title: The health system cost of post-abortion care in Rwanda.
abstract: Based on research conducted in 2012, we estimate the cost to the Rwandan health-care system of providing post-abortion care (PAC) due to unsafe abortions, a subject of policy importance not studied before at the national level. Thirty-nine public and private health facilities representing three levels of health care were randomly selected for data collection from key care providers and administrators for all five regions. Using an ingredients approach to costing, data were gathered on drugs, supplies, material, personnel time and hospitalization. Additionally, direct non-medical costs such as overhead and capital costs were also measured. We found that the average annual PAC cost per client, across five types of abortion complications, was $93. The total cost of PAC nationally was estimated to be $1.7 million per year, 49% of which was expended on direct non-medical costs. Satisfying all demands for PAC would raise the national cost to $2.5 million per year. PAC comprises a significant share of total expenditure in reproductive health in Rwanda. Investing more resources in provision of contraceptive services to prevent unwanted or mistimed pregnancies would likely reduce health systems costs.
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda mvlassoff@guttmacher.org.
authors.forename: Michael
authors.initials: M
authors.lastname: Vlassoff
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda.
authors.forename: Sabine F
authors.initials: SF
authors.lastname: Musange
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda.
authors.forename: Ina R
authors.initials: IR
authors.lastname: Kalisa
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda.
authors.forename: Fidele
authors.initials: F
authors.lastname: Ngabo
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda.
authors.forename: Felix
authors.initials: F
authors.lastname: Sayinzoga
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda.
authors.forename: Susheela
authors.initials: S
authors.lastname: Singh
authors.affiliation: Guttmacher Institute, New York, NY, USA, School of Public Health, National University of Rwanda, P.O. Box 5229, Kigali, Rwanda and Maternal and Child Health Unit, Ministry of Health, P.O. Box 84, Kigali, Rwanda.
authors.forename: Akinrinola
authors.initials: A
authors.lastname: Bankole
mesh_terms: D000024:Abortion, Illegal / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D000028:Abortion, Induced / Q000009:adverse effects / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D011247:Pregnancy; D012432:Rwanda
keywords: Abortion; PAC; Rwanda; cost; post-abortion care