Study: “Economic Impact of Unsafe Induced Abortion in Uganda”
PI: Babigumira, Joseph
Affiliation: University of Washington
Funding Partner: IIE
Data Source(s): Panel Data
Method(s): Cost-Effectiveness Analysis
Geographic Location: Uganda
The research quantifies the opportunity cost of unsafe abortion in terms of individual health and costs as well as health care and societal costs. Preventing unsafe abortions would reduce morbidity and mortality among Ugandan mothers and benefit society through increased productivity because young mothers are at the core of agricultural production and child care in Uganda. Preventing unsafe abortions would also reduce health care spending with the potential of diverting saved resources to other areas in the economy.
The study has three specific aims: to quantify the health and economic impact of the post-hospitalization complications of induced abortion; to estimate the national cost of unsafe induced abortions; and to calculate the cost-effectiveness of increasing contraceptive coverage (reducing the unmet need for contraception). Researchers conducted three independent studies: (1) a six-month observational cohort study comparing the health (outpatient visits, hospitalizations, all-cause mortality, self-reported health, and health-related quality of life) and economic (labor and school participation, earning, and savings) characteristics of women discharged following a complication of induced abortion and women who have not had an induced abortion; (2) a cost-of-illness study to determine the total economic impact of unsafe induced abortion on Ugandan society; and (3) a decision analytic cost-effectiveness model to calculate the incremental costs and benefits—in terms of lives saved and maternal quality-adjusted life years saved—of increasing contraceptive coverage in Uganda.
The results show that average societal cost per induced abortion was $177, which totals $64 million in average national costs. Most costs associated with abortion are from indirect costs due to lost productivity and direct costs such as medical care, which were incurred much more by patients than the government. Policymakers should take note that induced abortions are associated with substantial costs in Uganda, with patients incurring a majority of health care costs. Efforts should be made to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions. Additional efforts can be made to estimate potential economic gains that can be achieved with a more lax abortion law or increasing contraceptive coverage.
Babigumira, Joseph B., Stergachis, Andy, Veenstra, David L., Gardner, Jacqueline S., Ngonzi, Joseph, Mukasa-Kivunike, Peter & Garrison, Louis P. (2012). Potential cost-effectiveness of universal access to modern contraceptives in Uganda. PLoS ONE, 7(2), e30735. DOI: 10.1371/journal.pone.0030735
Babigumira, Joseph B., Stergachis, Andy, Veenstra, David L., Ngonzi, Joseph, Gardner, Jacqueline S., Mukasa-Kivunike, Peter & Garrison, Louis P. (2011). Estimating the Costs of Induced Abortion in Uganda: A Model-Based Analysis. BMC Public Health, 11(1), 904. DOI: 10.1186/1471-2458-11-904
Lubinga, Solomon et al. (2013). Health-related quality of life and social support among women treated for abortion complications in western Uganda. Health and Quality of Life Outcomes, 11(118). DOI: 10.1186/1477-7525-11-118