÇ³: È³½»ñ³ÛÇÝ μáõÅáõÙ ëï³óáÕ ¹Ç³μ»ïÇÏ é»ïÇÝáå³ÃÇ³Ûáí ÑÇí³Ý¹Ý»ñÇ ÃÇíÁ ï³ñ»Ï³Ý 120-Çó Ñ³ëóÝ»É 500-Ç: Þ³ù³ñ³ÛÇÝ ¹Ç³μ»ïáí ·ñ³Ýóí³Í μáÉáñ ÑÇí³Ý¹Ý»ñÇÝ ³å³Ñáí»É ³Ýí×³ñ ³ÏÝ³μáõÅ³Ï³Ý Ñ»ï³½áïáõÃÛáõÝÝ»ñ` ÏÛ³ÝùÇ Ñ³Ù³ñ íï³Ý· ëå³éÝ³óáÕ é»ïÇÝáå³¬ÃÇ³ÛÇ í³Õ Ñ³ÛïÝ³μ»ñÙ³Ý Ñ³Ù³ñ: 1. ÐÐ Ù³ñ½»ñÇ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñÇ ½³ñ·³óÙ³ÝÝ աջակցելու պարտավորությունը հանձն է առել ²ØÜ Ø¼¶ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅության Ý³Ë³·ÇÍÁ, áñÁ ÙÇÝã ûñë ß³ñáõÝ³ÏáõÙ է Çñ ·áñÍáõÝ»áõÃÛáõÝÁ: 2. Î³ï³ñ³ÏïÇ μáõÅÙ³Ý ¨ ÑëÏáÕáõÃÛ³Ý ³ñ¹ÛáõÝ³í»ï Ùáï»óáõÙÝ»ñÇ ÏÇñ³éÙ³Ý Ýå³ï³Ïáí Ï³ï³ñ³ÏïÇ íÇñ³Ñ³ïáõÃÛáõÝÁ Ï³ï³ñíáõÙ ¿ ³ÏÝ³μáõÅ³Ï³Ý ÏÉÇÝÇÏ³Ý»ñáõÙ Ï³Ù ³ÛÝ μ³½Ù³åñáýÇÉ ÑÇí³Ý¹³ÝáóÝ»ñÇ ³ÏÝ³μáõÅ³Ï³Ý μ³Å³ÝÙáõÝùÝ»ñáõÙ, áñáÝù áõÝ»Ý Ñ³Ù³å³ï³ëË³Ý ÉÇó»Ý½³íáñáõÙ, ³Û¹åÇëáí

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6. Որակի ապահովում: Համաձայն ÐÐ Ï³é³í³ñáõÃÛ³Ý 18.09.2009Ã. ÃÇí 35 ³ñÓ³Ý³·ñ³ÛÇÝ áñáßÙ³ն, Ùß³Ïí»Éáõ ¨ ՀՀ կառավարության հաստատմանն է ներկայացվել Ոñ³ÏÇ ·Ý³Ñ³ïÙ³Ý Ñ³յեցակարգը, áñÁ ÑÝ³ñ³íáñáõÃÛáõÝ ÏÁÝÓ»éÇ í»ñ³ÑëÏ»É μáõÅû·ÝáõÃÛ³Ý ¨ Ù³ïáõóíáÕ Í³é³ÛáõÃÛáõÝÝ»ñÇ áñ³ÏÁ` բուժօգնության բոլոր մակարդակներում /³Û¹ ÃíáõÙ ³ÏÝ³μáõÅáõÃÛ³Ý μÝ³·³í³éáõÙ/: Մասնագետների գիտելիքների բարձրացման նպատակով, ԱՄՆ ՄԶԳ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ կողմից պատրաստվել է հրատարակվել է ուսումնական ձեռնարկ Ակնաբուժության ընտրանի: Որակի ապահովմանն է ուղղված նաև ÐÐ Ï³é³í³ñáõÃÛ³Ý 05.12.2002Ã. ÃÇí 1936-Ü áñáßÙ³Ý å³Ñ³Ýçը, ըստ որի` Ûáõñ³ù³ÝãÛáõñ 5 ï³ñÇÝ Ù»Ï μÅÇßÏÝ»ñÇ Ù³ëÝ³·Çï³Ï³Ý í»ñ³å³ïñ³ëïáõÙÁ պարտադիր է: ՈõëïÇ, ³ÏÝ³μáõÛÅÝ»ñÁ ¨ë ³ÝóÝáõÙ »Ý ß³ñáõÝ³Ï³Ï³Ý ÏñÃáõÃÛáõÝ í»ñ³Ý³Ûí³Í ÏñÃ³Ï³Ý Íñ³·ñáí: ´áÉáñ åáÉÇÏÉÇÝÇÏ³Ý»ñÇ ³ÏÝ³μáõÅ³Ï³Ý Ï³μÇÝ»ïÝ»ñÝ áõÝ»Ý Ý»ñ³ÏÝ³ÛÇÝ ×ÝßáõÙÁ ã³÷»Éáõ ¨ ³ÏÝ³Ñ³ï³ÏÁ ½ÝÝ»Éáõ ÑÝ³ñ³íáñáõÃÛáõÝ: ԱՄՆ ՄԶԳ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ կողմից իրականացվել է կատարակտի վիրահատության մոնիտորինգ Աչքի շարժական հիվանդանոցում: Կատարակտի վիրահատության մոնիտորինգի փորձնական ծրագիր ներդրվում է Մալայանի անվան ակնաբուժական կենտրոնում: 7. Գլաուկոմա: êÏë³Í 2008Ã.-ից, ÐÐ ²Ü Ññ³Ù³Ýáí Ñ³ëï³տí³Í ã³÷áñáßիãáí /áñÁ å»ï³Ï³Ý å³ïí»ñÇ ï»Õ³¹ñÙ³Ý Ý³Ë³å³ÛÙ³Ý ¿/, ë³ÑÙ³Ýí»É ¿, áñ å³ñï³¹Çñ Ï³ÝË³ñ·»ÉÇã ³ÛóÇ ßñç³Ý³ÏÝ»ñáõÙ Çñ³Ï³Ý³óí»Éáõ ¿ ·É³áõÏáÙ³ÛÇ í³Õ Ñ³ÛïÝ³μ»ñÙ³Ý ëÏñÇÝÇÝ·: 2007-2010ÃÃ. ÁÝÃ³óùáõÙ ԱՄՆ ՄԶԳ – ՀԱՆ-ի կողմից Çñ»Ý ¹ÇÙ³Í μÝ³ÏãáõÃÛ³Ý ßñç³ÝáõÙ ¹Çïí»É ¿ ·É³áõÏáÙ³ÛÇ 1,653 ¹»åù, áñÇó 622-Á հայտնաբերվել է ³é³çÇÝ ³Ý·³Ù: ԲáÉáñ μÅßÏ³Ï³Ý ³ÙμáõÉ³ïáñÇ³Ý»ñÁ, ÁÝï³Ý»Ï³Ý μÅßÏÇ ·ñ³ë»ÝÛ³ÏÝ»ñÁ ¨ åáÉÇÏÉÇÝÇÏ³Ý»ñÇ ³ÏÝ³μáõÅ³Ï³Ý Ï³μÇÝ»ïÝ»ñÁ áõÝ»Ý ûýï³ÉÙáëÏáå/ տոնոմետր, Ù³ëÝ³·»ïÝ»ñÁ í»ñ³å³ïñ³ëïí»É ¨ ß³ñáõÝ³ÏáõÙ »Ý í»ñ³å³ïñ³ëïí»É ²ØÜ Ø¼¶ Ð²Ü-Ç ÏáÕÙÇó, áñáÝó ÁÝ¹Ñ³Ýáõñ ÃÇíÁ Ï³½ÙáõÙ ¿ -1600 մասնագետ: ¸Ç³μ»ïÇÏ é»ïÇÝáå³ïÇ³: ԱՄՆ ՄԶԳ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ կողմից իրականացվել է դիաբետիկ ռետինոպատիայի 400 լազերային միջամտություն: 2008 Ã.Ï³½Ù³Ï»ñåí»É ¿ ë»ÙÇÝ³ñ §¸Ç³μ»ïÁ ¨ ÏáõñáõÃÛáõÝÁ¦ Ã»Ù³Ûáí, áñÇÝ Ù³ëÝ³Ïó»É »Ý ³ÏÝ³μáõÛÅÝ»ñÁ ¨ Ý»ñ½³ï³μ³ÝÝ»ñÁ: Øß³Ïí»É ¨ å³ñμ»ñ³μ³ñ í»ñ³Ý³Ûí»É »Ý ¹Ç³μ»ïÇ í³ñÙ³Ý áõÕ»óáõÛóÝ»ñÁ ³é³çÝ³ÛÇÝ ûÕ³ÏÇ Ù³ëÝ³·»ïÝ»ñÇ Ñ³Ù³ñ: ì»ñçÇÝ í»ñ³Ý³Ûí³Í ¨ Éñ³Ùß³Ïí³Í ï³ñμ»ñ³ÏÁ Ñ³ëï³ïí»É ¿ ÐÐ ²Ü Ññ³Ù³Ýáí:

59 Üå³ï³Ï II. Üí³½»óÝ»É Ù³ÝÏ³Ï³Ý ÏáõñáõÃÛ³Ý ¹»åù»ñÇ ù³Ý³ÏÁ ¨ μ³ñ»É³í»É »ñ»Ë³Ý»ñÇ ³ãù»ñÇ ³éáÕçáõÃÛáõÝÁ: ºÝÃ³Ýå³ï³ÏÝ»ñ: ´áÉáñ ¹åñáó³Ñ³ë³Ï »ñ»Ë³Ý»ñÇÝ ³å³Ñáí»É ³Ýí×³ñ ³ÏÝ³μáõÅ³Ï³Ý Ñ»ï³½áïáõÃÛáõÝÝ»ñ` é»ýñ³ÏóÇáÝ Ë³Ý·³ñáõÙ¬Ý»ñÇ Ñ³ÛïÝ³μ»ñÙ³Ý ¨ ³é³í»É Ï³ñÇù³íáñÝ»ñÇÝ ³ÏÝáóÝ»ñáí ³å³ÑáíÙ³Ý Ýå³ï³Ïáí: Ð³Ýñ³å»ïáõÃÛáõÝáõÙ ëï»ÕÍ»É ³ÝÑ³ë Ýáñ³ÍÇÝÝ»ñÇ é»ïÇÝáå³ÃÇ³ÛÇ ÑëÏáÕáõÃÛ³Ý ³ñ¹ÛáõÝ³í»ï Ñ³Ù³Ï³ñ·: 1. ՀՀ մարզերում, կապված մասնագիտական ներուժի դիֆիցիտի հետ, երեխաների ակնաբուժական խնդիրներով զբաղվում եմ մեծերի մասնագետները, որոնց հետ, մանկության խնդիրների վերաբերյալ ուսուցման աշխատանք է տանում Հայկական ակնաբուժական նախագիծը: 2. ¸åñáó³Ñ³ë³Ï »ñ»Ë³Ý»ñÇ ßñç³ÝáõÙ Ï³ï³ñíáõÙ »Ý Ï³ÝË³ñ·»ÉÇã μÅßÏ³Ï³Ý ùÝÝáõÃÛáõÝÝ»ñ, áñÇ Å³Ù³Ý³Ï Ñ³ÛïÝ³μ»ñí³Í é»ýñ³ÏóÇáÝ Ë³Ý·³ñáõÙÝ»ñÇ ¹»åùáõÙ ³é³ç³ñÏíáõÙ ¿ Ù³ëÝ³·Çï³Ï³Ý μáõÅáõÙ, ïñ³Ù³¹ñíáõÙ »Ý ³ÏÝáóÝ»ñ /Ù³ñ¹³ëÇñ³Ï³Ý ×³Ý³å³ñÑáí ëï³óí³Í, ÇÝãå»ë Ý³¨ Ô³ñ³·Ûá½Û³Ý ÑÇÙÝ³¹ñ³ÙÇ ÏáÕÙÇó ºñ¨³ÝáõÙ, êÛáõÝÇùÇ, Èáéáõ ¨ ÞÇñ³ÏÇ Ù³ñ½»ñáõÙ/: 3. Երեխաների մասնագիտական աÏÝ³μáõÅ³Ï³Ý Ñ»ï³½áïáõÃÛáõÝÝ»ñը ¨ μáõÅáõÙը Ù³ÝÏ³Ï³Ý ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñ ãáõÝ»óáÕ Ù³ñ½»ñÇ Ñ»é³íáñ μÝ³Ï³í³Ûñ»ñáõÙ ³åñáÕ é»ýñ³ÏóÇáÝ Ë³Ý·³ñáõÙÝ»ñáí ¹åñáó³Ñ³ë³Ï »ñ»Ë³Ý»ñÇÝ իñ³Ï³Ý³óí»É ¿ ²ØÜ Ø¼¶ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ ÏáÕÙÇց: Կ³ï³ñí»É »Ý ³Ûó»ñ ÐÐ Ù³ñ½»ñ` ßñçÇÏ ³ÏÝ³μáõÅ³Ï³Ý խմբերի ÏáÕÙÇó ստուգվել է 72147 երեխա` ՀՀ մարզերում և Երևանում: 4. è»ýñ³ÏóÇáÝ Ë³Ý·³ñáõÙÝ»ñ áõÝ»óáÕ »ñ»Ë³Ý»ñÇ ÍÝáÕÝ»ñÇÝ ïñ³Ù³¹ñ»É Ñ³Ù³å³ï³ëË³Ý ÏñÃ³Ï³Ý ÝÛáõÃ»ñ, ÇëÏ ³Û¹åÇëÇ »ñ»Ë³Ý»ñÇÝ` ËáñÑñ¹³ïíáõÃÛáõÝ Æñ³Ï³Ý³óí»É ¿ ²ØÜ Ø¼¶ Ð²Ü ÏáÕÙÇó – ծնողների համար կազմակերպած հանրային կրթության դասերում մասնակցել է 843 ծնող, նաև տարածվել են 4 անուն բրյոշյուր, ներառյալ ռեֆրակցիոն խանգարումների մասին` ծնողների համար: 5. Նախատեսվում է կ³½Ù³Ï»ñå»É Ûáõñ³ù³ÝãÛáõñ Ù³ñ½Çó Ù»Ï ³ÏÝ³μáõÛÅÇ í»ñ³å³ïñ³ëïáõÙ ³ÝÑ³ë Ýáñ³ÍÇÝÝ»ñÇ é»ïÇÝáå³ÃÇ³ÛÇ í³Õ ³ËïáñáßÙ³Ý ¨ μáõÅÙ³Ý í»ñ³μ»ñÛ³É` Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ աջակցությամբ: 6. ²ÝÑ³ë Ýáñ³ÍÇÝÝ»ñÇ é»ïÇÝáå³ÃÇ³ÛÇ μáõÅÙ³Ý Ýå³ï³Ïáí ºñ¨³ÝÇ ØËÇÃ³ñ Ð»ñ³óáõ ³Ýí³Ý å»ï³Ï³Ý μÅßÏ³Ï³Ý Ñ³Ù³Éë³ñ³Ý äà²Î-Ç Ð³Ù³Éë³ñ³Ý³Ï³Ý ³ÏÝ³μáõÅ³Ï³Ý ÏÉÇÝÇÏ³Ï³Ý ÑÇí³Ý¹³ÝáóÇÝ ïñ³Ù³¹ñ»É É³½»ñ³ÛÇÝ ë³ñù³íáñáõÙÝ»ñ: Ð³Ýñ³å»ïáõÃÛ³Ý μáÉáñ åáÉÇÏÉÇÝÇÏ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÇ Ù³ÝÏ³Ï³Ý ³ÏÝ³μáõÛÅÝ»ñÇ Ñ³Ù³ñ Ùß³Ï»É ¨ Çñ³Ï³Ý³óÝ»É í»ñ³å³ïñ³ëïÙ³Ý

