The Cost of Postabortion Care and Legal Abortion in Colombia

Prada, Elena; Maddow‐Zimet, Isaac; Juárez, Fátima

doi:10.1363/3911413

Cited by 25 publications

(26 citation statements)

References 12 publications

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“…Thus, 22 studies were included in our narrative review of which 15 provided disaggregated component cost for our analysis (figure 1). Nineteen of the included studies were retrieved from peer-review literature, [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45] while the remaining three were sourced from grey literature. [46][47][48] distribution and quality assessment of included studies Thirteen studies were conducted in low-income countries (LICs) including four in Rwanda, 35 41 45 46 two each in Tanzania 32 36 and Uganda 29 34 and one each in Burkina Faso, 43 Democratic Republic of the Congo, 27 Ethiopia, 33 Haiti 48 and Somalia.…”

Section: Resultsmentioning

confidence: 99%

The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review

et al. 2020

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IntroductionMaternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective.MethodsWe searched multiple peer-reviewed databases (including African Journal Online, CINAHL Plus, EconLit, Popline, PubMed, Scopus and Web of Science) and grey literature for relevant articles published from year 2000. Articles meeting our inclusion criteria were selected with quality assessment done using relevant cost-focused criteria of the Consolidated Health Economic Evaluation Reporting Standards checklist. For comparability, disaggregated costs data were inflated to 2019 US$ equivalents. Costs and cost drivers were systematically compared. Where heterogeneity was observed, narrative synthesis was used to summarise findings.ResultsTwenty-two studies were included, with most studies costing vaginal and/or caesarean delivery (11 studies), antenatal care (ANC) (9) and postabortion care (PAC) (8). Postnatal care (PNC) has been least costed (2). Studies used different methods for data collection and analysis. Quality of peer-reviewed studies was assessed average to high while all grey literature studies were assessed as low quality. Following inflation, estimated provision cost per service varied (ANC (US$7.24–US$31.42); vaginal delivery (US$14.32–US$278.22); caesarean delivery (US$72.11–US$378.940; PAC (US$97.09–US$1299.21); family planning (FP) (US$0.82–US$5.27); PNC (US$5.04)). These ranges could be explained by intercountry variations, variations in provider type (public/private), facility type (primary/secondary) and care complexity (simple/complicated). Personnel cost was mostly reported as the major driver for provision of ANC, skilled birth attendance and FP. Economies of scale in service provision were reported.ConclusionThere is a cost savings case for task-shifting and encouraging women to use lower level facilities for uncomplicated services. Going forward, consensus regarding cost component definitions and methodologies for costing maternal health services will significantly help to improve the usefulness of cost analyses in supporting policymaking towards achieving Universal Health Coverage.

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Section: Resultsmentioning

confidence: 99%

The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review

et al. 2020

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“…If women are turning to unsafe abortion (an important cause of maternal morbidity) following Zika diagnosis, treating the complications associated with these procedures is also costly: one study estimated an average cost of $94 USD per case (2006 dollars) in Latin America, and a regional health system cost of $274 million USD annually [ 84 ]. Provision of safe abortion may be less expensive than treating these complications, but this appears to be heavily dependent on the context and provider: for example, the cost of safe abortion in Colombia ranged from $45 USD in a specialty clinic to up to $213 USD in secondary/tertiary facilities, whereas the average cost per case of treating complications of unsafe abortion was $141 [ 85 ]. It is also important to consider that there may be intangible costs related to anxiety, psychological suffering, stigma, and fatigue derived from either carrying or terminating a pregnancy following a diagnosis of Zika or CZS [ 7 , 17 , 37 , 42 , 43 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

The Zika epidemic and abortion in Latin America: a scoping review

Carabalí

Austin

King

et al. 2018

glob health res policy

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BackgroundLatin America presently has the world’s highest burden of Zika virus, but there are unexplained differences in national rates of congenital malformations collectively referred to as Congenital Zika Syndrome (CZS) in the region. While Zika virulence and case detection likely contribute to these differences, policy-related factors, including access to abortion, may play important roles. Our goal was to assess perspectives on, and access to, abortion in Latin America in the context of the Zika epidemic.MethodsWe conducted a scoping review of peer-reviewed and gray literature published between January 2015 and December 2016, written in English, Spanish, Portuguese, or French. We searched PubMed, Scielo, and Google Scholar for literature on Zika and/or CZS and abortion, and used automated and manual review methods to synthesize the existing information.Results36 publications met our inclusion criteria, the majority of which were qualitative. Publications were generally in favor of increased access to safe abortion as a policy-level response for mitigating the impact of CZS, but issues with implementation were cited as the main challenge. Aside from the reform of abortion regulation in Colombia, we did not find evidence that the Zika epidemic had triggered shifts in abortion policy in other countries.ConclusionAbortion policy in the region remained largely unchanged following the Zika epidemic. Further empirical research on abortion access and differential rates of CZS across Latin American countries is required.Electronic supplementary materialThe online version of this article (10.1186/s41256-018-0069-8) contains supplementary material, which is available to authorized users.

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“…Women seeking care are of course the ultimate recipients of these programs. Aside from Portugal and Uruguay, interviewees reported that many women were inadequately informed about safe legal care options and therefore continued to resort to illegal and often unsafe procedures …”

Section: Recipientsmentioning

confidence: 99%

“…The cost of private provision remains a barrier. Moreover, the lack of understanding of the legal grounds for abortion that prevails among many women and clinicians leads some women to expensive private or uncertified providers, some of whom may offer dangerous alternatives …”

Section: Remaining Concernsmentioning

confidence: 99%

Implementing and expanding safe abortion care: An international comparative case study of six countries

Chavkin

Stifani

Bridgman-Packer

et al. 2018

Intl J Gynecology & Obste

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We conducted a comparative case study‐based investigation of health sector strategies that were useful in expanding or establishing new abortion services. We selected geographically diverse countries from across the human development index if they had implemented new abortion laws, or changed interpretations of existing laws or policies, within the past 15 years (Colombia, Ethiopia, Ghana, Portugal, South Africa, and Uruguay). Factors facilitating the expansion of services include use of a public health frame, situating abortion as one component of a comprehensive reproductive health package, and including country‐based health and women's rights organizations, medical and other professional societies, and international agencies and nongovernment organizations in the design and rollout of services. Task sharing and the use of techniques that do not require much infrastructure, such as manual vacuum aspiration and medical abortion, are important for rapid establishment of services, especially in low‐resource settings. Political will emerged as the key factor in establishing or expanding access to safe abortion services.

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The Cost of Postabortion Care and Legal Abortion in Colombia

Cited by 25 publications

References 12 publications

The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review

The cost of maternal health services in low-income and middle-income countries from a provider’s perspective: a systematic review

The Zika epidemic and abortion in Latin America: a scoping review

Implementing and expanding safe abortion care: An international comparative case study of six countries

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