title: Cost of abortions in Zambia: A comparison of safe abortion and post abortion care.
abstract: Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion.
authors.affiliation: a School of Health Sciences , City University London , London , UK.
authors.forename: Divya
authors.initials: D
authors.lastname: Parmar
authors.affiliation: b London School of Economics , London , UK.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Leone
authors.affiliation: b London School of Economics , London , UK.
authors.forename: Ernestina
authors.initials: E
authors.lastname: Coast
authors.affiliation: c International Development Institute , King's College London , London , UK.
authors.forename: Susan Fairley
authors.initials: SF
authors.lastname: Murray
authors.affiliation: b London School of Economics , London , UK.|d School of Medicine , Options Consultancy Services , London , UK.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Hukin
authors.affiliation: e School of Medicine , University of Zambia , Lusaka , Zambia.
authors.forename: Bellington
authors.initials: B
authors.lastname: Vwalika
mesh_terms: D000024:Abortion, Illegal / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data; D000028:Abortion, Induced / Q000191:economics* / Q000331:legislation & jurisprudence / Q000379:methods / Q000706:statistics & numerical data; D000029:Abortion, Legal / Q000009:adverse effects / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D000022:Abortion, Spontaneous / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000191:economics* / Q000592:standards / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008428:Maternal Mortality; D061214:Patient Safety / Q000191:economics* / Q000592:standards; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D055815:Young Adult; D015024:Zambia / Q000453:epidemiology
keywords: Abortion; Zambia; cost; health system; termination of pregnancy