title: Documenting the individual- and household-level cost of unsafe abortion in Uganda.
abstract: BACKGROUND
  Although Uganda has a restrictive abortion law, illegal abortions performed under dangerous conditions are common. Data are lacking, however, on the economic impact of postabortion complications on women and their households.
  
  
  METHODS
  Data from a 2011-2012 survey of 1,338 women who received postabortion care at 27 Ugandan health facilities were used to assess the economic consequences of unsafe abortion and subsequent treatment. Information was obtained on treatment costs and on the impact of abortion complications on children in the household, on the productivity of the respondent and other household members, and on changes in their economic circumstances.
  
  
  RESULTS
  Most women reported that their unsafe abortion had had one or more adverse effects, including loss of productivity (73%), negative consequences for their children (60%) and deterioration in economic circumstances (34%). Women who had spent one or more nights in a facility receiving postabortion care were more likely than those who had not needed an overnight stay to experience these three consequences (odds ratios, 1.6-2.8), and women who had incurred higher postabortion care expenses were more likely than those with lower expenses to report deterioration in economic circumstances (1.6). Wealthier women were less likely than the poorest women to report that their children had suffered negative consequences (0.4-0.5).
  
  
  CONCLUSIONS
  The impact of complications of unsafe abortion and the expense of treating them are substantial for Ugandan women and their households. Strategies to reduce the number of unsafe procedures, such as by expanding access to contraceptives to prevent unintended pregnancies, are urgently needed.
authors.affiliation: Senior Research Associate, Guttmacher Institute, New York, asundaram@guttmacher.org.
authors.forename: Aparna
authors.initials: A
authors.lastname: Sundaram
authors.forename: Michael
authors.initials: M
authors.lastname: Vlassoff
authors.forename: Frederick
authors.initials: F
authors.lastname: Mugisha
authors.forename: Akinrinola
authors.initials: A
authors.lastname: Bankole
authors.forename: Susheela
authors.initials: S
authors.lastname: Singh
authors.forename: Leo
authors.initials: L
authors.lastname: Amanya
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Onda
mesh_terms: D000024:Abortion, Illegal / Q000191:economics* / Q000517:prevention & control / Q000706:statistics & numerical data*; D000028:Abortion, Induced / Q000009:adverse effects / Q000191:economics* / Q000706:statistics & numerical data*; D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D020380:Needs Assessment / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology; D016387:Women's Health / Q000191:economics*; D055815:Young Adult