¹³ëÁÝÃ³ó` ³ÝÑ³ë Ýáñ³ÍÇÝÝ»ñÇ é»ïÇÝáå³ÃÇ³ÛÇ í³Õ ³ËïáñáßÙ³Ý ¨ μáõÅÙ³Ý, ÇÝãå»ë Ý³¨ é»ýñ³ÏóÇáÝ Ë³Ý·³ñáõÙÝ»ñÇ í»ñ³μ»ñÛ³É: ՀԱՆ-ը ձեռք է բերել երկու ռետինալ ֆոտոխցիկ և դիոդային լազեր` անհաս ռետինոպաթիայի ախտորոշման և բուժման համար: 7. Անհաս Ï³Ù ó³Íñ ù³ßáí »ñ»Ë³Ý»ñÇ ³ÏÝ³μáõÅ³Ï³Ý Ñ»ï³½áïáõÃÛ³Ý ¨ μáõÅÙ³Ý Ñ³ÙÁÝ¹Ñ³Ýáõñ ÁÝÃ³ó³Ï³ñ·»ñը և դրա իրականացման ²½·³ÛÇÝ Íñ³·ñÇ Ý³Ë³·ÇÍÁ նախաå³ïñ³ëïí»É ¿ Հայկական ակնաբուժության նախագծի ÏáÕÙÇó, հաստատվել է ÐÐ ²Ü-ի կողմից: È³ÛÝ³Í³í³É ³ßË³ï³ÝùÝ»ñÁ »ÝÃ³¹ñíáõÙ ¿ ëÏë»É 2010 ë»åï»Ùμ»ñÇó: Üå³ï³Ï III. Ð³Ýñ³å»ïáõÃÛáõÝáõÙ ½³ñ·³óÝ»É ÏáõñáõÃÛ³Ý Ï³ÝË³ñ·»ÉÙ³ÝÁ Ýå³ëïáÕ »ÝÃ³Ï³éáõóí³ÍùÝ»ñÁ: ºÝÃ³Ýå³ï³ÏÝ»ñ: ¼³ñ·³óÝ»É ³ÏÝ³μáõÅáõÃÛ³Ý ³é³çÝ³ÛÇÝ ûÕ³ÏÁ ·ÛáõÕ³Ï³Ý μÝ³Ï³í³Ûñ»ñáõÙ: ´³ñ»É³í»É ³ÏÝ³μáõÅáõÃÛ³Ý ³é³çÝ³ÛÇÝ ûÕ³ÏÁ åáÉÇÏÉÇÝÇÏ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñáõÙ: ²ñ¹Ç³Ï³Ý³óÝ»É ¨ ë³ñù³íáñáõÙÝ»ñáí Ñ³Ù³Éñ»É ·áÛáõÃÛáõÝ áõÝ»óáÕ Ù³ñ½³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñÁ: ²ñ¹Ç³Ï³Ý³óÝ»É Ð³Û³ëï³ÝáõÙ ³ÏÝ³μáõÅáõÃÛ³Ý »ññáñ¹³ÛÇÝ ûÕ³ÏÁ: 1. Նախատեսվել էր ըÝïñí³Í ·ÛáõÕ³Ï³Ý ³ÙμáõÉ³ïáñÇ³Ý»ñáõÙ Ï³Ù ÁÝï³Ý»Ï³Ý μÅßÏÇ ·ñ³ë»ÝÛ³ÏÝ»ñáõÙ ëï»ÕÍ»É ·ÛáõÕ³Ï³Ý μáõÅÏ»ï»ñ (20,000 μÝ³ÏãÇ Ñ³ßíáí Ù»Ï Ï»ÝïñáÝ), áñáÝù ÏÍ³é³Û»Ý áñå»ë ³é³çÝ³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñ: Üáñ Ï»ÝïñáÝÝ»ñÇ ëï»ÕÍÙ³Ý Ñ»ï Ï³åí³Í é»ëáõñëÝ»ñÇ ËÝ³ÛáÕáõÃÛ³Ý Ýå³ï³Ïáí áñå»ë ³Û¹åÇëÇù ¹Çï³ñÏíáõÙ ¿ ï³ñ³Í³ßñջ³Ý³ÛÇÝ åáÉÇÏÉÇÝÇÏ³Ý»ñÇ Ï³Ù μáõÅÙÇ³íáñáõÙÝ»ñÇ åáÉÇÏÉÇÝÇÏ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÇ ³ÏÝ³μáõÅ³Ï³Ý Ï³μÇÝ»ïÝ»ñÁ, որոնք հագեցվել են սարքավորումներով ՀԲ առողջապահական վարկային ծրագրի շրջանակներում կամ ëï³ó»É »Ý ³ç³ÏóáõÃÛáõÝ ÙÇç³½·³ÛÇÝ Ï³½Ù³Ï»ñåáõÃÛáõÝÝ»ñÇ /մասնավորապես ԱՄՆ ՄԶԳ/ ÏáÕÙÇó: 2. Գլաուկոմայի կանխարգելման նպատակով, սÏë³Í 2008Ã. –ից, ÐÐ ²Ü Ññ³Ù³Ýáí Ñ³ëï³տí³Í ã³÷áñáßիãáí /áñÁ å»ï³Ï³Ý å³ïí»ñÇ ï»Õ³¹ñÙ³Ý Ý³Ë³å³ÛÙ³Ý ¿/, ë³ÑÙ³Ýí»É ¿, áñ å³ñï³¹Çñ Ï³ÝË³ñ·»ÉÇã ³ÛóÇ ßñç³Ý³ÏÝ»ñáõÙ Çñ³Ï³Ý³óí»Éáõ ¿ ·É³áõÏáÙ³ÛÇ í³Õ Ñ³ÛïÝ³μ»ñÙ³Ý ëÏñÇÝÇÝ·, áñÁ »ÝÃ³¹ñáõÙ ¿ Ý³¨ Ý»ñ³ÏÝ³ÛÇÝ ×ÝßÙ³Ý ã³÷áõÙ: Պոլիկլինիկաների և ԱՄՆ ՄԶԳ Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÍÇ կողմից ընդհանուր ստուգումների

61 ժամանակ վեր է հանվել ակնային ճնշման կասկած ունեցող 1730 հիվանդ: 3. Ø³ñ½³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñÇ հագեցումը ակնաբուժական սարքավորումներով /այդ թվում լազերային/, նախատեսվել և իրականացվում է ՀԲ առողջապահական ՎԾ շրջանակներում <<Մարզային հիվանդանոցների արդիականացման ծրագրի ենթատեքստում: 4. ì»ñ³Ýáñá·»É ¨ ³ñ¹Ç³Ï³Ý ë³ñù³íáñáõÙÝ»ñáí Ñ³·»óÝ»É ì³Ý³ÓáñÇ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÁ: Վանաձորում կենտրոնի ստեղծումը չի իրականացվել, դրա փոխարեն ստեղծվել է Գեղարքունիքի մարզի Սևան քաղաքում Հայաստանի Ամերիկյան համալսարանի և Լայոնս Ակումբի աջակցությամբ: Կենտրոնը ունի լավ շենքային պայմաններ, հագեցված է ժամանակակից սարքավորումներով: 2008թ. լիցենզավորվել է ՀՀ ԱՆ կողմից: 5. §²Ï³¹»ÙÇÏáë ê.²í¹³Éμ»ÏÛ³ÝÇ ³Ýí³Ý ³éáÕç³å³ÑáõÃÛ³Ý ³½·³ÛÇÝ ÇÝëïÇïáõï¦ ö´À-Ç ³ãùÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ ³ÙμÇáÝÇÝ ÏÇó ëï»ÕÍվել է ò³Íñ ï»ëáÕáõÃÛ³Ý Ï»ÝïñáÝ, որը համապատասխանում է ÙÇç³½·³ÛÇÝ ã³÷áñáßÇãÝ»ñÇն: Այն ստեղծված է ԱՄՆ ՄԶԳ Հայկական ակնաբուժության նախագծի աջակցությամբ` Քանաքեռ-Զեյթուն ԲԿ-ի կազմում, որը հանդիսանում է §²Ï³¹»ÙÇÏáë ê.²í¹³Éμ»ÏÛ³ÝÇ ³Ýí³Ý ³éáÕç³å³ÑáõÃÛ³Ý ³½·³ÛÇÝ ÇÝëïÇïáõï¦ ö´À-Ç ³ãùÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ ³ÙμÇáÝÇ բազան: Üå³ï³Ï IV. ´Ý³ÏãáõÃÛ³ÝÁ å³ïß³× ³ÏÝ³μáõÅ³Ï³Ý Í³é³ÛáõÃÛáõÝÝ»ñÇ Ù³ïáõóÙ³Ý Ñ³Ù³ñ ½³ñ·³óÝ»É Ù³ñ¹Ï³ÛÇÝ/կադրային/ é»ëáõñëÝ»ñÁ: ºÝÃ³Ýå³ï³ÏÝ»ñ: ´³ñÓñ³óÝ»É Ñ³Ýñ³å»ïáõÃÛáõÝáõÙ ³ÏÝ³μáõÅáõÃÛ³Ý ³é³çÝ³ÛÇÝ ûÕ³ÏÇ μáõÅ³ßË³ïáÕÝ»ñÇ ÏñÃáõÃÛ³Ý Ù³Ï³ñ¹³ÏÁ: ´³ñÓñ³óÝ»É Ù³ñ½³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñÇ ³ÏÝ³μáõÛÅÝ»ñÇ ·Çï»ÉÇùÝ»ñÇ Ù³Ï³ñ¹³ÏÁ: ²ÏÝ³μáõÅáõÃÛ³Ý áõëáõóÙ³Ý Ù³Ï³ñ¹³ÏÁ Ñ³ëóÝ»É ²ÏÝ³μáõÅ³Ï³Ý ÙÇç³½·³ÛÇÝ ËáñÑñ¹Ç ¨ ²ÏÝ³μáõÅ³Ï³Ý Ï³½Ù³Ï»ñåáõÃÛáõÝÝ»ñÇ ÙÇç³½·³ÛÇÝ ý»¹»ñ³óÇ³ÛÇ ÏáÕÙÇó ë³ÑÙ³Ýí³Í ã³÷³ÝÇßÝ»ñÇÝ 1. Ð³Ýñ³å»ïáõÃÛ³Ý μáÉáñ Ù³ñ½»ñÇ ·ÛáõÕ³Ï³Ý ³ÙμáõÉ³ïáñÇ³Ý»ñÇ ¨ ÁÝï³Ý»Ï³Ý μáõÅùáõÛñ»ñն ÁÝ¹·ñÏվ»É են ³é³çÝ³ÛÇÝ ûÕ³ÏáõÙ ³ÏÝ³μáõÅáõÃ¬Û³Ý í»ñ³μ»ñÛ³É »ռûñÛ³ í»ñ³å³ïñ³ëïÙ³Ý ¹³ëÁÝÃ³óÝ»ñում, որի շրջանակներում ԱՄՆ ՄԶԳ Հայկական ակնաբուժության նախագծի աջակցությամբ վերապատրաստվել է 1600 մասնագետ: Կրկնակի վերապատրաստում են անցել 57 ընտանեկան բժիշկ մարզերում, վերապատրաստվել է նաև 37 ակնաբուժական բուժքույր:

