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Now

Restrictions on private insurance coverage of abortion pose a danger to abortion access and better health coverage
Reproductive Health Matters
November 2018

Comparing Women’s Financial Costs of Induced Abortion at a Facility vs. Seeking Treatment for Complications from Unsafe Abortion in Zambia

Ann M. Moore,Guttmacher Institute
Mardieh Dennis,Population Council
Ragnar Anderson,Guttmacher Institute
Akinrinola Bankole,Guttmacher Institute
Anna Abelson,Population Council
Giulia Greco,London School of Hygiene and Tropical Medicine
Bellington Vwalika,University of Zambia
First published online: November 2, 2018 DOI: https://doi.org/10.1080/09688080.2018.1522195

Although abortion is legal in Zambia under a variety of broad conditions, unsafe abortion remains common. The purpose of this project was to compare the financial costs for women when they have an induced abortion at a facility, with costs for an induced abortion outside a facility, followed by care for abortion-related complications. We gathered household wealth data at one point in time (T1) and longitudinal qualitative data at two points in time (T1 and T2, three-four months later), in Lusaka and Kafue districts, between 2014 and 2015. The data were collected from women (n = 38) obtaining a legal termination of pregnancy (TOP), or care for unsafe abortions (CUA). The women were recruited from four health facilities (two hospitals and two private clinics, one of each per district). At T2, CUA cost women, on average, 520 ZMW (USD 81), while TOP cost women, on average, 396 ZMW (USD 62). About two-thirds of the costs had been incurred by T1, while an additional one-third of the total costs was incurred between T1 and T2. Women in all three wealth tertiles sought a TOP in a health facility or an unsafe abortion outside a facility. Women who obtained CUA tended to be further removed from the money that was used to pay for their abortion care. Women’s financial dependence leaves them unequipped to manage a financial shock such as an abortion. Improved TOP and post-abortion care are needed to reduce the health sequelae women experience after both types of abortion-related care.

Full article available at Reproductive Health Matters

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Topic

International

  • Abortion

Geography

  • Sub-Saharan Africa: Zambia

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