Estimating the magnitude and health system costs of unsafe abortion

Ipas researchers and country-based partners have conducted nationally-representative, prospective health facility surveys of abortion cases in Ethiopia, Kenya, Malawi and Cambodia. A smaller-scale study has also been carried out in hospitals in Sierra Leone. These data are used to estimate the annual number of women treated for abortion complications in facilities, clinical severity of complications, numbers of abortion-related deaths, and clinical management of care, information which is largely unavailable in routine health information systems. In Kenya, Ethiopia, Malawi and Cambodia, Ipas and partners developed estimates of the number and rate of abortion, helping to fill major gaps in abortion knowledge among health care policymakers, clinical providers and advocates in these countries.

A common question raised by health officials relates to the costs of treating complications of unsafely-performed abortions in their countries. Ipas and research partners have conducted research in Nigeria, Malawi, Uganda, Ethiopia and Sierra Leone to estimate the health system costs to treat women with varying morbidities from unsafe abortion. Documentation of the health system cost benefits with a shift from postabortion treatment in a legally restrictive environment to safe, induced abortion offered in a liberal context has been a valuable source of information for policy reform efforts in such countries as Malawi and Sierra Leone.