2. ²ØÜ Ø¼¶ Հայկական ակնաբուժության նախագծի աջակցությամբ ՀՀ մ³ñ½³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñÇ 61 ³ÏÝ³μáõÛÅÝ»ր í»ñ³å³ïñ³ëïվ»É են ÷áùñ Ïïñí³Íùáí ¨ Ý»ñ³ÏÝ³ÛÇÝ áëåÝÛ³ÏÇ ï»Õ³¹ñÙ³Ùμ Ï³ï³ñ³ÏïÇ ¿ùëïñ³Ï³åëáõÉÛ³ñ íÇñ³Ñ³ïáõÃÛáõÝÝ»ñÇ ï»ËÝÇÏ³ÛÇ, ·É³áõÏáÙ³ÛÇ ½³Ý·í³Í³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñÇ ¨ μáõÅÙ³Ý, ÇÝãå»ë Ý³¨ ¹Ç³μ»ïÇÏ é»ïÇÝáå³ÃÇ³ÛÇ É³½»ñ³ÛÇÝ μáõÅÙ³Ý áõÕÕáõÃÛ³Ùμ: 3. ²ÏÝ³μáõÅáõÃÛáõÝ áõëáõó³ÝáÕ áõëáõÙÝ³Ï³Ý Ñ³ëï³ïáõÃÛáõÝÝ»ñÇ áõëáõÙÝ³Ï³Ý Íñ³·ñ»ñը ÙÇç³½·³ÛÇÝÇ Ù³Ï³ñ¹³ÏÇÝ Ñ³Ù³å³ï³ëË³Ý»óÝ»Éու պահանջը կատարվում է սկսած 2009 թվականից, համաձայն ՀՀ կառավարության որոշման, ըստ որի` բոլոր կրթական ծրագրերը, այդ թվում նաև ակնաբուժական, համապատասխանեցվում է միջազգային չափանիշներին: Üå³ï³Ï V. ´³ñÓñ³óÝ»É ÏáõñáõÃÛ³Ý, áñå»ë Ï³ñ¨áñ³·áõÛÝ Ñ³Ýñ³ÛÇÝ ³éáÕç³å³Ñ³Ï³Ý ÑÇÙÝ³Ñ³ñóÇ í»ñ³μ»ñÛ³É μÝ³ÏãáõÃÛ³Ý Çñ³½»ÏáõÃÛáõÝÁ: ºÝÃ³Ýå³ï³ÏÝ»ñ: ²ÝóÏ³óÝ»É μÝ³ÏãáõÃÛ³Ý Çñ³½»ÏáõÃÛ³Ý μ³ñÓñ³óÙ³Ý ½³Ý·í³Í³ÛÇÝ ÙÇçáó³éáõÙÝ»ñ Ï³ï³ñ³ÏïÇ, ·É³áõÏáÙ³ÛÇ ¨ ¹Ç³μ»ïÇÏ é»ïÇÝáå³ÃÇ³ÛÇ í»ñ³μ»ñÛ³É: Øß³Ï»É ¨ ³ÝóÏ³óÝ»É ³ãùÇ ³éáÕçáõÃÛ³Ý í»ñ³μ»ñÛ³É ½³Ý·í³Í³ÛÇÝ ÏñÃ³Ï³Ý ÙÇçáó³éáõÙÝ»ñ ¹åñáó³Ñ³ë³Ï »ñ»Ë³Ý»ñÇ ¨ Ýñ³Ýó ÍÝáÕÝ»ñÇ ßñç³ÝáõÙ: 1. ÀÝï³Ý»Ï³Ý μÅÇßÏÝ»ñÇ áõëáõÙÝ³Ï³Ý Íñ³·ñáõÙ ÁÝ¹É³ÛÝվ»É է ³ÏÝ³μáõÅáõÃÛ³Ý μ³ÅÇÝÁ, թ³ñÙ³óվ»É է հանրության առողջապահական ÏñÃությանն ուղղված Íñ³·ñ»ñÇ í»ñ³μ»ñÛ³É ·áÛáõÃÛáõÝ áõÝ»óáÕ ÝÛáõÃ»ñÁ: 2. ԲÝ³ÏãáõÃÛ³Ý Çñ³½»ÏáõÃÛ³Ý μ³ñÓñ³ó¬Ù³Ý ½³Ý·í³Í³ÛÇÝ ÙÇçáó³éáõÙÝ»ñն իրականացվում են ԱՄՆ ՄԶԳ ԱԱՊԲ և ԱՄՆ ՄԶԳ ՀԱՆ ծրագրերի կողմից: Պատրաստվել և բաժանվել են հանրային կրթության 12 անվանում բրոշյուրներ ` ընդհանուր 600 000 քանակով: 3. Ð³Ýñ³å»ïáõÃÛáõÝáõÙ ՀԱՆ-ի ջանքերով նշվում է î»ëáÕáõÃÛ³Ý Ñ³Ù³ßË³ñÑ³ÛÇÝ ûñÁ ուրաքանչյուր տարվա հոկտեմբերի երկրորդ շաբաթվա հինգշաբթին: Üå³ï³Ï VI. ÎáõñáõÃÛ³Ý Ï³ÝË³ñ·»ÉÙ³Ý áÉáñïáõÙ Çñ³Ï³Ý³óÝ»É Ñ»ï³½áïáõÃÛáõÝÝ»ñ ¨ ½³ñ·³óÙ³Ý Íñ³·ñ»ñ: ºÝÃ³Ýå³ï³ÏÝ»ñ: Øß³Ï»É ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ í»ñ³ÑëÏÙ³Ý, ³éáÕç³å³ÑáõÃÛ³Ý Ï³é³í³ñÙ³Ý ¨ Í³é³ÛáõÃÛáõÝÝ»ñÇ Ù³ïáõóÙ³Ý Ó»éÝ³ñÏÝ»ñ ¨ áõÕ»óáõÛóÝ»ñ: Æñ³Ï³Ý³óÝ»É Ñ³Ù³×³ñ³Ï³μ³Ý³Ï³Ý ¨ ÏÉÇÝÇÏ³Ï³Ý Ñ»ï³½áïáõÃÛáõÝÝ»ñ:

63 ²ÝóÏ³óÝ»É ÏáõñáõÃÛ³Ý Ï³ÝË³ñ·»ÉÙ³Ý ³½·³ÛÇÝ é³½Ù³í³ñ³Ï³Ý Íñ³·ñÇ Çñ³Ï³Ý³óÙ³Ý ·Ý³Ñ³ïáõÙ ¨ ³ÝÑñ³Å»ßïáõÃÛ³Ý ¹»åùáõÙ Ï³ï³ñ»É Ñ³Ù³å³ï³ëË³Ý áõÕÕáõÙÝ»ñ: 1. Î³ï³ñվում է ß³ù³ñ³Ëïáí ·ñ³Ýóí³Í ÑÇí³Ý¹Ý»ñÇ ïíÛ³ÉÝ»ñÇ áõëáõÙÝ³ëÇñáõÃÛáõÝÝ»ñ` որպես ÏáõñáõÃÛ³Ý å³ï×³é Ñ³Ý¹Çë³óáÕ ³ãùÇ ÑÇí³Ý¹áõÃÛáõÝÝ»ñÇ éÇëÏ³ÛÇÝ ·áñÍáÝի: Այդ նպատակով ՀՀ ԱՆ կողմից 2010 թվականից ներդրվել է Միդաս-3 ավտոմատացված հաշվետվական համակարգը` լրացվում է 002 ձևը, որում ներառվել է շաքարային դիաբետը: 2. ՀՀ ԱՆ և ԱՄՆ ՄԶԳ Հայկական ակնաբուժության նախագծի կողմից մß³Ïվ»É են ·ÛáõÕ³Ï³Ý ³ÙμáõÉ³ïá¬ñÇ³Ý»ñÇ ¨ Ù³ñ½³ÛÇÝ ³ÏÝ³μáõÅ³Ï³Ý Ï»ÝïñáÝÝ»ñÇ μáõÅ³ßË³-ïáÕÝ»ñÇ ëï³Ý¹³ñï³óí³Í ³ßË³ï³Ï³ñ·»ñ/ չափորոշիչներ: Այդպիսի չափորոշիչներ մշակվում և հասցվում են համակարգին ամեն տարի: Դրանցում ներառվում են նաև ամբուլատոր – պոլիկլինիակական հաստատությունների կողմից ակնաբուժական ծառայության մատուցման կազմակերպչական մոտեցումները: 3. Նախատեսվել է իñ³Ï³Ý³óÝ»É Ù³ÝÏ³Ï³Ý ÏáõñáõÃÛ³Ý ¨ ¹åñáó³Ñ³ë³Ï »ñ»Ë³Ý»ñÇ Ùáï é»ýñ³ÏóÇáÝ Ë³Ý·³ñáõÙÝ»ñÇ ï³ñ³Íí³ÍáõÃÛ³Ý í»ñ³μ»ñÛ³É ³½·³ÛÇÝ Ñ»ï³½áïáõÃÛáõÝÝ»ñ, որի վերաբերյալ համագործակցության առաջարկներ են ներկայացվել միջազգային կազմակերպություններին, այդ թվում ԱՄՆ ՄԶԳ -ին:

MINISTRY OF HEALTH REPUBLIC OF ARMENIA

COUNTDOWN TOWARDS 2020 ACTIVITIES AND STATISTICS ACTIVITIES CARRIED OUT BY THE ARMENIAN EYECARE PROJECT AND THE EYE HEALTH SITUATION ANALYSIS IN THE REPUBLIC OF ARMENIA

This publication was made possible with the support of the American People through the U.S. Agency for International Development (USAID) and the Armenian EyeCare Project (AECP). The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views of USAID or the U.S. Government.

YEREVAN 2010

Group of Authors Author Nairuhi Jrbashyan Roger Ohanesian Alexander Malayan Nune Yeghiazaryan Varvara Kalashyan

Data Analysis by Nairuhi Jrbashyan Design by Minas Hambardzumyan

This pubication presents the activities carried out by the Armenian EyeCare Project (AECP) in Armenia and services provided to the population during 2003-2009. At the same time, it presents the estimates of main indicators of eye health and incidence of main eye diseases in Armenia. These indicators will serve as a basis for policy makers to analyze the eye health situation and estimate the demand of eye care services in the country.

