Academic journal article International Perspectives on Sexual and Reproductive Health

In This Issue

Academic journal article International Perspectives on Sexual and Reproductive Health

In This Issue

Article excerpt

A study of the costs of postabortion care and legal abortion in Colombia by Elena Prada and colleagues reports that the country's health system could greatly reduce its expenditures on these services without sacrificing quality of care by performing them at primary-level facilities rather than at the secondary or tertiary facilities where most such services are now provided [page 114]. For example, the average cost of a legal abortion at secondary and tertiary facilities in 2012 was US$200, compared with $45 in primary-level private clinics. According to the authors, medical providers at higher-level facilities routinely use dilation and curettage (D&C)--which is costly because it is time-consuming, requires general anesthesia and, in Colombia, often an overnight stay after an abortion. In contrast, the cost at primary-level private clinics, which provide outpatient services only and routinely use manual vacuum aspiration and medication abortion, was only $45.

Seasonal migration is common among men in many former Soviet republics, but little research has examined contraceptive use and abortion among women in such low-fertility, high-migration settings. According to a study conducted in rural Armenia by Arusyak Sevoyan and Victor Agadjanian, the odds of a woman's pregnancy ending in abortion are associated with her household's economic well-being, but not with her husband's migration status [page 124]. Using data from two surveys among married women aged 18-45 in rural areas--one conducted in 2005 and another in 2007--the authors found that with increased household wealth, modern contraceptive use rose among women with a nonmigrant husband, but decreased slightly among women with a migrant husband. The researchers comment that there is a great need for programs that promote the benefits of using modern contraceptives rather than abortion for fertility control.

Can unmet need be reduced more effectively by making modern contraceptives available to women who have never used them, despite not wanting to become pregnant, or by supporting current users and encouraging women who have discontinued to resume use? Using data collected from married women in Demographic and Health Surveys conducted in 34 developing countries between 2005 and 2010, Anrudh K. Jain and colleagues examined the contribution of discontinuation of modern methods to unmet need at the time of the survey and in the future [page 133]. …

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