Cost of abortions in Zambia: A comparison of safe abortion and post abortion care

Divya Parmar*, Tiziana Leone, Ernestina Coast, Susan Fairley Murray, Eleanor Hukin, Bellington Vwalika

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Citations (Scopus)


Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion.

Original languageEnglish
Pages (from-to)1-14
Number of pages14
JournalGlobal Public Health
Early online date27 Dec 2015
Publication statusE-pub ahead of print - 27 Dec 2015


  • Abortion
  • cost
  • health system
  • termination of pregnancy
  • Zambia


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