199982 Cost of unsafe abortion: A prospective study among women identified with post-abortion complications in selected hospitals of Madhya Pradesh, India

Monday, November 9, 2009

Kathryn Andersen, PhD , Ipas, Chapel Hill, NC
Sushanta Kumar Banerjee , Research & Evaluation, Ipas, New Delhi, India
While much is known about health effects of unsafe abortion, less attention has been paid to economic impact. This study describes 381 patients presenting for complications of unsafe abortion at ten selected hospitals in Madhya Pradesh, India. Many women accessing post abortion care (PAC) first attempted pregnancy induction at home by themselves or with the help of a family member or friend. Women report as many as four visits to health care providers (either legal or illegal) in resolving their induced abortion. Median direct costs (travel plus medical care) of all visits associated with unsafe abortion ranges from Rs 0 to 10250, with a median of Rs 215. The primary contributors to overall costs are travel/transport to facilities and medicines. Costs were relatively stable across sociodemographic characteristics with a few exceptions: higher among older women and working women, while lower among unmarried women and those from the scheduled tribe caste. Higher costs are observed among second trimester patients and women who first attempted to induce their abortion at home. Costs increase with increasing number of visits and severity of complications. Additional analysis will provide expanded examination of the cost components of each visit, bivariate analysis using nonparametric methods, and consideration of lost wages to the patients and their families as a result of seeking care.

Learning Objectives:
Discuss the pathways through which the cost of unsafe abortion affects individual women. Describe the magnitude and components of direct costs of unsafe abortion. Evaluate the factors associated with higher costs.

Keywords: Abortion, Cost Issues

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Participated in data analysis and writing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.