Health system costs of menstrual regulation, abortion, and post-abortion care: the case of Bangladesh

Heidi Johnston, ICDDR,B: Centre for Health and Population Research
Elizabeth Oliveras, ICDDR,B: Centre for Health and Population Research
Shamima Akhter, ICDDR,B: Centre for Health and Population Research
Damian Walker, Johns Hopkins University

Cost data from Bangladesh will be applied to an abortion-oriented costing spreadsheet developed to enable users to estimate and compare costs to the health system of different strategies of menstrual regulation (MR), abortion, and postabortion care. Information on costs of essential medications, supplies, provider salaries etc., were collected in July 2008 using a detailed survey of MR providers at 21 primary, secondary, and tertiary level public sector health facilities in urban and rural Bangladesh. Based on evidence from studies in Africa and Latin America, and based on a preliminary application of data to the costing spreadsheet, we anticipate that the estimated costs of the current system of service delivery in the Bangladesh MR Programme will indicate WHO-recommended safe abortion care best practices are cost-effective. Application of data to the model may yield alternative MR Programme strategies that could further reduce health system costs while maintaining quality.