CONTENTS INTRODUCTION.....................................................................................................................................68 68 1. THE ARMENIAN EYECARE PROJECT: OBJECTIVE AND PRESENT ACHIEVEMENTS.................................................................................69 59 1.1. THE 0BJECTIVE, ESSENCE AND PARTNERS OF THE PROJECT.........................................69 69 1.2. MAIN ACHIEVEMENTS OF THE PROJECT...............................................................................71 71 2. THE AECP INITIATIVE “BRINGING SIGHT TO ARMENIAN EYES”, ITS COMPONENTS AND RESULTS....................................................................................................71 71 2.1. THE ESSENCE AND MAIN RESULTS OF THE INITIATIVE.....................................................71 71 2.2. GENERAL DESCRIPTION OF THE INITIATIVE COMPONENTS...........................................72 72 • General screening and medical aid.......................................................................................72 72 • Data analysis and scientific-practical activities................................................................7373 • Medical education and training.............................................................................................74 74 • Public education..........................................................................................................................74 74 • Capacity building.........................................................................................................................75 75 3. BRIEF DESCRIPTION OF THE EYECARE SERVICES PROVIDED BY THE AECP TO THE ARMENIAN POPULATION IN THE PERIOD OF 2003-2009........................................80 80 3.1. BRIEF DESCRIPTION OF THE AECP EYECARE SERVICES RENDERED DURING THREE MEDICAL TOURS IN THE PERIOD OF 2003-2009..........................................................80 80 3.2. BRIEF DESCRIPTION OF THE AECP ACTIVITIES DURING THE THIRD MEDICAL TOUR IN THE PERIOD OF 2007-2009....................................................84 84 4. SUMMARY OF THE AECP DATABASE ANALYSES..................................................................85 85 4.1. METHODOLOGY OF COLLECTION AND PROCESSING OF THE EYE HEALTH DATA AMONG THE POPULATION SCREENED BY THE AECP..................................86 86 4.2. EYE DISEASES DIAGNOSED AMONG THE RA POPULATION DURING THE AECP THREE MEDICAL TOURS IN THE PERIOD OF 2003-2009......................................87 87 4.3. ESTIMATES OF THE EYE DISEASES PREVALENCE AMONG THE RA POPULATION ACCORDING TO THE AECP DATA...........................................................91 91 5. EYECARE SERVICES RENDERED TO THE RA POPULATION BY THE AECP DURING THREE MEDICAL TOURS IN THE PERIOD OF 2003-2009 AT THE MARZ LEVEL.............................................................................................................................9595 5.1. 5.2. 5.3. 5.4. 5.5. 5.6. 5.7. 5.8. 5.9.

THE ARAGATSOTN MARZ................................................................................................95 95 THE ARARAT MARZ ...........................................................................................................96 96 THE ARMAVIR MARZ.........................................................................................................9797 THE KOTAYK MARZ............................................................................................................9898 THE LORI MARZ..................................................................................................................99 99 THE SHIRAK MARZ.............................................................................................................100 100 THE SYUNIK MARZ.............................................................................................................101 101 THE TAVOUSH MARZ.........................................................................................................102 102 THE VAYOTS DZOR MARZ................................................................................................103 103

APPENDICES..........................................................................................................................................105 105

INTRODUCTION The pain and suffering of blindness is incalculable. The restoration of sight is priceless. Vision problems worldwide as well as in Armenia are ranked among public health issues. A large portion of the population, especially after 50, is in the risk group for blindness. Vision 2020, a worldwide initiative of the World Health Organization and International Agency for the Prevention of Blindness / IAPB/ calls for more active actions to reach the goal of reducing preventable blindness worldwide by 100, 000 persons by 2020. The World Sight Day, celebrated annually since 1999 in many countries at the Vision2020 initiative is meant to voice the problems of those who have eye problems and remind the world of its commitments. The motto of this year’s World Sight Day is “Countdown towards 2020”. It calls for a sum-up of the activities and accomplishments in this field and for reasonable planning of the work to be done before 2020, including the implementation process of National Blindness Prevention Strategies. The Armenian EyeCare Project (AECP) is one of the organizations largely involved in eyecare in Armenia. The AECP mission is to eliminate preventable blindness in Armenia and to make 21st Century eye care accessible to every Armenian child and adult. Following its mission and the priorities of the Vision2020, the AECP is pleased to mark the celebration of the World Sight Day, 2010 with the publication of its analytical report “Countdown towards 2020: Activities and Statistics”, in cooperation with the RA Ministry of Health and the United States Agency for International Development. The publication is very much in line with the motto of this year’s World Sight Day “Countdown to 2020”. It sums up the results of the work done by the AECP since its establishment in 1992, touches upon the main initiatives and achievements, and presents the results of its scientific research, which would allow estimating the eye health of the population and evaluating the eye care demand for the country. In addition, following the logic of the “Countdown towards 2020” the brochure provides certain information on the accomplishments of the National Blindness Prevention Strategy in Armenia and the AECP contribution in reaching the goals set up in the Strategy (the Information note was kindly provided by the RA Ministry of Health and is presented in the Annex 2) . Impressive results are reached thanks to the coordinated work of the AECP comprehensive program “Bringing Sight to Armenian Eyes”, the USAID/AECP “Primary and Ophthalmologic Health Care Alliance” as well as its numerous partners and donors. 68

69 The beauty of the statistics presented to you is also in its uniqueness for Armenia. For many years any comprehensive information on the eye care and eye diseases has been very limited. The brochure has introduced the Index of Eye Health Vulnerability for the population of 50+, cataract surgery coverage rate among the population, the prevalence of the main widespread diseases causing blindness and blindness as well as blindness and visual impairment estimates. All mentioned estimates were calculated at the country and marz level for the first time. We hope that this analytical report will be useful for healthcare decision makers, scientists and practitioners dealing with eye care services planning and implementation at the country and regional level. The authors would like to thank the partners, the AECP staff and medical teams involved in the preparation of this work, for their support and assistance.

1. THE ARMENIAN EYECARE PROJECT: OBJECTIVE AND PRESENT ACHIEVEMENTS 1.1

THE OBJECTIVE OF THE PROJECT, ITS ESSENCE AND PARTNERS

The Armenian EyeCare Project (hereafter AECP) is a US-based charity organization founded in 1992 by Armenian-American ophthalmologist Dr. Roger Ohanesian. Its mission is to eliminate preventable blindness and make eye care accessible to all people in Armenia. To this end, many highly qualified American academic ophthalmologistshave been invited to visit Armenia to treat patients and share the knowledge with their Armenian colleagues. As well, large quantities of medication and equipment have been brought during this time to Armenia. The AECP carries out its activities in the Republic of Armenia in close cooperation with it partners in Armenia and outside. The main partners of the AECP are as follows: • Ministry of Health • Ministry of Labor and Social Issues • Governors offices in all the marzes of Armenia, Yerevan municipality, community councils,, • S. Malayan Ophthalmologic Center • Kanaker Zeitun Medical Center • Yerevan State Medical University #1 eye clinic, • Regional medical centers, health centers and FAPs (village health points), • United States Agency for International Development and relevant medical and educational programs • Numerous organizations and individuals in the Diaspora • Embassies of a number of countries in Armenia • Numerous non-governmental and international organizations

1.2.

MAIN ACHIEVEMENTS OF THE PROGRAM

During the entire course of its operations in Armenia starting 1992, the AECP has carried out large- scale activities, resulting in impressive achievements. Some of such achievements are listed below.

• • • • • • • • •

•

• • • 70

Organized and carried out 36 U.S. medical missions to Armenia, with the participation of 55 U.S. academic ophthalmologists. The latter have traveled to Armenia, at their own expense, to teach and treat patients. Initiated $18,5 million worth donations of medical equipment and supplies to Armenian hospitals and clinics by American pharmaceutical and medical manufacturing companies and private individuals Initiated. Developed ophthalmology residency literature to improve teaching methods in compliance with Western standards, as well as authored and published two books “Eye Diseases” (2005) and “Essentials of Ophthalmology” (2007) for primary health care providers and ophthalmologists respectively. Developed legislation for an Eye Bank that was approved by the Government in February 1998. Sponsored 8 ophthalmology fellowships in the United States for Armenian physicians and 3 observerships. Sponsored and organized 11 International Ophthalmology Teaching Conferences in Yerevan. Sponsored 15 patients requiring specialized surgical care in the U.S. and provided services at no charge. Established and equipped five specialty clinics in the Malayan Ophthalmologic Center: • Vitreo-Retinal Disorders Clinic & Operating Room, 1998 • Glaucoma Clinic & Operating Room, 2000 • Corneal & Uveitis Disorders Clinic, 2001 • Neuro-ophthalmology and Orbital Surgery, 2004 • Eye Bank, 2005 The Mobile Eye Hospital was designed and built with American donations and delivered to Armenia in 2002 to travel throughout regions of the country. Up to date, it has accomplished three medical tours in the marzes of Armenia. The fourth tour started in October of 2009. Launched country-wide comprehensive program “Bringing Sight to Armenian Eyes” in June 2003 Launched country-wide public education and awareness campaign in 2005. Published 12 handouts (total of 600.000 copies) on eye care, safety and eye diseases of children and adults. Established and equipped USAID/AECP Education & Diagnostic Center in partnership with the Malayan Ophthalmology Center in May 2006.

• • •

Established and equipped USAID/AECP Low Vision Center in the Kanaker Zeitun Medical Center. Established and equipped a Wet Lab thanks to the generous donation of the Pfizer company, with the purpose to provide doctors and students with opportunities for surgical practice, 2007. Launched a Screening and Treatment Program on Retinopathy of Prematurity (ROP) in Armenia, 2010.

On the whole, the AECP activities have greatly contributed to the implementation of the “Armenian National Strategy of Blindness Prevention program” which was put into effect in 2006 (see appendix 2, which presents a document prepared by the Ministry of Health on the implementation of the National Strategy Blindness Prevention program , approved by the 02.11.2006 #43-N decree of the Government of the Republic of Armenia).

2. THE AECP INITIATIVE “BRINGING SIGHT TO ARMENIAN EYES”, ITS COMPONENTS AND RESULTS 2.1.

THE ESSENCE AND MAIN RESULTS OF THE INITIATIVE

Having established as “The Armenian EyeCare Project” Charitable Foundation in Armenia, the AECP launched a comprehensive program “Bringing Sight to Armenian Eyes” in 2003. It is aimed at strengthening the eye care delivery system and reducing preventable blindness in Armenia. Since October 2004 the USAID and the AECP has started cooperation within “Primary and Ophthalmologic Health Care Alliance” in the framework of the Global Development Alliance. The main objective of the Initiative is realized in five inter-linked directions, which make up the main components of the AECP work.

• • • • •

Screening of the population and direct patient care, Data analysis and scientific-practical research, Medical education and training, Public education and awareness, Capacity building.

The donations received from various individuals and companies, as well as the USAID Global development Alliance resources, has enabled the AECP, with its Mobile Eye Hospital and medical screening groups, to carry out regular visits to all Marzes (regions) of Armenia, including Yerevan. The AECP field missions provide

people with full-scale services – general screening, referral, surgery and laser treatment in MEH, prescription and provision of eye-glasses. In 2006, 2007, 2008 and 2010 as a separate project, the AECP visited Nagorno-Karabakh to provide high quality eye services there too. The main results achieved through all the components of the Initiative “Bringing Sight to Armenian Eyes” since June 2003 to September 2010 are as follows:

• • • • •

• • •

2.2.

264,568 people (including 128,933 children) were screened by the AECP medical groups in their villages or in adjacent settlements 27,091 people underwent thorough examination on the MEH 11,303 patients were operated on and treated on the MEH 29,546 eyeglasses were provided The created database incorporates data on the people screened by the AECP medical groups. Scientific-practical analyses of the data have allowed drawing estimates on the prevalence of eye diseases and visual impairment among the RA population. 1,684 health care providers, including 61 regional ophthalmologists and 37 ophthalmic nurses, were trained in eye diseases 501,156 public education handouts were distributed 360 public education classes for 9000 children and 900 parents and health activists were delivered.

GENERAL DESCRIPTION OF THE INITIATIVE COMPONENTS

Screening of the population and direct patient care The main objective of the Initiative “Bringing Sight to Armenian Eyes” is to make the quality eye care accessible to population in all the regions of Armenia which will help to prevent avoidable blindness in the country. Within the scope of the project the AECP Medical teams and the state-of-the-art Mobile Eye Hospital (MEH) travel to rural and urban communities throughout Armenia to render the following services:

• • •

General screening of children and adults Refraction for all and provision of eyeglasses to the socially vulnerable population On the Mobile Eye Hospital - detailed eye examination and laser treatment for all as well as surgery for vulnerable population

73 For timely prevention and treatment of eye diseases, special emphasis is placed on detection of diseases leading to blindness such as the cataract, glaucoma, diabetic retinopathy, macular degeneration etc. After general screening the patients get referrals to the MEH for detailed examination, laser treatment or surgery as needed. To secure more accessibility, the MEH is stationed in all central cities and towns of Armenia. Since June 2003 up to September 2009 the AECP completed three tours throughout Armenia. The fourth tour of the AECP field mission started in October of 2009 and is expected to be completed in September of 2011.

