The Costs of Postabortion Care in Developing Countries Are Substantial and Vary across Settings

Abstract

163 technical personnel, such as laboratory technicians, were more involved in postabortion care in Colombia than in the three African countries. Overall, salaries of health personnel were highest in Colombia and lowest in Uganda. The total labor cost per case for postabortion care was considerably higher in Colombia (I$301) than in the African countries (Uganda, I$43; Ethiopia, I$45; and Rwanda, I$58). There was less variation by country in the remaining components of direct costs: The average cost of drugs and supplies per case ranged from I$79 in Colombia to I$115 in Rwanda. The researchers also examined the indirect costs of postabortion care in the four countries; however, data for Ethiopia were deemed “deficient” and were excluded. The total indirect costs per postabortion care case were highest in Colombia (I$618), followed by Uganda (I$270) and Rwanda (I$150). The researchers summed the direct and indirect costs to calculate the total cost per postabortion care case in each country, which was I$972 for Colombia, I$407 for Uganda and I$334 for Rwanda. Labor and overhead accounted for 81% of the total cost of postabortion care in Colombia, but only 22% and 46% in Uganda and Rwanda, respectively; drugs and supplies and capital costs accounted for larger proportions of the total cost in the two African countries than in Colombia. The cost of treating one postabortion patient was 11% of the annual per capita income in Colombia, 29% in Rwanda and 35% in Uganda. The researchers note several limitations of the Post-Abortion Care Costing Methodology. Because the methodology has evolved over time, comparison across studies is somewhat restricted. In addition, although the results of abortion incidence studies conducted in the four countries were available for comparison, the inherent difficulty of collecting data on abortion means that some uncertainty remains (for example, on the proportion of women with postabortion complications not treated in the health system). Despite these limitations, the researchers note, the The Costs of Postabortion Care in Developing Countries Are Substantial and Vary Across Settings