The economic impact of unsafe abortion

The costs of treating complications arising from unsafe abortion are a burden on health systems in developing countries. They divert scarce health resources when safe, cost-effective alternatives are available.

Alternatives to unsafe abortion, such as contraception or safe abortion services (where legal), are cost-effective.

Abortion is a sensitive subject so data on most aspects of unsafe abortion are limited. The research used two methods to develop estimates. Firstly, an extensive literature search found 28 small-scale studies on post-abortion costs per case. These studies did not measure all costs, which should include direct costs (such as drugs, supplies and personnel) and indirect costs (such as overheads and capital). In practice, some costs were often excluded and the cost components included were not always identified. But it was possible from these to produce a range of probable costs.

The second approach broke down all possible post-abortion treatments into their constituent inputs (such as the quantity of antibiotics used and the quantity of gynecologist's time used). It covered all costs of the ideal treatments that women should receive, which may differ across countries.

The most important findings are:

• From cost-per-case surveys, the mean per-patient cost for post-abortion care lies between US$96 and US$131 (2005 US dollars). The global cost to health systems ranges from US$509 million to US$676 million.
• Using the second costing approach, global health system costs lie between US$677 million and US$1.08 billion.
• Regionally, Africa and Asia each have a 42 percent share of the total global cost, while Latin America and the Caribbean's share is around 14 percent.
• Per-patient treatment costs are substantially higher in southern, eastern and northern Africa.

The key policy implications are:

• Health systems in low-income countries spend large sums treating complications from unsafe abortion despite the existence of cost-effective alternatives.
• These studies offer a conservative estimate of total costs to already overburdened developing country health systems. The economic impact of unsafe abortion is several times larger than estimated health system costs.

Further, millions of women with serious post-abortion complications are not treated. This means that the costs to households and national economies of lost productivity due to abortion-related injury and death are considerable. There are also substantial costs in terms of orphaning of other children. More empirical research is urgently needed to measure these significant economic and social costs.

Michael Vlassoff
michaelvlassoff@hotmail.com

See also

Economic Impact of Abortion-Related Morbidity and Mortality: Modeling Worldwide Estimates, paper commissioned by the Hewlett Foundation, by Michael Vlassoff, April 2006
www.eldis.org/go/topics/resource-guides/health&id=32275&type=Document

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