Data Analysis and Research Data analysis and scientific-practical research is a cornerstone of the AECP activities. As a result of the AECP outreach activities carried out since 2003, a database was created incorporating data on around 160,000 screened patients. The data processed in concordance with internationally accepted methodologies has allowed coming up with important indicators on the prevalence of eye diseases as well as drawing comparative analyses of the general ophthalmic health situation in the regions of Armenia. The collected data allows detecting the main causes of eye disorders and evaluating prevalence rate of diseases among the population such as the cataract, glaucoma, retina and eye fundus diseases. Based on the prevalence of the main eye diseases, the eye health vulnerability index for the AECP beneficiaries above 50 years was calculated. The latter, in fact, describes the risk factor of blindness in Armenia. The AECP has conducted two other surveys to evaluate patient satisfaction level with the AECP services. According to the research results, 94% of the patients who used the AECP services rated those as either good or excellent. To assess productivity of the eye surgeries performed on the Mobile Eye Hospital, the AECP conducted a follow-up survey in 2007 among the beneficiaries in the Armavir marz who were operated in the period of 2003-2006. The survey revealed that particularly the results of the 2006 are in conformity with international standards: for 91.5% of cataract surgeries good or borderline result was recorded. In addition, jointly with the Malayan Ophthalmic Center, the AECP has introduced a pilot monitoring system for cataract surgery outcomes based on the methodology and recommendations of the WHO. It is expected that the system will be incorporated in other health care institutions all over Armenia as well.

Medical Education and Training Medical training provides physicians at the primary, secondary and tertiary levels with up-to-date knowledge and skills to secure quality services to the population country-wide. The AECP has organized and conducted many training courses for regional ophthalmologists and family medicine doctors. Our partners in this sphere are the USAID contractors “Primary Health Care Reform” and “Academy for Educational Development” (AED). As of today, more than 1,600 primary healthcare providers in Yerevan and the regions were trained. Two books —the “Eye Diseases” and the “Essentials of Ophthalmology” authored by AECP, are the first textbooks on ophthalmology in the Armenian language, are in the core of the training. These books serve as a reference for the professional upgrade of the primary healthcare specialists and ophthalmologists. In addition, the regional primary health care workers and ophthalmologists have an opportunity to enrich their experiences by participating in the AECP screenings in the hometowns as well as to familiarize themselves with modern ophthalmic equipment by undertaking observership on the MEH during its visits to the regions. With the financial support of the USAID and assistance from the Ophthalmologic Center after S. Malayan, the Armenian EyeCare Project opened the Education and Diagnostic Center furnished with state-of-the-art equipment in 2006. Thanks to this Center, the Armenian physicians and students can familiarize themselves with the latest ophthalmologic achievements and developments in electronic and print formats. The Center incorporates Haik Babikian memorial library thus providing access to one of the richest collection of the specialized ophthalmologic literature in Armenia. Thanks to the generous donation of the US-based company Pfizer, the AECP brought Wet Lab to Armenia where the Armenian ophthalmologists improve their surgical skills.

Public Education The main goal of the Public Education program is educating the population about the measures for the prevention of eye diseases as well as highlighting the importance of using eye care services. By raising awareness through Public Education program, the AECP aims at integrating healthy eye care and safety practices into everyday life of the general public and particularly the children. In order to disseminate information about common eye diseases, eye care and 74

75 safety practices to a wider audience, the AECP published six hundred thousand copies of 12 educational brochures targeting different groups of population. The brochures are disseminated in the regions and communities where the AECP works. To raise public awareness, the AECP works with different target groups. Thematic talks on eye care and safety are conducted for schoolchildren, parents, teachers and medical personnel of the schools. During the talks they receive information about childhood and adult eye diseases, symptoms as well as safety measures and injury prevention. Thematic performances such as puppet shows and pantomime performances were organized for schoolchildren. In cooperation with local and international organizations, the AECP conducts training of trainers sessions with active community groups and healthcare providers, who disseminate the eye care related information in their respective communities, thus making the basic knowledge available for a larger number of people.

Capacity Building The AECP and its partners aim at turning Armenia into a Center of Excellence in Ophthalmology in the Caucasus region. Building blocks of the “Capacity building” are the transfer of knowledge and institutionalization of services. Since 1992, American physicians have been visiting Armenia on a semi-annual basis to transfer the know-how and skills in ophthalmology to their Armenian colleagues. In addition, 11 international training conferences were organized. By the initiative of the AECP, six specialty clinics were established and equipped/ revamped in the major ophthalmic centers of Armenia - S. Malayan Ophthalmologic Center and Kanaker – Zeitun Medical Center. These specialty clinics are -Retina, Glaucoma, Cornea and Uveitis, Neuro-orbital, Eye bank, and Low vision. These clinics are led by the Armenian ophthalmologists who had their fellowship in the finest eye care institutions of the US thanks to the AECP sponsorship. The AECP fellows now transfer their knowledge to their colleagues and students. As a separate direction, the AECP continues its program of the “Prevention and Treatment of the Prematurity of Retinopathy in Armenia”. It was launched in June of 2010 with the AECP medical mission and International Conference devoted on the prevention of the Retinopathy of Prematurity (ROP). In accordance with the respective instruction of the RoA Ministry of Health, the AECP-trained physicians regularly screen all premature infants in the Neonatal Intensive Care Units. Those in need of treatment undergo laser procedure. Annually, the program is expected to save about 100 premature infants in the risk group from lifelong blindness.

3. BRIEF DESCRIPTION OF THE EYECARE SERVICES PROVIDED BY THE AECP TO THE ARMENIAN POPULATION IN THE PERIOD OF 2003-2009 The AECP impressive results are reached thanks to the coordinated work of all components and partners, nonetheless, prior to presenting the results of the AECP data analysis and scientific research, we would like to single out the component of medical outreach. The latter can be considered as the “base” of the Project due to its widespread nature, direct target to the population and immediate results. Analysis of the information gathered through this component allows coming up with important indicators charactering the eye health of the country. The ultimate goal of the AECP is the elimination of avoidable blindness and securing increased access to modern eye care for every citizen of Armenia. The AECP Initiative “Bringing Sight to Armenian Eyes”, launched in 2003 is meant to reach this goal. General screenings among the population of rural and urban communities in Armenia, thorough examination, surgery and laser procedures performed on the Mobile Eye Hospital bring the high quality eye care services to the population at large. The AECP completed three medical tours all over Armenia within the Initiative “Bringing Sight to Armenian Eyes” in the period from 2003-2009 and we will present a brief summary of their logistic, organizational and medical aspects with an emphasis on the third tour in 2007-2009.

3.1. BRIEF DESCRIPTION OF THE AECP EYECARE SERVICES RENDERED DURING THREE MEDICAL TOURS IN THE PERIOD OF 2003-2009 Since 2003 through 2009, the AECP medical groups and the Mobile Eye Hospital (MEH) engaged the overwhelming majority of urban and rural communities in the general screening. Despite certain variations, the logistical protocols, medical approaches and orientations are quite similar in all three medical tours. During the mentioned time period, the AECP medical groups, on the whole, have visited 841 rural and urban communities of the country (nearly 90% of the RA communities)1. Well in advance, the AECP screening and MEH activities were widely advertised in the local media (television and radio announcements). Announcements were placed in all public places (polyclinics, mayor’s offices, post offices, banks, etc). In 1 In this section, the analysis of the data received due to screening in nine marzes (excluding the marz of Gegharkunik and Yerevan) during 2003-2009 is presented.

81 addition, local health professionals and social workers encouraged visits of the patients with specific problems as well as the population at large. Screenings were mainly carried out in local polyclinics, ambulatories and health posts. All services rendered by the AECP are free of charge - screening, eye glasses prescription and laser treatment were available to everyone. Surgeries were performed only for the most needy (eligibility verified against the vulnerability lists of the Ministry of Labor and Social Issues) while other patients identified with problems were referred to tertiary care facilities. This approach stimulated significant interest among the population at large. Eye screening and examination were conducted by a trained team of ophthalmologists and clinical residents from Yerevan’s tertiary care clinics. A standard protocol and eye examination record was used. Examination included testing of visual acuity using Landolt charts and Sivtsev-Golovin charts. Pinhole vision was taken for those individuals with a vision of <6/18 (either eye). Assessment of cause of vision loss was undertaken using a standard protocol with a direct ophthalmoscope. Causes of vision loss in cases that needed further examination or treatment (surgery or laser treatment) were referred to the MEH. Eye pressure was measured by a tonopen or Maklakov . For more complicated cases, when a patient needed a thorough diagnosis or future treatment (surgery or laser procedure), s/he was referred to the MEH for a more detailed examination and/or treatment. In such cases, children were referred to the Yerevan eyecare institutions. Patients needing continuous treatment or care, were referred to the local ophthalmologist. Due to the mentioned large-scale activities in the period from 2003-2009, the AECP had screened and rendered eye services to 156,688 people (around 5% of country’s population). The overwhelming majority of them were adults (61%), while children constituted 39% (up to 16 year olds), the women exceeded in numbers and made up 57% of those screened. Early detection and timely prevention of eye diseases among children greatly contributes to the prevention of blindness and low vision among the population. For that reason, the AECP, during its second tour, had attempted to pay more attention to school screenings. In the second medical tour, more than half of the population screened by the AECP – 55%, where children from 320 schools in 245 rural communities. This fact explains the high representation of children – 39% in the structure of the AECP screened population, in comparison with the demographic structure of the population of the country (24%). Taking into consideration the poor access of primary and secondary eye care services for the rural

communities, the AECP screenings were geared towards the rural population, constituting 58% of the screened population. The AECP had prescribed and prepared 29,549 eyeglasses for those in need from the socially vulnerable layers of the population.

The regional distribution of the screened population shows that the residents of the marzes of Ararat, Armavir, Kotayk and Lori were more represented in the total numbers.

In the period of 2003-2009, the AECP Mobile Eye Hospital (MEH) had rendered detailed examination to 16,518 persons in need of help (17.3% of the total screened), out of whom, 7,939 patents (8.3% of the screened adults) underwent a surgery or a laser procedure.

On the whole, in the period from 2003-2009, 8,394 surgeries and laser procedures were performed on the MEH. Most of them (70%) were cataract- related various surgeries.

3.2 BRIEF DESCRIPTION OF THE AECP ACTIVITIES DURING THE THIRD MEDICAL TOUR IN THE PERIOD OF 2007-2009 During the third medical tour in 2007-2009, the AECP screening groups and the Mobile Eye Hospital have visited nine marzes of Armenia (with the exception of Yerevan, where the AECP services targeted special groups of the population and schools) and the marz of Gegharkunik 1. During the third tour, the AECP medical groups have carried out screening activities in 490 communities of the country, or in other words, in 54% of Armenia’s communities. The AECP has screened the people from 615 different communities, mainly from rural areas. On the whole, the majority of the screened - 68% were from the rural communities, where health and eye care services are especially inaccessible. The AECP has screened 26,711 people (or around 0.9% of country’s population), out of which 16,837, or 63% were women, while 1,195 were children (up to 16 years old): More than half (52%) of those screened by the AECP were from poor, vulnerable or special layers of the population.

The overwhelming majority of the screened population by the AECP were above the reproductive age, i.e. those above 49 made up 72.3% of the screened, while people of 70 years of age and above made up one third of the screened – 31%. The age distribution of the screened population is presented below in Graph 2. 1 The AECP has restricted its activities in the marz of Gegharkunik since there is a modern eye clinic renovated and equipped with sponsorship of Garo Meghrigian Eye Institute for Preventive Ophthalmology within the American University of Armenia and the Lions Club International.

The MEH, while stationed in the Armenian cities and towns, has received and examined 3,943 previously screened people in need of thorough diagnosis (15.5% of the screened adults). Thus, the access to high quality care was made closer not only to the residents of those towns but also for the people of the adjacent settlements. Nearly half of those people â&#x20AC;&#x201C; 1893 (or 7.4% of the screened adults) underwent surgery or laser procedure on the Mobile Eye Hospital. The AECP has prescribed, prepared and provided with eyeglasses to 9,793 people belonging to vulnerable and special groups.

SUMMARY OF THE AECP DATABASE ANALYSES RESULTS

Since 2003, the AECP has combined general screenings of the population with information collection and analysis. The data of the around 160,000 screened people were assembled in the AECP database, while the results of scientific analyses has made it possible to receive data on the eye health and prevalence of eye disease among the Armenian population in accordance with internationally accepted methodology and indicators. The received data also allow comparisons at the regional level. Hereafter, we will present scientific estimates of the eye health and eye disease prevalence among the population of the Republic of Armenia, which will enable the decision makers to evaluate eye care situation among the population as well as determine the demand for eye care services in the country. The mentioned estimates are based on the AECP screening and MEH activities carried out in nine marzes during the third medical mission, in the period from 2007-2009, since it contains the freshest data with extensive and detailed information on the screened people1. In addition, we will present dynamic time series on the main diseases from all three tours. 1 With the exception of Yerevan, where the AECP had confined its activities only to schools and social institutions (childrenâ&#x20AC;&#x2122;s homes, nursing homes, soup kitchens, detention places, etc.) and the marz of Gegharkunik, which has more access to modern eye care.

