Abstract
Objective
The objective was to investigate public funding policies for abortion in countries
with liberal or liberally interpreted laws (defined as permitting abortion for economic
or social reasons or upon request).
Study design
In May 2011–February 2012 and June 2013–December 2014, we researched online resources
and conducted an email-based survey among reproductive health experts to determine
countries' public funding policies for abortion. We categorized countries as follows:
full funding for abortion (provided for free at government facilities, covered under
state-funded health insurance); partial funding (partially covered by the government,
covered for certain populations based on income or nonincome criteria, or less expensive
in public facilities); funding for exceptional cases (rape/incest/fetal impairment,
health/life of the woman or other limited cases) and no public funding.
Results
We obtained data for all 80 countries meeting inclusion criteria. Among the world's
female population aged 15–49 in countries with liberal/liberally interpreted abortion
laws, 46% lived in countries with full funding for abortion (34 countries), 41% lived
in countries with partial funding (25 countries), and 13% lived in countries with
no funding or funding for exceptional cases only (21 countries). Thirty-one of 40
high-income countries provided full funding for abortion (n=20) or partial funding (n=11); 28 of 40 low- to middle-income countries provided full (n=14) or partial funding for abortion (n=14). Of those countries that did not provide public funding for abortion, most provided
full coverage of maternity care.
Conclusion
Nearly half of countries with liberal/liberally interpreted abortion laws had public
funding for abortion, including most countries that liberalized their abortion law
in the past 20 years. Outliers remain, however, including among developed countries
where access to abortion may be limited due to affordability.
Implications
Since cost of services affects access, country policies regarding public funding for
services should be monitored, and advocacy should prioritize ensuring the affordability
of care for low-income women.
Keywords
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Article info
Publication history
Published online: July 22, 2016
Accepted:
June 27,
2016
Received in revised form:
June 24,
2016
Received:
January 22,
2016
Footnotes
☆Conflicts of interest: none.
☆☆Role of the funding source: The study was funded by grants from the William and Flora Hewlett Foundation, the David and Lucile Packard Foundation, and an anonymous foundation.
★These funders played no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
