Background and methodology Strategies to reduce health systems costs of providing abortion and post-abortion care while simultaneously improving quality of care are well documented but infrequently applied. We created ‘Savings’, a spreadsheet-based tool that allows policymakers and other stakeholders to estimate and compare the feasibility and sustainability of different strategies of providing abortion and post-abortion care. By applying cost data primarily from Uganda, we showed the per-case costs under four policy and service delivery scenarios.
Results The mean per-case cost of abortion care (in US dollars) was #45 within the setting that placed heavy restrictions on elective abortion and used a conventional approach to service delivery; #25 within the restrictive legal setting that used recommended interventions for treating complications; #34 within the legal setting that allowed elective abortion and relied on a conventional approach to service delivery; and #6 within the liberal legal setting that used recommended interventions.
Discussion and conclusions Using recommended technical interventions substantially reduced costs regardless of the legal setting. The greatest reduction in costs (86%) occurred from using recommended interventions within a liberal legal setting rather than using conventional interventions within a restricted setting. These findings should support policy and practice efforts to reform abortion laws and to offer accessible, safe abortion services.
- post-abortion care
- reproductive health services
- Accepted August 3, 2007.
- Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
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