Inclusion of abortion-related care in national health benefit packages: results from a WHO global survey

作者：Katharine Footman, Kratu Goel, Ulrika Rehnström Loi, Andrew J. Mirelman, Veloshnee Govender, Bela Ganatra · 发表于：BMJ Global Health · 年份：2023 · DOI：10.1136/bmjgh-2023-012321 · 被引用次数：5 · 研究领域：Reproductive Health and Contraception、Global Maternal and Child Health、Reproductive Health and Technologies

INTRODUCTION: Service inclusion in a country's health benefit package (HBP) is an important milestone towards universal health coverage. This study aimed to explore HBP inclusion of abortion interventions globally. METHODS: Secondary analysis of the WHO HBP survey, in which officially nominated survey focal points were asked which interventions were included within the HBP of their country or area's largest government health financing scheme. Abortion inclusion was compared by region, income, legal status of abortion and HBP design process variables. Abortion inclusion was compared with other sexual and reproductive health (SRH) services. RESULTS: Below half (45%) reported that abortion is included, but treatment of complications from unsafe abortion was more commonly included (63%). Fewer fully included essential abortion medications (22% mifepristone, 42% misoprostol). Abortion was less commonly included than any other SRH service in the survey. Unlike most SRH services, higher cost, higher technology care to treat complications of unsafe abortion was more commonly included than the relatively lower cost, lower technology service of induced abortion. Higher-income contexts and less restrictive legal environments had higher abortion inclusion. Some contexts had additional restrictions, with abortion inclusion dependent on the patient's reason for seeking care. CONCLUSION: This global survey finds that abortion services and medications are often not included within HBPs, whil...