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conferenceseries
.com
September 25-26, 2017 | Atlanta, USA
2
nd
World Congress on
Medical Sociology & Community Health
Volume 7, Issue 4 (Suppl)
J Community Med Health Educ, an open access journal
ISSN:2161-0711
Medical Sociology 2017
September 25-26, 2017
J Community Med Health Educ 2017, 7:4 (Suppl)
DOI: 10.4172/2161-0711-C1-028
ESTIMATING USER COSTS ASSOCIATED WITH ABORTION SERVICES AT GOVERNMENT
FACILITIESINMADHYAPRADESH:APOLICYDISCUSSIONONDEMANDSIDEINFLUENCES
ONACCESS IN INDIA
Aparna
a
a
London School of Hygiene and Tropical Medicine, UK
S
tatement of the Problem: Problem of rising out of pocket payments to access healthcare within the Indian health system is
significant, exacerbated by problems of marginalization and vulnerability. Reproductive health reveals similar patterns, impacted
further by patriarchal systems that limit women’s access to care. In particular, despite a relatively liberal abortion policy, unaffordability
of services leaves women unable to seek specialized abortion care. Methodology &Theoretical Orientation: A mixed methods policy
study using pre-collected secondary data as well as extensive policy review has been analysed. Ensor and Cooper’s three delays model
served as the theoretical framework. Findings: Average total cost of an abortion in Madhya Pradesh was Rs.710 ($11.5), with non-
medical costs, on average, higher than treatment costs, suggesting high OOP expenses act as factors for delays in care-seeking. OOP
burdens were highest on those most vulnerable, the poorest and those younger than 20 years of age. Surgical methods were widely
used in abortion with majority use of invasive dilatation and curettage (D&C) requiring longer facility stay post procedure. Minority
used contraception during time of conception and few were offered family planning methods post-abortion. More women used
facilities for post abortion care rather than terminating a pregnancy, although latter is cheaper. Although intangible cost calculations
have been excluded, time cost estimates were highest on those least well off, as they spent the longest time reaching the facility and
staying there in comparison to the richest. Conclusion & Significance: Increasing use of Manual Vacuum Aspiration, not relying
extensively on D&C, offers less invasive procedures and on average, lowers inpatient time at facility, reducing user costs. Addressing
non-medical costs in accessing care, which are out of pocket, are vital, particularly for lower income households. However, greater
contraceptive access and availability, including better knowledge on using these methods is foremost priority.
aparna.ananthakrishnan@gmail.com