4.1. METHODOLOGY OF COLLECTION AND PROCESSING OF THE EYE HEALTH DATA AMONG THE POPULATION SCREENED BY THE AECP Parallel to general screening, the Armenian Eye Project has gathered certain information on those screened. Each person referred to the AECP for screening had filled in a questionnaire which included sets of questions related to the general health status (with an emphasis on common medical problems that affect vision: diabetes, hypertension, and infectious diseases); healthcare, frequency of visits to eye doctors, as well as perceptions of the population regarding healthy lifestyles and attitudes. On the last (fourth) page, the AECP medical team inserted results of eye examination, diagnostics, as well as necessary or proposed medical intervention. The data of the filled-in questionnaire was entered in a special software, which made up the AECP database. Please, see the Annex 1 for the modified questionnaire, used in the tours of 2007-2009, and 2010. Monitoring and evaluation, as well as regular feedback in the logistical, organizational and conceptual aspects have allowed the AECP to work towards improvement during the entire process of the work. A large number of protocols, guidelines, standards were prepared to facilitate the work of the screening groups in the field, as well as standardize the reporting process. The AECP questionnaire has been modified, which allowed having a more detailed breakdown of diseases and keeping comparability with the previous data at the same time. For this reason, the analysis of the available data presented in this brochure is more geared towards the third round. It is worth mentioning that the AECP database is not a result of sample survey, since the participation of the population in the AECP screening has been of a voluntary nature. The screening groups have rendered services to all those who elected to come to the AECP screening. For that reason, the age-gender as well as geographic (rural-urban and marzes) proportion of the screened population had not corresponded to the demographic and geographic characteristics of the country. Therefore, to receive reliable estimates on the prevalence of eye diseases, the received data have been weighed. Thus, the mentioned proportions were rectified to comply with the countryâ&#x20AC;&#x2122;s overall demographic characteristics. In this survey, estimations and indicators have been calculated mainly for the adult population (16 years old and above) and particularly, 50+, due to the fact that the latter are the main age group in risk. In addition, the database contains dynamic time series which correspond to the two-year-long three tours that the AECP has accomplished in nine marzes of Armenia in 2003-2005, 2005-2007 and 2007-2009. Therefore, the comparison of results in dynamics has certain specifics, which the reader should approach with caution. 86

4.2. EYE DISEASES DIAGNOSED AMONG THE RA POPULATION DURING THE AECP THREE MEDICAL TOURS IN THE PERIOD OF 2003-2009 The RA Ministry of Health, in its statistical yearbooks, officially publishes two main indicators characterizing the eye health of the country’s population: the number of first time revealed diseases of eye and adnexa as well as general morbidity of the population related to eye diseases and adnexa, with a specification of glaucoma cases. The cases of population’s morbidity are registered when people refer for eye care or during mandatory preventive examinations1 . The dynamics of these indicators show that the number of population registered with diseases of eye and adnexa in our country has increased almost twofold in the period of 2004-2008, summing up to 2,610 persons per 100,000 persons in 2008 (total of 68,544 persons). Starting 2005, almost 47% of the patients who have mentioned diseases, were diagnosed for the first time.

The official statistics, however, specifies only on the glaucoma cases among all the eye diseases and adnexa. According to the RA Ministry of Health, as of 2008, 5,320 people were diagnosed with glaucoma, out of whom 1,274 were diagnosed for the first time this year. The official statistics on other diseases of the eye and adnexa is non-existent. Graph 4 demonstrates the number of diseases of eye and adnexa (assorted in certain groups) diagnosed among the adults (16 years and above) by the AECP medical teams during the three medical tours in 2003-2009. The graph evidences that on the whole, during all that period, the AECP has diagnosed 27,032 cases 1 See: “Statistical yearbook of 2008”, Republican information-analytical center of the RA Ministry of Health, National Institute of Health, 2008

of cataract, while its majority - 60%, were revealed for the first time. In the same period, the AECP medical groups have revealed 14, 437 various cases of fundus diseases, out of which 62% were revealed for the first time; 6, 877 various cases of cornea diseases, out of which 62% - for the first time; 5,411 cases of glaucoma, out of which 54.5% were revealed for the first time. On the whole, during six years of work in the regions, the AECP has diagnosed 53,757 cases of the mentioned diseases (one person can have various diseases) out of which 32, 456 or 60.4% were revealed for the first time in life. Early detection of diseases causing blindness, or first time diagnoses can enable the patients to timely refer to the second and third level ophthalmologic services and prevent blindness through receiving eye care there. Hence, the AECP activities in terms of revealing potentially blinding diseases greatly contribute to the prevention of blindness in the country.

The distribution of the above mentioned diseases registered by the AECP in 20032009 on the regional level is presented below:

Source: AECP database 88

Source: AECP database Out of the 95,607 adult population (16+) screened in the period of 2003-2009, the AECP medical teams have diagnosed some 40,000 persons with at least one disease of the eye and adnexa. It makes up 42% of those screened. However, taking into consideration the specifics of the screened populationâ&#x20AC;&#x2122;s demographics, this indicator cannot be considered an indicator of eye disease prevalence. The prevalence of different eye diseases were estimated after having weighed the AECP database results and are presented in the next paragraph. The regional distribution of the population screened by the AECP who have at least one disease is presented in the map below.

Source: AECP database

Since 2003 through 2009, on the whole, the AECP s diagnosed 16, 520 persons with visual impairment, out of whom 3,173 were blind, while 13, 347 had low vision2 .

The visual impairment cases are mainly caused by cataract. More than half (50%) of the adults who underwent the AECP screening and were diagnosed with visual impairment, had cataract; 8% had glaucoma; 22% had fundus problems, and 15% had corneal diseases.

2 According to the definition of the World Health Organization, blind is considered a person whose visual acuity in the better seeing eye with best possible correction is 3/60 (less than 0.05). A person whose visual acuity in the better seeing eye, with best possible correction, is in the interval of 3/60-6/18 (0.05-0.33) has low vision, while people with visual impairment are those who belong to either of the described groups (visual acuity is 0.0- 0.33).

91 As already stated, blindness caused by cataract can be prevented by timely surgery. According to the results of the AECP third tour, 2.3% of the RoA adult population (16+), have had cataract surgery in one eye and another 0.7% in both eyes. While the cataract surgical coverage (the proportion of people with bilateral cataract who have received cataract surgery at least in one eye in the total number of people with bilateral cataract) makes up only 23.8%3 . This means that only 24% of those who have cataract in two eyes have had cataract surgery at least in one eye.

4.3. ESTIMATES OF THE EYE DISEASE PREVALENCE AMONG THE RA POPULATION ACCORDING TO THE AECP DATA After having weighed the AECP data against the sex, age and geographical characteristics of the country, which allowed adjusting and spreading the available data, we developed median estimates for blindness, including low vision, for the two-year-long periods of 2003-2005, 2005-2007 and 2007-2009.

3 For comparison, it is worth mentioning that even developing countries have higher indicators of cataract surgery coverage. It is 63% for India and 44% for Pakistan.

In the Republic of Armenia, as of 2007-2009, blind were on average 0.7% of the population, 4.1% had low vision, according to the presented estimates. On the whole, 4.8% of countryâ&#x20AC;&#x2122;s population had visual impairment. Over time, the blindness prevalence estimates have altered - decreasing from 1.3% to 0.7%, while the estimates of low vision have increased. The latter solely has contributed to the increase in the visual impairment indicators in the country. Nonetheless, for 2007-2009, the blindness prevalence estimates for Armenia are in between the lower and upper thresholds set by the World Health Organization for the Caucasus, while the low vision estimates exceed the upper threshold by 1.2%. Visual impairment is more prevalent among the population of 50 years old and above. A significant portion of people with visual impairment are 50 years old or more. Prevalence of blindness among this age group is essentially higher. According to the AECP data, in 2007-2009, the prevalence of blindness in this age group had been higher than that of the average country by 2.7% and the low vision by 1.6% (see graph 7).

Weighing of the data collected by the AECP (adjustment to the age-sex structure of the population of the Republic of Armenia) and spreading have allowed receiving estimates for the prevalence of eye diseases in the country (see table 6). The latter, however, has been calculated based on the data of the AECP third tour, taking into consideration two reasons: 1) regular upgrades of the AECP questionnaires secured a more detailed breakdown of eye diseases, 2) these data are fresher. 92

93 According to these estimates, most widespread eye diseases among the RA population are cataract (8.4%) and fundus diseases (7.9%).

Prevalence estimates are especially important for eye diseases causing blindness (glaucoma, cataract, corneal diseases, diabetic retinopathy and macular degeneration). Table 6 evidences that the portion of the population who have at least one eye disease causing blindness in countryâ&#x20AC;&#x2122;s population makes up 13.3% and cataract is the most widespread one (8.4%). The regional picture of the prevalence of eye diseases causing blindness is presented in Map 6. It shows that the portion of the population which has at least one eye disease causing blindness is the highest in the marzes of Tavoush, Ararat and Armavir (16.3, 16 and 15.5 respectively) and the lowest are in Syunik and Vayots Dzor.

As already noted, eye diseases are more prevalent among the population of 50+. Table 8 demonstrates that the prevalence of eye diseases causing blindness among the population of the Republic of Armenia of 50+ is significantly higher than among the population on the whole and makes up 37% as opposed to 13.3% for the general population.

The AECP has developed and calculated the Index of Eye Health Vulnerability (EHV) among the RA population of 50 years old and above. Those persons of 50+ who were screened by the AECP and were diagnosed with at least one eye disease (glaucoma, cataract, cornea diseases, diabetic retinopathy and macular degeneration) were considered vulnerable from the eye health point of view. The EHV is the percentage of people having at least one of the mentioned diseases and disorders in the total number of population above the age of 50. The AECP data evidence, that 37% of the 50+ population has vulnerable eye health. This means that each fourth citizen of the Republic of Armenia has at least one disease causing blindness. Moreover, on the marz level, the highest EHV indicators were identified in the Ararat, Armavir and Aragatsotn marzes (see Map 7).

5. THE 2003-2009 AECP SREENING AND TREATMENT SERVICES RENDERED TO THE POPULATION OF ARMENIA THROUGH THREE MEDICAL TOURS AT A MARZ LEVEL This section presents the activities of the Armenian Eye Care Project within the Initiative “Bringing Sight to Armenian Eyes” in the period of 2003-2009. It summarizes the AECP screening and treatment work carried out through three medial tours at a marz level.

5.1.

THE ARAGATSOTN MARZ

To carry out screening and treatment, the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Aragatsotn marz in 2003, 2005 and 2007. During that time, the AECP on the whole screened 20,750 persons, out of which 52.8 % was the adult population, while 47.2 % were children. In this marz, the screening has been significantly geared towards children. The AECP services target the rural population who are more deprived of eye care services. The rural population constitutes 68.2 % of the screened.

In the period of 2003-2007, 1,319 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 552 patients received treatment and laser procedure.

The AECP has provided 1,924 eyeglasses to the representatives of the vulnerable population and special groups in the Aragatsotn marz.

5.2.

THE ARARAT MARZ

To carry out screening and treatment, the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Ararat marz in 2004, 2006 and 2008. During that time, the AECP on the whole has screened 23,870 persons, out of which 51 % was the adult population, while 49 % were children.

In the period of 2003-2008, 2,504 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 865 patients received treatment and laser procedure. 96

The AECP has provided 2,732 eyeglasses to the representatives of the vulnerable population and special groups in the Ararat marz.

5.3.

THE ARMAVIR MARZ

To carry out screening and treatment, the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Kotayk marz in 2003, 2006 and 2008. During that time, the AECP on the whole has screened 25,115 persons, out of which 53 % was the adult population, while 47% were children.

In the period of 2003-2008, 2,405 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 1,084 patients received treatment and laser procedure.

The AECP has provided 1,518 eyeglasses to the representatives of the vulnerable population and special groups in the Armavir marz.

5.4.

THE KOTAYK MARZ

To carry out screening and treatment, the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Kotayk marz in 2005, 2007 and 2009. During that time, the AECP on the whole has screened 18,949 persons, out of which 50 % was the adult population.

In the period of 2005-2009, 2,051 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 893 patients received treatment and laser procedure. 98

The AECP has provided 2,270 eyeglasses to the representatives of the vulnerable population and special groups in the Kotayk marz.

5.5.

THE LORI MARZ

To carry out screening and treatment, the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Lori marz in 2005, 2007 and 2009. During that time, the AECP on the whole has screened 18,569 persons, out of which 68 % was the adult population, while 32 % were children.

In the period of 2005-2009, 2,815 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 1,165 patients received treatment and laser procedure.

During the second and third tours, the AECP has provided 4,653 eyeglasses to the representatives of the vulnerable population and special groups in the Lori marz.

