The public health and economic consequences of unintended pregnancies in South Africa
ESC Congress Library. Steyn P. 05/28/14; 50518; A-103
Prof. Dr. Petrus S Steyn
Prof. Dr. Petrus S Steyn
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Rate & Comment (0)

Unintended pregnancy (UIP) poses considerable humanistic and economic burden in both developed and developing countries. Obtaining specific estimates on UIP in developing countries is difficult due to data limitations and differences in classifying and reporting of pregnancies.


Objective: To estimate the burden of UIP in a developing country.
Design & Methods: A decision-analytic model was developed using probabilities for pregnancy related outcomes related to UIPs in a single year. The model evaluates contraceptive methods that are currently in use in South Africa. The annual cases of UIP among women of reproductive age in South Africa were estimated using distribution of contraceptive use across methods and the associated failure rates. The major outcomes of UIP s evaluated in the model were induced abortion, miscarriage, ectopic pregnancy and live birth. Maternal mortality and related costs to the public health system were assessed for each of these outcomes. 
Results: 636 040 annual UIP were estimated, resulting in 91 439 abortions, 6 996 ectopic pregnancies, 101 766 miscarriages and 435 838 births. The annual maternal deaths were estimated to be 1 134 of which 219 (19.3%) were attributed to abortions and 915 attributed to complications from miscarriages, ectopic pregnancies and deliveries. The costs attributed to UIP birth outcomes accounted for R3.42 billion annually. Annual costs of UIP live births were estimate to be 82.8% of the total costs with abortion and miscarriage accountable for 8.3% and 8.4%, respectively. The number of infant deaths attributed to UIP within 12-months following birth was estimated at 30 754. We estimated 76 272 preterm deliveries attributed to unintended pregnancies. The estimated number of neonatal admissions associated with UIP was 100 175, which included all preterm deliveries and 7.6% of term deliveries.
Conclusions: UIP are partly due to lack of service provision and not meeting women's contraceptive needs. However, a large proportion of these pregnancies also occur due to lack of knowledge and myths regarding contraception, failure and discontinuation of short-term hormonal contraception. Efficacy can also be impaired because women commonly switch methods, often with a period of delay before starting the new method rendering them susceptible to unintended pregnancies. In this context, long acting reversible contraceptive (LARC) methods combine reversibility with high effectiveness and do not depend so much on compliance or correct use.

Unintended pregnancy (UIP) poses considerable humanistic and economic burden in both developed and developing countries. Obtaining specific estimates on UIP in developing countries is difficult due to data limitations and differences in classifying and reporting of pregnancies.


Objective: To estimate the burden of UIP in a developing country.
Design & Methods: A decision-analytic model was developed using probabilities for pregnancy related outcomes related to UIPs in a single year. The model evaluates contraceptive methods that are currently in use in South Africa. The annual cases of UIP among women of reproductive age in South Africa were estimated using distribution of contraceptive use across methods and the associated failure rates. The major outcomes of UIP s evaluated in the model were induced abortion, miscarriage, ectopic pregnancy and live birth. Maternal mortality and related costs to the public health system were assessed for each of these outcomes. 
Results: 636 040 annual UIP were estimated, resulting in 91 439 abortions, 6 996 ectopic pregnancies, 101 766 miscarriages and 435 838 births. The annual maternal deaths were estimated to be 1 134 of which 219 (19.3%) were attributed to abortions and 915 attributed to complications from miscarriages, ectopic pregnancies and deliveries. The costs attributed to UIP birth outcomes accounted for R3.42 billion annually. Annual costs of UIP live births were estimate to be 82.8% of the total costs with abortion and miscarriage accountable for 8.3% and 8.4%, respectively. The number of infant deaths attributed to UIP within 12-months following birth was estimated at 30 754. We estimated 76 272 preterm deliveries attributed to unintended pregnancies. The estimated number of neonatal admissions associated with UIP was 100 175, which included all preterm deliveries and 7.6% of term deliveries.
Conclusions: UIP are partly due to lack of service provision and not meeting women's contraceptive needs. However, a large proportion of these pregnancies also occur due to lack of knowledge and myths regarding contraception, failure and discontinuation of short-term hormonal contraception. Efficacy can also be impaired because women commonly switch methods, often with a period of delay before starting the new method rendering them susceptible to unintended pregnancies. In this context, long acting reversible contraceptive (LARC) methods combine reversibility with high effectiveness and do not depend so much on compliance or correct use.

    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.


Save Settings