CONTEXT: Treatment of complications of unsafe abortion can be a significant financial drain on health system resources, particularly in developing countries. In Bangladesh, menstrual regulation is provided by the government as a backup to contraception. The comparison of economic costs of providing menstrual regulation care with those of providing treatment of abortion complications has implications for policy in Bangladesh and internationally. METHODS: Data on incremental costs of providing menstrual regulation and care for abortion complications were collected through surveys of providers at 21 public-sector facilities in Bangladesh. These data were entered into an abortion-oriented costing spreadsheet to estimate the health system costs of providing such services. RESULTS: The incremental costs per case of providing menstrual regulation care in 2008 were 8-13% of those associated with treating severe abortion complications, depending on the level of care. An estimated 263,688 menstrual regulation procedures were provided at public-sector facilities in 2008, with incremental costs estimated at US$2.2 million, and 70,098 women were treated for abortion-related complications in such facilities, with incremental costs estimated at US$1.6 million. CONCLUSION: The provision of menstrual regulation averts unsafe abortion and associated maternal morbidity and mortality, and on a per case basis, saves scarce health system resources. Increasing access to menstrual regulation would enable more women to obtain much-needed care and health system resources to be utilized more efficiently.
CONTEXT: Treatment of complications of unsafe abortion can be a significant financial drain on health system resources, particularly in developing countries. In Bangladesh, menstrual regulation is provided by the government as a backup to contraception. The comparison of economic costs of providing menstrual regulation care with those of providing treatment of abortion complications has implications for policy in Bangladesh and internationally. METHODS: Data on incremental costs of providing menstrual regulation and care for abortion complications were collected through surveys of providers at 21 public-sector facilities in Bangladesh. These data were entered into an abortion-oriented costing spreadsheet to estimate the health system costs of providing such services. RESULTS: The incremental costs per case of providing menstrual regulation care in 2008 were 8-13% of those associated with treating severe abortion complications, depending on the level of care. An estimated 263,688 menstrual regulation procedures were provided at public-sector facilities in 2008, with incremental costs estimated at US$2.2 million, and 70,098 women were treated for abortion-related complications in such facilities, with incremental costs estimated at US$1.6 million. CONCLUSION: The provision of menstrual regulation averts unsafe abortion and associated maternal morbidity and mortality, and on a per case basis, saves scarce health system resources. Increasing access to menstrual regulation would enable more women to obtain much-needed care and health system resources to be utilized more efficiently.
Authors: Yana van der Meulen Rodgers; Ernestina Coast; Samantha R Lattof; Cheri Poss; Brittany Moore Journal: PLoS One Date: 2021-05-06 Impact factor: 3.240
Authors: Erin Pearson; Kathryn L Andersen; Kamal Biswas; Rezwana Chowdhury; Susan G Sherman; Michele R Decker Journal: Int J Gynaecol Obstet Date: 2016-12-16 Impact factor: 3.561
Authors: Michael M Mutua; Beatrice W Maina; Thomas O Achia; Chimaraoke O Izugbara Journal: BMC Pregnancy Childbirth Date: 2015-10-07 Impact factor: 3.007
Authors: Samantha R Lattof; Ernestina Coast; Yana van der Meulen Rodgers; Brittany Moore; Cheri Poss Journal: PLoS One Date: 2020-11-04 Impact factor: 3.240