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. 2011 Dec 6:11:904.
doi: 10.1186/1471-2458-11-904.

Estimating the costs of induced abortion in Uganda: a model-based analysis

Joseph B Babigumira  1 , Andy Stergachis, David L Veenstra, Jacqueline S Gardner, Joseph Ngonzi, Peter Mukasa-Kivunike, Louis P Garrison
Affiliations

Estimating the costs of induced abortion in Uganda: a model-based analysis

Joseph B Babigumira et al. BMC Public Health. .

Abstract

Background: The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda.

Methods: A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty.

Results: The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average.

Conclusion: Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.

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Figures

Figure 1
Figure 1
Decision tree showing the consequences of induced abortion in Uganda. A circle corresponds to a chance node (defined by the probability of an event occurring) and a triangle corresponds to an end node.
Figure 2
Figure 2
Tornado diagram of univariate sensitivity analysis. The 20 most influential variables are shown.
See this image and copyright information in PMC

References

    1. Republic of Uganda, Penal Code Act (CAP 106), Revised Edition. 1984.
    1. CIA-World Factbook--Uganda. https://www.cia.gov/library/publications/the-world-factbook/geos/ug.html... Accessed 13th July 2010.
    1. Uganda Catholic Bishops' Conference, Open Letter to the government and people of Uganda, 2006. http://www.catholicculture.org/library/view.cfm?recnum=6792&longdesc accessed April 16th 2008.
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    1. Namagembe I. Study of the knowledge, practices and attitudes of men from Kampala institutions towards illegally induced abortions, study presented at the 1st meeting of East, Central and Southern Africa Association of Obstetrical and Gynecological Societies, Kampala, Uganda. 1997. pp. 5–9.

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