5.6.

THE SHIRAK MARZ

To carry out screening and treatment the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Shirak marz in 2005, 2007 and 2009. During that time, the AECP on the whole has screened 16,834 persons, out of which 86 % was the adult population, while 14 % were children. Though the population of the marz is main urban, the AECP activities and rendered services have been significantly targeted towards the rural residents, who are more deprived or eye care services. Given that Gyumri â&#x20AC;&#x201C; the capital of the Shirak marz, has primary, secondary and tertiary level eye care services, Gyumri was not included in the AECP schedule during the third tour. Hence, the coverage of the marzâ&#x20AC;&#x2122;s urban and rural population do not deviate from the usual proportion, making up 53 and 47% (while the urban population of the marz constitutes around 63 %, according to the National Statistical Service of the Republic of Armenia).

100

101 In the period of 2005-2009, 2,724 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 1,153 patients received treatment and laser procedure.

During the second and third tours, the AECP has provided 3,948 eyeglasses to the representatives of the vulnerable population and special groups in the Shirak marz.

5.7.

THE SYUNIK MARZ

To carry out screening and treatment the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Syunik marz in 2004, 2006 and 2008. During that time, the AECP on the whole has screened 12,928 persons, out of which 56 % was the adult population, while 44 % were children.

In the period of 2004-2008, 1,264 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 502 patients received treatment and laser procedure.

The AECP has provided 1.739 eyeglasses to the representatives of the vulnerable population and special groups in the Syunik marz.

5.8.

THE TAVOUSH MARZ

To carry out screening and treatment the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Tavoush marz in 2004, 2007 and 2009. During that time, the AECP on the whole has screened 14,210 persons, out of which 65% was the adult population, while 35% were children.

In the period of 2003-2008, 1,497 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them, 606 patients received treatment and laser procedure. 102

103

The AECP has provided 3,171 eyeglasses to the representatives of the vulnerable population and special groups in the Tavoush marz.

5.9

THE VAYOTS DZOR MARZ

To carry out screening and treatment the AECP medical teams and the Mobile Eye Hospital have accomplished three tours in the urban and rural communities of the Vayots Dzor marz in 2003, 2006 and 2008. During that time, the AECP on the whole has screened 10,047 persons, out of which 62% was the adult population, while 38% were children.

In the period of 2003-2008, 1,071 persons underwent thorough examination on the AECP Mobile Eye Hospital. Out of them 452 patients received treatment and laser procedure.

The AECP has provided 549 eyeglasses to the representatives of the vulnerable population and special groups in the Vayots Dzor marz.

104

105

APPENDICES APPENDIX 1 AECP Armenian EyeCare Project

------------------------------------------------------------------------------------Eye Screening Questionnaire Questionnaire number Date day

month

year

Location: 1. Region ___________________________________(name) 2. Community________________________________(name) 3. Community type

City

Village

Patient’s characteristics: Name_____________________________________ Father’s Name______________________________ Surname___________________________________ Gender :

male

female

Year of birth:

Passport serial number: Residency: 1. Region _________________ 2. Community________________ 3. Address________________________ name name street, house, appartment Tel. number_____________________________ Registered in the Family Allowance System? (mark the answer “Yes”) Belongs to the list of officially supported vulnerable groups? (mark the answer “Yes”) Visited AECP doctors during the previous screenings?_____________________________

1. Yes 2. No

If yes, what kinds of services were provided to the patient by AECP? (mark the answers “Yes”) 1. Eye Screening

4. Examination on MEH

2. Eyeglasses Prescription

5. LASER on MEH

3. Eyeglasses

6. Surgery on MEH

Section A. Personal Health and Health Care 1. YesÆ A_3 2. No

A_1. During the last 12 months did you visit a doctor or consult a health professional? A_2. If no, then when did you you visit a doctor or consult a health professional the last time?

1. 1-1,5 years ago 2. 2-2,5 years ago 3. 3-4 years ago 4. 5 and more years ago 5. Never

A_3. Have you ever been diagnosed having the following types of diseases/disorders? (mark the answers “Yes”) 1. Cardiovascular 5 Kidney 2. Blood 6. Lungs/respiratory tract 3. Ɍhyroid gland 7. Arthritis 4. Gastrointestinal 8. Other________________________(specify)

A_4. Do you have hypertension/high blood pressure? _________________________________

1. Yes 2. NoÆ A 9

A_5. If you have it, then for how many years?_________________________ A_6. Have your hypertension been diagnosed by doctor?__________________

1. Yes 2. NoÆ A 9

A_7. If yes, did the doctor refer you to the ophthalmologist?_____________

1. Yes 2. NoÆ A 9

A_8. If yes, did you apply to the ophthalmologist according to the referral?

1. Yes 2. No

A_9. Have you ever been diagnosed having diabetes? _________________________________

1. Yes 2. NoÆ A 13

A_10. If yes, how many years ago? (number of years) _____________________ A_11. If yes, did the doctor refer you to the ophthalmologist?____________

1. Yes 2. NoÆ A 13

A_12. If yes, did you apply to the ophthalmologist according to the referral?_

1. Yes 2. No

A_13. Do you observe the following symptoms? (mark the answers “Yes”) 1. Excessive thirst

4. Tingling or numbness of extremities

2. Excessive urination

5. Persistent tiredness

3. Weight gain or loss

6. No, didn’t observe any of above mentioned symptoms

A_14. Do you have blood relatives diagnosed with the following diseases? (mark the answers “Yes”) General Diseases Eye Diseases Diabetes Glaucoma Cataract 1 No, I haven’t a relative having this disease 2 Yes, my parents/parent 3 Yes, my brother/sister 4 Yes, my grandparents/grandparent 5 Yes, other close blood relative A_15. Please describe your general health condition.____________________________

A_16. Do you smoke?._______________________________________________________

1.Very bad 2.Bad 3.Satisfactory 4.Good 5.Very good 1. Yes 2. No

106

1. Yes 2. No

A_17. Do you drink alcohol systematically? ( 4-5 times per week).__________________

Section B. Eye Health and Eye Care B_1. During the last 12 months have you had any problems or complaints related to your eyes or vision?___________________________________________________

1. Yes 2. NoÆ B_4

B_2. If yes, did you applied to an ophthalmologist?____________________________________

1. YesÆ B_5 2. No

B_3. If you had any ophthalmic complaints and didn’t apply to an ophthalmologist, then why? 1. The nearest ophthalmologist is too far 2. No time 3. No money 4. Don’t trust in local ophthalmologist 5. Other_______________________/specify/ B_4. When did you you visit an ophthalmologist last time? ______________________________ 1. During the last 12 months 2. 1-1,5 years ago 3. 2-2.5 years ago 4. 3-4 years ago 5. 5 and more years ago 6. NeverÎB 6

B _5. For what purposes did you visit an ophthalmologist last time?._________________ 1. Preventive checking 2. Treatment/consulting 3. Surgery 4. Eyeglasses prescription 5. Other________________________(specify)

B _6. Have you ever been diagnosed having an eye disease or disorder?________________ B _7. If yes, what disease or disorder? (mark the answers “Yes”) 6. Low vision 1. Glaucoma 4. Pterygium 7. Nearsightedness 2. Cataract 5. Fundus 8. Farsightedness 3. Inflammation

1. Yes 2. NoÆ B 8

9. Strabismus 10. Other______________/specify/

B _8. Have you ever had an eye surgery?________________________________________ B _9. Have you ever told by a doctor, that you have to ware glasses?________________

B _10. Do you wear glasses?_________________________________________________

B _11. If you have an eyeglasses prescription and don’t wear them, then why?_____________ B _12. Why did you come to the screening today?_______________________________

1. Yes 2. No 1. Yes, for far vision 2. Yes, for near vision 3. Yes, both 4. No 1. Yes 2. No 1. Don’t help 2. Discomfort 3. Feel shy 4. No money to buy 5. Other

1. No complaints, just want to be checked preventively Æ finish 2. Have complaints related to my eyes/vision

B _13. If you have complaints, then what type of complaints exactly? (mark the answers “Yes”) 1. Difficulties in reading 2. Worsening of vision 3. Inflammation 4. Eye itch 5. Discharge from the eyes

6. Eye pain 7. Eye watering 8. Need eyeglasses prescription/eyeglasses 9. Filling of foreign body in eye(s) 10. Filling of discomfort in eye(s) 11. Other__________________________/specify/ 3

AECP Medical Records Station 1: Visual acuity (VA)

No Globe

VA without glasses VA with pinhole VA with glasses ------------------------------------------------------------------------------------------------------------------------------------------------

Refractive error No R R ------------------------------------------------------------------------------------------------------------------------------------------------

Station 2: IOP

Palpation is higher than normal

Tonophen measurement

IOP

Glaucoma suspect G ------------------------------------------------------------------------------------------------------------------------------------------------

Station 3: Globe, eyelids, cornea and cataract

Disorders of Eyelids E Strabismus S Disorders of the Globe Gl Conjunctivitis Con Pterygium P Corneal disorders K Cataract, of which: C Total or mature cataract CC -----------------------------------------------------------------------------------------------------------------------------------------------

Station 4: Previous eye surgeries

Previous eye surgery, of which: Operated Cataract, of which: Aphakia Pseudoaphakia Fibrosis Operated Glaucoma Operated Cornea

SP Cp A PA Fib Gp Kp

Station 4: Glaucoma, Optic Nerve and Fundus

AECP will prepare Glasses

Right eye Sph.

Glaucoma G Non-glaucomatic disorders of optic nerve N Fundus disorders, of which: F Diabetic retinopathy DR Hypertonic retinopathy HR High myopia M Macular degeneration MD Other___________________________________Specify

Cyl.

Ax.

Left Eye Sph. .

Cyl.

Ax.

DPP mm

Treatment: The treatment was suggested to the patient__________________________________________ Refracted

Refraction and Glasses: AECP will prepare and provide glasses AECP provided glasses Referrals to:

MEH for further examination Yerevan, ophthalmologic clinics

Local neurologist Local therapeutist

Local ophthalmologist

Local endocrinologist

Screening team doctor

Clinical ordin.

Nurse 4

108

109

APPENDIX 2 The “Vision2020” initiated by the World Health Organization and the International Agency for Blindness Prevention, is aimed at significantly reducing avoidable blindness worldwide by 2020. It urges the governments of countries worldwide to elaborate and put into implementation national blindness prevention strategies. In response to the “Vision2020” call, the RA Ministry of Health, in collaboration with the American University of Armenia and Garo Meghrikian Eye Institute of Preventive Ophthalmology, started the development of the National Blindness Prevention Program (NBPP) for Armenia. To facilitate this process, the Blindness Prevention National Committee was created in 2004. The Armenian national blindness prevention program reiterates the priorities and goals set in Vision2020 with the consideration of the Armenian reality. It is aimed at coordinating the activities of the governmental and non-governmental bodies and institutions active in eye care delivery, which would allow development of eye care services and effective reduction of blindness in the country. The Program was approved by the Armenian Government in 2006 (02/11/2006, decision # 43-N) and covers the period from 2006-2010. The Armenian EyeCare Program is among the organizations that have contributed to the implementation of the NBPP in Armenia. The activities of the AECP comprehensive program refer to each and all of the goals set by the Program. This is documented in the Information Note marking the completion of the NBPP implementation period prepared by the RA Ministry of Health.

INFORMATION NOTE ON THE IMPLEMENTATION OF THE 02.11.2006 #43-N DECREE OF THE GOVERNMENT OF ARMENIA PREPARED BY THE RA MINISTRY OF HEALTH OVERVEW In 2007-2010, in cooperation with the Ministry of Health, the Armenian EyeCare Project, in the framework of the USAID/ACE “Primary and Healthcare Alliance”, has carried out large scale activities, in the regions of the RA marzes, as well as the Republic of Nagorno Karabagh. The results are as follows:

• • • • • • • • • • • • •

•

• •

• • 110

131, 790 people (including 72,147 children) were screened, Out of the screened population, 11, 026 persons were referred to the Mobile Eye Hospital 4961 surgeries (including 1434 laser procedures) were performed on the Mobile Eye Hospital 24106 eyeglasses were provided to the vulnerable population 773 family nurses, village and school nurses were re-trained in basics of ophthalmology 57 family medicine doctors were retrained in basics of ophthalmology 61 regional ophthalmologists underwent intensive professional re-training 37 regional ophthalmologist underwent intensive professional re-training 349 public education sessions were carried out 8814 schoolchildren participated in the public education sessions on eyecare 841 communities were visited by the AECP medical teams AECP medical mission has been in the marzes for 903 days on the whole. The Initiative has developed “National program of the Prematurity of Retinopathy”. To start the nationwide program, the AECP is planning international conference “Prevention and Treatment of the Prematurity of Retinopathy in Armenia” on June 28-29, 2010, in cooperation with the RA Ministry of Health, and the United States Agency for International Development (USAID). This international conference will mark the start of the nationwide ROP prevention and treatment program. The AECP has already imported the necessary equipment. During the international conference, the selected Armenian specialists will undergo special training. The renowned ROP specialists will train the Armenian specialists through telemedicine. Thanks to the program, around 100 premature infants will be saved of blindness. A “Low vision center”, was established in the Kanaker - Zeitun Medical Center (teaching base of the National Institute of Health). The center complies with international standards and allows rendering various services to the RA citizens with visual impairment problems. A “Wet Lab” was established and equipped to provide doctors and students with opportunities for surgical practice. Developed ophthalmology residency programs and books, as well as improved teaching methods to meet Western standards, as well as authored and published two books “Eye Diseases” (2005) and “Essentials of Ophthalmology” (2007) for primary health care providers and ophthalmologists respectively. Prepared guidelines for ophthalmologists, family medicine doctors and village nurses. Carried out a cataract surgery monitoring survey in the Mobile Eye Hospital.

