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Unsafe Abortion: The Costs to National Health Systems

Safe abortion advertisement in South Africa. (photo: Tiago Pinhal on Flickr)

Written by Christi van der Westhuizen for – News, commentary and community for reproductive justice.

This is the third in a series of articles from Keeping Our Promise: Addressing Unsafe Abortion in Africa this week. The conference has brought together more than 250 health providers, advocates, policy makers and youth participants for a discussion of how to reduce the impact of unsafe abortion in Africa.

How much does unsafe abortion cost national health systems? This is exactly the question that a group of medical experts and health researchers set out to answer in 2007, using the example of the east African country Ethiopia.

Ethiopia was selected because its policymakers sought more information about the economic burden that unsafe abortion placed on the country’s health system. The Ethiopian government liberalised abortion care in 2005, allowing it in cases of incest, rape, threats to the woman’s life and health and in cases where the patient is a minor or has physical or mental disabilities.

The researchers wanted to show how much money could be saved if surgery and medication for care after unsafe abortions were not needed. This is an important consideration as such savings would free up money for other health priorities, explains Dr Haile Gebreselassie, senior research advisor at Ipas Africa and involved in the design of the cost study. . . .

The study was presented at the “Keeping Our Promise. Addressing Unsafe Abortion in Africa” conference in Accra, Ghana, hosted by Ipas and supported by, among others, Ghana’s ministry of health.

The first step was to conduct a magnitude study. Its findings were that, in 2008, unsafe abortions that required post-abortion care numbered 53,000. Safe abortions inside facilities numbered 103,000 while abortions outside facilities that did not require post-abortion care came in at 58,000. Unsafe abortions resulting in untreated complications were still the most prevalent at 163,000.

For the second phase of the study, five categories of complications were identified: shock, sepsis, uterine evacuation, vaginal or cervical lacerations and uterine perforation. The researchers investigated which medical resources are generally used to treat each of these complications, from staff to facilities to medication.

The total direct cost per case was as follows: shock $39.70; sepsis $40.40; uterine evacuation $23.69; vaginal or cervical lacerations $114.86; and uterine perforation $153.15.

The study did not stop there. Read more

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