The study carried out for the Family Planning Association of Nepal (FPAN), has made an attempt to assess the economic impacts of abortion both safe and unsafe collecting data from six Global comprehensive abortion care (GCACP) districts namely Ilam, Sarlahi, Palpa, Banke, Kailali and Kanchanpur. Exit interviews were conducted with 62 safe abortion clients and similar information was collected from 36 women who have had unsafe abortion in the last six months. Interviews were also conducted with 360 women of reproductive age (60 women each from 6 districts) from the surrounding areas of six GCACP clinics to elicit information on economics of abortion. Abortion clinic providers’ opinions on abortion economics were also sought and similarly stakeholders of these six districts were interviewed.
About 5 percent abortion clients were unmarried but more (8 percent) unsafe abortion clients were unmarried compared to married clients (3 percent). Overall, more (61.2 percent) abortion clients were from urban areas than rural areas (38.8 percent); this was true of safe and unsafe abortion clients too.
About one in three women had to go on foot to the clinic for abortion; the others took public transport or other means of transportation. Knowledge of legalization of abortion appears quite widespread as nearly 3 in 4 community women have heard of it and it was higher (83 percent) in urban areas than in rural areas (63 percent).
Economic impact or costs of abortion in this study has been estimated by asking client series of questions related to money spent on several activities that have to do with abortion. Also attempts have been made to estimate woman’s earnings lost because of time lost due to abortion. The components of costs for an episode of induced abortion studied included fees paid for abortion service, cost of drug, client’s own transportation, accompanying person’s transportation, expenses for client’s tea/snacks and that of accompanying person’s tea/snacks, other costs and earnings lost. The service fees the abortion clients paid, on average, was Rs. 2,064 but unsafe abortion clients paid more than three times (Rs. 3,656) the cost compared to their counterparts who had safe abortion (Rs. 1,140). About 13 percent safe abortion clients said that the fees they paid was “too high” and the corresponding figure for unsafe abortion clients was nearly two times (25 percent).