111 A pilot system of cataract monitoring system was introduced in the Malayan Ophthalmological Center.

The works accomplished in line with the objectives defined by the RA government decree are: Goal 1. Decrease the prevalence of bilateral blindness in population 50 years old and over from 0.5 to 0.2 % • • • • • • •

CATARACT: Increase cataract surgical rate in Armenia from 1,000 surgeries per million population to 3,000 surgeries per million population Increase the total number of ECCE+IOL surgeries in the ROUs from 0.03% to 80% Decrease % of poor outcomes from 23% to 5 % as per WHO PBL standards GLAUCOMA: Double the proportion of glaucoma patients diagnosed at early stages of the disease. Increase yearly number of glaucoma surgeries by 30% DIABETIC RETINOPATHY: Increase yearly number of diabetic retinopathy patients receiving laser treatment from 120/year to 500/year Achieve full coverage of registered diabetic patients with free ophthalmic screening for early diagnostics of life threatening retinopathy.

1.The AECP/USAID Alliance has committed itself to supporting the regional ophthalmological centers and continues its work up to date. 2. To secure effective approaches in the treatment and follow-up of cataract, surgery is performed in the ophthalmologic clinics or the eyecare departments of multi-profile hospitals which have respective license. That secures the professional quality of surgery and follow-up. In the mentioned institutions the cataract surgery is performed free of charge for the representatives of various vulnerable and special groups. Members of the families that have vulnerability points of 30 and above (family benefit system scoring), persons eligible for free of charge healthcare since they belong to special groups, as well as those solicited by the regional authorities as extremely poor (even though they may not be registered in any of the social systems) are treated on the AECP Mobile Eye Hospital in the regions. The Malayan Ophthalmological Center also renders free services to them as part of charity actions. In special cases, as exception, free of charge surgery for the persons not enlisted in the social groups is carried out at the permission of the RA Minister of Health, with the referral of the RA Ministry of Health.

3. The RA Ministry of Health issued order of #1565- A, dated 29.12.2006, to organize mandatory visits of the specialists from regional/marz centers to villages and settlements (minimum once per month) and “ open door days”(minimum twice per year). The schedule of mandatory visits to the villages has been put into effect . In addition, primary health care became free for all groups of the population in all the polyclinics all over Armenia starting 2006. 4. In the period from 2007-2010, the AECP/USAID Alliance has visited total of 850 rural communities, where the AECP medical groups screened total of 41.000 rural residents. During the visits in the marzes, 3,612 cataract surgeries and/or laser procedures were performed on the AECP Mobile Eye Hospital. At the same time, local specialists participated in the AECP activities in screening and on the MEH, to improve their clinical skills. 5. Extracapsular surgeries with the implantation of the intraocular lens has become mandatory in the regional/marz eyecare centers, if it is not counter-indicated by other diseases. IOLs are provided to the representatives of vulnerable and social groups by the Ministry of Health through various humanitarian sources. The AECP/USAID Alliance provides all services, including the IOLs for free. Extracapsular surgeries with IOL implantation is carried out in all marzes of Armenia. The percent of IOL implants is close to 100%. 6. In accordance with the RA Government # 35 order of 18.09.2009, the “Concept of quality assurance” was developed and submitted for RA Government approval. The Concept would allow overseeing the quality of medical care and all rendered services at all levels (including eyecare). The AECP has prepared and published a teaching manual “Essentials of Ophthalmology” to improve the knowledge of the specialists. The requirement of the Government # 1639-N decision is aimed at securing adequate quality, according to which retraining of physicians is mandatory each 5 years. Therefore, ophthalmologists also undergo continuous education with a revised educational program. Ophthalmologists’ offices in all polyclinics are have equipment to measure intraocular pressure and examine fundus of the eye. The AECP/USAID Alliance carried out cataract surgery monitoring survey on the Mobile Eye Hospital. The pilot program of cataract surgery monitoring system has been introduced in the Malayan Ophthalmologic Center.

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113 7. Glaucoma: Starting 2008, in accordance with the standards described in the decree of the RA Ministry of Health, (which is a precondition for the state order) it has been defined that screening for early detection of glaucoma should be performed in the framework of mandatory preventive visit. During the screenings in 2007-2010, the AECP had diagnosed 1,653 cases of glaucoma, 622 out of which were revealed for the first time. All medical ambulatories, offices of family medicine doctors and ophthalmologic offices of polyclinics have an ophthalmoscope, tonometer, the specialists are continuously being retrained and their number makes up total of 1600 specialists. 8 . Diabetic retinopathy The AECP has performed 400 laser procedures for diabetic retinopathy. In 2008, a seminar “Diabetes and Blindness” was organized with the participation of ophthalmologists and endocrinologists. Guidelines for the management of diabetes for the primary health care level have been elaborated and are regularly updated. The last modified version has been approved by the RA Ministry of Health.

Goal 2. Reduce childhood blindness and improve children’s eye health. REFRACTIVE ERROR: Achieve full coverage of school age children with free eye screening to detect refractive errors and provide prescribed eyeglasses for those in need ROP :Establish effective ROP control system in Armenia 1. In the marzes of Armenia, due to the lack of pediatric ophthalmologists there, general ophthalmologists deal with children’s issues as well. 2. Preventive school screenings are carried out at schools. Parents and teachers of children identified with refraction problems during screenings are alerted of the problem. If the child comes from a vulnerable family, s/he is offered treatment and eyeglasses (received through charity pipelines as well as by the Karageozyan foundation in Yerevan, Syunik, Lori and Shirak marzes). 3. Children’s screenings in the marzes that do not have specialized pediatric ophthalmologic services is carried out by the AECP. The AECP medical groups have screened 72,147 children in the RA marzes and Yerevan. .The ophthalmologists and optometrists of «Union Médicale Arménienne de France» (UMAF) have

been working in the remote regions of Armenia and Karabagh providing quality screening and eyeglasses to children. 4. Provision of respective information to the parents whose children have refractive problems - The AECP/USAID Alliance has conducted public education sessions, with the participation of 843 parents, disseminated four types of brochures related to childrenâ&#x20AC;&#x2122;s eye disorders and diseases, including refraction. 5. It is expected to organize the training of one ophthalmologist per marz related to retinopathy of prematurity by the AECP/USAID Alliance. 6. The AECP/USAID Alliance has acquired two retinal cameras and diode laser for the detection and treatment of the retinopathy of prematurity. 7. Protocols for the screening and treatment of premature and/or low weigh infants have been prepared by the AECP/USAID Alliance and adopted by the RA Ministry of Health. Large scale activities are expected to start in September of 2010.

Goal 3. Strengthen the infrastructure to support blindness prevention efforts throughout the country PRIMARY EYE CARE: Strengthen primary eye care in the rural areas Improve primary eye care at the polyclinical level SECONDARY EYE CARE : Upgrade and equip existing ROUs according to the WHO List*TERTIARY EYE CARE: Modernize the tertiary eye care in Armenia 1. The program has envisioned establishment of village health points in selected village ambulatories or family medicine offices that would serve as primary ophthalmologic centers (one center per 20,000 inhabitants). For the purpose of saving resources, ophthalmologic offices in the regional polyclinics or medical units, which are furnished with equipment within the World Bank loan program or have received certain support from international organizations (namely the USAID) are viewed as an option of such centers . 2. Starting 2008, in accordance with the standards described in the decree of the RA Ministry of Health, (which is a precondition for the state order) it was defined that screening for early detection of glaucoma should be performed in the framework of mandatory preventive visit. During general screenings in the regional polyclinics, the AECP/USAID Alliance has identified 1730 cases of glaucoma suspect.

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115 3. The upgrade and provision of equipment (including lasers) to the ophthalmic offices in regional polyclinics (RP) is carried out within the framework of the World Bank Health program “Modernization program of regional hospitals”. 4. The American University of Armenia, in cooperation with the Lions Club and the Ministry of Health has renovated and equipped an Eye Center in the city of Sevan. It received a MOH license in 2008 and covers the needs of the Gegharkunik population. The renovation of the Vanadazor ophthalmologic center has not taken place. 5. A low vision center was established in the Kanaker-Zeitun Medical Center, which is the teaching base of the National Health Institute. The Low vision Center established by the AECP/USAID Alliance, corresponds to international standards.

Goal 4. Develop human resources to provide appropriate eye care to the population PRIMARY EYE CARE Reinvigorate primary eye care education in the country; SECONDARY EYE CARE Strengthen training of ROU ophthalmologists TERTIARY EYE CARE Upgrade training in ophthalmology to correspond to the standards of International Council of Ophthalmology /International Federation of Ophthalmic Societies (ICO/IFOS)Within the educational component of the AECP/ USAID alliance, family medicine and village ambulatory/FAP nurses) from all the marzes of Armenia took a three-day training course on the basics of ophthalmology; refresher courses were organized for 57 family medicine doctors in the regions; 37 ophthalmic nurses underwent a one week intensive course. 2. The AECP/USAID conducted, in cooperation with the AED, two –week intensive courses for 61 regional ophthalmologists on theory and practical needs, as well as general screening technique for cataract, glaucoma and diabetic retinopathy. 3. The requirement of the NSP to revise curricula of the academic institutions providing education in eye care to correspond to ICO/IFOS standards, is implemented since 2009, in accordance with the decision of the RA Government, whereby all educational programs, including the ophthalmological one, should be in line with international standards.

Goal 5. Increase awareness of blindness as a major public health issue Conduct a public awareness campaign regarding cataract, glaucoma and diabetic retinopathy for general public. Design and deliver an eye health education campaign for school age children and their parents.

1.The ophthalmology part in the curricula of the family medicine doctors has been enhanced, public awareness materials have been reviewed and revised. 2.The AECP/USAID Alliance has prepared and published total of 600,000 copies of 12 brochures on adults’ and children’s eye diseases, eyecare and eye safety at home and workplace. The brochures are being distributed during screenings and public education sessions. 3. World Sight Day (second Thursday of October) is being celebrated in Armenia since 2003 thanks to the efforts of the AECP.

Goal 6. Initiate research and development in the field of blindness prevention Develop tools and guidelines for disease control, health care management, and service delivery Initiate epidemiological and clinical research. Conduct evaluation of the National Plan and develop policy recommendations for the Government of RA. 1. Data of the patients with diabetes is analyzed as a risk factor for blindness. For this purpose, the RA Ministry of Health has introduced automated registering system “Midas 3”, form #02 including diabetes is being filled in. 2. The AECP/USAID Alliance and the RA Ministry of Health have elaborated standards/protocols for village ambulatories and offices of regional ophthalmologists. Such standards are being developed and revised on a yearly basis. They also include organizational aspects of the eye care delivery. The draft of the guideline has been presented by the AECP/USAID Alliance and the RA Ministry of Health. 3. National research on children’s blindness and refractive error prevalence among the children of school age is expected to be conducted. The RA MOH has applied to international organizations, including USAID for cooperation in this matter.

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Ð³ÛÏ³Ï³Ý ³ÏÝ³μáõÅáõÃÛ³Ý Ý³Ë³·ÇÍ §ÈáõÛë Ñ³ÛÇ ³ãù»ñÇÝ¦ Íñ³·Çñ Ð³ëó»` ²Û·»ëï³Ý 5-ñ¹ ÷., ïáõÝ 7, ºñ¨³Ý 0070, Ð³Û³ëï³Ý Ð»é.`(374 10) 55 90 68; ü³ùëª (374 10) 57 76 94; ¿É-÷áëï` aecp@cornet.am; www.eyecareproject.com The Armenian EyeCare Project Bringing Sight to Armenian Eyes Aygestan 5th str., house 7; Yerevan; Armenia Phone (374 10) 55 90 68; Fax (374 10) 57 76 94 E-mail: aecp@cornet.am; Web: www.eyecareproject.com