Costs Associated with Unsafe Abortion Michael Vlassoff Panel on Fertility Regulation Costs 16 July, 2008.

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Presentation transcript:

Costs Associated with Unsafe Abortion Michael Vlassoff Panel on Fertility Regulation Costs 16 July, 2008

Nigeria PAC Cost Study (Chapter 4) Data Sources Abortion incidence data from 1996 study Out-of-pocket costs from hospital- based survey (33 hospitals in 8 states and all 4 health zones) PAC costing: MBP accounting framework, WHO-CHOICE data, key informants in 10 facilities

Cost of Post-Abortion Care – Nigeria (Health-System Costs) Actual PAC Women receiving PAC 74,000 Health-system Cost $7.6 m. Potential PAC Women not receiving PAC111,000 Health-system Cost $11.4 m. Total Potential System Cost$19.0 m. (Average Cost per Case: $103)

Cost of Contraception – Nigeria Data and Assumptions Cost data from UNFPA database (Modern) method-mix data from DHS Assume new users have same use pattern Assume marginal cost equals average cost

Cost-Effectiveness Nigeria Health System Cost per case (PAC)$103 Cost per case (FP)$25 Cost-effectiveness Ratio4:1

Out-of-Pocket Medical Expenses Nigeria: Hospital-based Sample Post-abortion care Per case Health-system costs $132 Out-of-pocket costs $95 Out-of-pocket proportion 72% Cost of prior abortion attempt $24 Total out-of-pocket cost $115 GNI per capita (2006) $620

Other Costing Studies Developing world synthesis Uganda 4-scenario study Kazakhstan (Chapter 6)

Costs of Unsafe Abortion (Developing World) Health-system costs Actual$550 m. Potential$370 m. Infertility treatment $6,000 m. Individual/household costs Out-of-pocket costs$400 m. Income lost due to morbidity$920 m. Income lost due to mortality $9 m.

Cost of Abortion – Uganda 4 Scenarios $45$34 $25$6 Conventional Recommended RestrictedLiberal (Cost per case)

Kazakhstan Cost Comparisons Average cost of abortion $26 Per-case cost of PAC$59 Cost-effectiveness Ratio (Abortion : Contraception) 3.2 : 1

Thank You For more information, visit