Current Per-Case and Annual Costs of Post-Abortion Care Provision in Malawian Public Health Facilities

Janie Benson, Ipas
Keris S. KrennHrubec, Ipas
Maribel Manibo Lazzarino, Ipas
Hailemichael Gebreselassie, Ipas
Godfrey Kangaude, Ipas
Heidi Bart Johnston, Ipas
Brooke A. Levandowski, Ipas
Kari Points, Ipas

Unsafe abortion is a major contributor to pregnancy-related morbidity and mortality, and consumes significant health system costs. Using Savings, an Excel-based cost modeling tool, the current health system costs of treating complications from unsafe abortion were estimated. Data collected from 15 postabortion care (PAC)-providing public health facilities in Malawi were used to estimate the per-case and annual cost of PAC for study facilities and nation-wide. Overall, simple PAC was estimated to cost US $16 per case, ranging from US $11 to US $19, depending on procedure type. Treatment of additional complications such as sepsis, a blood transfusion, or surgical care increase costs further. Annually, the 15 study facilities are estimated to spend approximately US $156,735 on PAC alone. Nationally, all 93 PAC-providing public health facilities spend approximately US $408,464 annually on PAC. Reducing the severity of PAC complications by reducing restrictions on safe abortion care could potentially reduce these costs.