Comparing women's financial costs of induced abortion at a facility vs. seeking treatment for complications from unsafe abortion in Zambia
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...
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| Published in | Reproductive health matters Vol. 26; no. 52; pp. 138 - 150 |
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| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Taylor & Francis
01.12.2018
Taylor & Francis, Ltd Taylor & Francis Ltd |
| Subjects | |
| Online Access | Get full text |
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| Summary: | 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. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 AM contributed to the design of the study, secured IRB approval from the Guttmacher Institute, trained the first set of interviewers, monitored the fieldwork remotely, collaborated on the analysis, and led the write-up of the results. MD secured IRB approval from the University of Zambia and Population Council, trained the second set of interviewers, coordinated and supervised fieldwork including implementation of the study protocol including data cleaning, conducted a portion of the analysis, and collaborated on writing up the results. RA coded most of the data, conducted a portion of the analysis and collaborated on writing up the results. AB conceived of the original design of the study and contributed to various modifications to the study design, assisted in securing IRB approval, contributed to the study instruments, and participated in data interpretation. AA helped with the fieldwork supervision and implementation, conducted a portion of the analysis, and contributed to the write-up of the results. GG helped design the instrument, contributed to the analysis and to the write-up of the results. BV contributed to the study design, instruments, analysis and write-up. Authors’ contributions Current affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Current affiliation: PhD Student, London School of Hygiene and Tropical Medicine, London, UK. |
| ISSN: | 0968-8080 1460-9576 2641-0397 |
| DOI: | 10.1080/09688080.2018.1522195 |