Quality and efficiency of care for complications of unsafe abortion: A case study from Bangladesh

Abstract

Treating complications of unsafe abortion can be financially draining for health systems. This analysis assessed incremental health system costs of service delivery for abortion-related complications in the Bangladesh public health system and confirmed that providing postabortion care with vacuum aspiration is less expensive than using dilation and curettage (D&C). Implementing several evidence-based best practices, such as replacing D&C with vacuum aspiration, reducing use of high-level sedation, authorizing midlevel providers to offer postabortion care, and providing postabortion contraceptive counseling and services to women while still at the health facility, could increase the quality and cost efficiency of postabortion care in Bangladesh.

A cross‐sectional analysis of Kenyan postabortion care services using a nationally representative sample

“…Use of appropriate technology for PAC in the first and second trimesters can be seen against the backdrop of high cost of some of the highly invasive and inappropriate procedures such as dilation and curettage. Some providers are thought to have shown a preference for these inappropriate methods for financial gain rather than as patient‐centered treatment choices …”

“…Some providers are thought to have shown a preference for these inappropriate methods for financial gain rather than as patient-centered treatment choices. 6 Unwanted pregnancies are a leading cause of unsafe induced abortion, the majority of which can be attributed to an unmet need for contraception. 20 The number of PAC patients who receive modern FP methods is therefore a critical component of the PAC quality framework and remained high in the present study (9 of 10 patients), although seven of these nine cases received only a barrier method (male condom).…”

“…A high proportion of women who undergo unsafe induced abortion will require medical care; however, access to quality PAC remains a challenge, especially among low‐income countries . Furthermore, induced abortion is illegal in many low‐income countries, and women often fail to seek intervention owing to a fear of legal repercussions .…”

“…4 A high proportion of women who undergo unsafe induced abortion will require medical care 5 ; however, access to quality PAC remains a challenge, especially among low-income countries. 6 Furthermore, induced abortion is illegal in many low-income countries, and women often fail to seek intervention owing to a fear of legal repercussions. 7 Conversely, many patients who actively seek PAC do not receive immediate and adequate treatment at healthcare facilities, mainly due to too many patients in healthcare facilities and other access restrictions such as cost.…”

Changes in Morbidity and Abortion Care in Ethiopia After Legal Reform: National Results from 2008 and 2014

“…In addition, research in several countries has shown that women receiving care from midlevel providers are more likely to accept a contraceptive method following their care. 29–31 …”