Costing and cost-effectiveness analysis of abortion methods in South Africa

Cost-effectiveness data for abortion give decision makers information about which abortion methods offer the most benefit per expenditure. Given limited health care budgets, shifts towards offering a full range of reproductive health services will likely require making difficult decisions about which services to add and when. Cost-effectiveness data could help policymakers weigh the costs and potential benefits of adding one service over another at various time points.

The goal of this project is to collect facility-based and women’s cost data for medication abortion in the first and second trimesters in order to provide guidance for policymakers and service managers on the comparative costs of the methods. The project consists of a model for costing and cost-effectiveness analysis of select public sector facilities in the provinces of KwaZulu-Natal and Western Cape, South Africa. Data related to facility costs will be collected through a questionnaire and interviews with hospital administration and termination of pregnancy nurses. These interviews will focus on personnel time, supplies required, and costs. We are collecting women’s cost-related data in conjunction with other Ibis studies taking place in South Africa. We are asking women about costs related to transportation, medication, and missing work, as well as other costs, to determine costs incurred by women when undergoing a safe medication abortion in the first or second trimester. By informing policymakers and service managers about the cost and cost-effectiveness of different methods, we hope to improve abortion service provision and women’s health outcomes.