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Located between Russia and Romania, Moldova gained its full independence from the former Soviet Union in 1991. Considered one of the most economically depressed countries of the former Soviet Union, Moldova has experienced growth over the past three years.

Moldova has a 50-year history of legal abortion. Now that abortion providers have access to more training and education opportunities, their former techniques are being replaced with safer methods. NAF training has afforded health care professionals in Moldova the opportunity to learn a new and safer method of abortion and significantly improve the quality of care women receive.

In May 2002, a team of NAF faculty worked with colleagues to train physicians in Manual Vacuum Aspiration (MVA) using local anesthesia at a hospital in Chisinau, Moldova. By November 2002, the number of Moldovan physicians trained in MVA increased to 25. MVA has become the principal method of abortion at the hospital, and counseling and local anesthesia have become a routine practice in care.

'We understand that the MVA project offered us the opportunity not only to change the abortion technique, but to improve all abortion practice and to improve the genera quality of abortion services, to better meet women's rights and needs. This approach was very important--to consider MVA not only as a new abortion method, but as a new abortion policy.' - Rodica Comendant, MD, PhD, Attendant Professor of the Obstetrical Gynecological Department, Coordinator of the 'Manual Vacuum Aspiration in Moldova' project


In December 2001, the initial site assessment took place at the largest clinic - Ob-Gyn Clinic #1 - in Chisinau, the capital of Moldova. Based on the assessment, training goals were established to:

  • implement patient education and preference for general or local anesthesia;
  • implement MVA technique in first trimester abortion care;
  • implement tissue examination for confirmation of procedure completion; and
  • provide models of patient centered abortion care.


In May 2002, three NAF faculty went to Chisinau to conduct a 10-day training course in comprehensive abortion care. The training involved didactic, interactive, and clinical components to present and implement the abortion care models. The process was rigorous and energizing for the participants and faculty. Physicians in Moldova were extremely skilled in ob-gyn practices and had no difficulty in learning the new concepts.


As of December 2003, the hospital reports that sharp curettage has been replaced with MVA and that 86% of procedures are done with local anesthesia. The original participants who were trained using MVA have trained others and as a result there are currently 60 physicians in Moldova trained in MVA technique and comprehensive abortion care. Trainers from Moldova are now participating as faculty in other NAF training programs in Eastern Europe and Central Asia.

Example of MVA Training Curriculum

Introduction to MVA
Safety, Efficacy, and Service Delivery Implications of MVA
Infection Prevention Practices
Pregnancy Verification and Estimation of Gestational Age
Patient Selection and Medical Screening
Counseling, Patient Preparation, and Informed Consent
MVA Abortion Technique
Pain Management in First Trimester Abortion
Post-Abortion Care and Follow-Up
Tissue Examination
Review of Abortion Complications
Quality Management of MVA Services
Contraception Counseling


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