A M E R I C A N U N I V E R S I T Y O F A R M E N I A - CHSR

weight [13]. This belief is more common among illiterate mothers, especially in developing
countries [13].
Definition of the problem
The socioeconomic crisis in Armenia has had a profound and adverse impact on the public
healthcare system, decreasing accessibility to health services for the larger public [14]. Indeed,
the number of visits for medical service has declined dramatically in recent years [15]. The
reason is not in the improved health of children, rather in the increase of medical service costs,
and the lack of communication [15].
Since independence the structure of Armenia’s economy has dramatically changed. “The
share of industry in GDP dropped from 44.5% in 1990 to 23.4% in 1998, due to the war with
Azerbaijan, the collapse in trade with the former Soviet Union and the transition to market
prices” [14].
According to the Profile of Internal Displacements, [16] extreme poverty is increased in rural
areas. In particular as an effect of the drought during summer 2000, approximately 55 % of the
population cannot meet their basic food needs and such factors like unemployment, female head
of household, refugee status, lack of access to land, pensioner status, and the lack of support
from abroad, translated into high rates of malnutrition among children [16]. This is likely to
contribute to an increase in the already high rate of anemia, which was, according to the Health
and Demographic survey in 2000, about 39% in children aged 0-5 in Tavoush Marz [17].
Armenia inherited from the Soviet period the ineffective health care practices with heavy
emphasis on hospital care [18]. In addition, public expenditure on health care fell from 2.7% of
GDP in 1990 to 1.3% in 1997 and income of most care-takers dropped. Combined with use of
clinically unapproved and costly ineffective guidelines, both at out-patient and in-patient level,
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