The health system cost of post-abortion care in Ethiopia

Tamara Fetters, Ipas

This paper estimates the cost of unsafe abortion in Ethiopia focusing on the provision of post-abortion care (PAC) by the health system. In 2008, 14 public and private health facilities, representing three levels of health care, were surveyed. Detailed cost information on drugs, supplies, material, personnel time, and out-of-pocket expenses were collected from key informants at the facilities. Sensitivity analysis was used to determine the likely ranges of various costs. The average cost per client, across five types of abortion complications, was $36.21. The annual direct cost nationally ranged from $6.5 to $8.9 million. Including indirect costs and satisfying all demand raised the estimated annual national cost to $47 million. Post-abortion care consumes a large portion of the total expenditure in reproductive health in Ethiopia. Investing in strategies to reduce unwanted pregnancies would be cost-beneficial to the health system.