BACKGROUND AND METHODOLOGY: Strategies to reduce health systems costs of providing abortion and post-abortion care while simultaneously improving quality of care are well documented but infrequently applied. We created 'Savings', a spreadsheet-based tool that allows policymakers and other stakeholders to estimate and compare the feasibility and sustainability of different strategies of providing abortion and post-abortion care. By applying cost data primarily from Uganda, we showed the per-case costs under four policy and service delivery scenarios. RESULTS: The mean per-case cost of abortion care (in US dollars) was $45 within the setting that placed heavy restrictions on elective abortion and used a conventional approach to service delivery; $25 within the restrictive legal setting that used recommended interventions for treating complications; $34 within the legal setting that allowed elective abortion and relied on a conventional approach to service delivery; and $6 within the liberal legal setting that used recommended interventions. DISCUSSION AND CONCLUSIONS: Using recommended technical interventions substantially reduced costs regardless of the legal setting. The greatest reduction in costs (86%) occurred from using recommended interventions within a liberal legal setting rather than using conventional interventions within a restricted setting. These findings should support policy and practice efforts to reform abortion laws and to offer accessible, safe abortion services.
BACKGROUND AND METHODOLOGY: Strategies to reduce health systems costs of providing abortion and post-abortion care while simultaneously improving quality of care are well documented but infrequently applied. We created 'Savings', a spreadsheet-based tool that allows policymakers and other stakeholders to estimate and compare the feasibility and sustainability of different strategies of providing abortion and post-abortion care. By applying cost data primarily from Uganda, we showed the per-case costs under four policy and service delivery scenarios. RESULTS: The mean per-case cost of abortion care (in US dollars) was $45 within the setting that placed heavy restrictions on elective abortion and used a conventional approach to service delivery; $25 within the restrictive legal setting that used recommended interventions for treating complications; $34 within the legal setting that allowed elective abortion and relied on a conventional approach to service delivery; and $6 within the liberal legal setting that used recommended interventions. DISCUSSION AND CONCLUSIONS: Using recommended technical interventions substantially reduced costs regardless of the legal setting. The greatest reduction in costs (86%) occurred from using recommended interventions within a liberal legal setting rather than using conventional interventions within a restricted setting. These findings should support policy and practice efforts to reform abortion laws and to offer accessible, safe abortion services.
Authors: Joseph B Babigumira; Andy Stergachis; David L Veenstra; Jacqueline S Gardner; Joseph Ngonzi; Peter Mukasa-Kivunike; Louis P Garrison Journal: BMC Public Health Date: 2011-12-06 Impact factor: 3.295
Authors: Michael Vlassoff; Frederick Mugisha; Aparna Sundaram; Akinrinola Bankole; Susheela Singh; Leo Amanya; Charles Kiggundu; Florence Mirembe Journal: Health Policy Plan Date: 2012-12-29 Impact factor: 3.344
Authors: Michael Vlassoff; Sabine F Musange; Ina R Kalisa; Fidele Ngabo; Felix Sayinzoga; Susheela Singh; Akinrinola Bankole Journal: Health Policy Plan Date: 2014-02-17 Impact factor: 3.344
Authors: Marlene Makenzius; Monica Oguttu; Marie Klingberg-Allvin; Kristina Gemzell-Danielsson; Theresa M A Odero; Elisabeth Faxelid Journal: BMJ Open Date: 2017-10-10 Impact factor: 2.692