placestats

Out-of-pocket health spending vs. Unintended pregnancies ending in abortion

Holds up after adjusting for income

Across 140 countries, Out-of-pocket health spending and Unintended pregnancies ending in abortion rise and fall together at r = +0.39 (on a scale from −1 to +1, where 0 means no link). It holds up almost unchanged when only countries with similar income (GDP per person) are compared (r = +0.45, q = 0.011, allowing for the many pairs tested).

Comparing countries across the middle half of unintended pregnancies ending in abortion, 31.3% to 58.7% of unintended pregnancies, out-of-pocket health spending is worse by 11.7% of health spending at the top of that range than the bottom. Comparing only countries with similar national income, the gap is 13% of health spending.

Link before adjusting (r)+0.393p = 1.6e-6 · 140 countries
After adjusting for national income+0.455p = 1.9e-8 · likely range [+0.31, +0.58]
p, allowing for regions0.036standard error 0.169 · 7 regions
Check for luck (q)0.011across 14,952 pairs

How to read these.r runs from −1 (one goes up as the other goes down) to +1 (they rise together), and 0 means no link. Adjusting for national income means comparing countries with the same GDP per person, so differences in wealth can’t explain the link. Income is used in percentage terms, since an extra $1,000 means more to a poor country than to a rich one. p is how likely a link this strong would be if there were really none. Below 0.05 means it is unlikely to be chance. Very small values are written in short form: 1.1e-32 means a decimal point followed by 31 zeros and then 11, so very close to zero. The likely range is where the true figure probably lies, and a range that crosses zero means the link could easily be chance. Countries in the same region tend to resemble each other, so the third figure allows for that, which gives a fairer p. The standard error is the typical size of the error in r. Finally, testing this many pairs means some will look strong by luck alone. A q below 0.05 means this link is unlikely to be one of those.

Out-of-pocket health spending · % of health spendinglink with income -0.34 · moderate
Unintended pregnancies ending in abortion · % of unintended pregnancieslink with income +0.12 · independent

“Link with income” is how closely each measure tracks GDP per person across countries, from −1 to +1.

Every country as a dot

Out-of-pocket health spending · % of health spending →Unintended pregnancies ending in abortion · % of unintended pregnancies →3.16%80.5%19.7%86.1%Angola: 32.5% of health spending, 28.1% of unintended pregnanciesAlbania: 48.3% of health spending, 59.2% of unintended pregnanciesArgentina: 24.5% of health spending, 48.4% of unintended pregnanciesArmenia: 80.5% of health spending, 81.8% of unintended pregnanciesAustralia: 15.8% of health spending, 43.1% of unintended pregnanciesAzerbaijan: 64.6% of health spending, 77.6% of unintended pregnanciesBurundi: 24.5% of health spending, 26.2% of unintended pregnanciesBelgium: 21.5% of health spending, 37.1% of unintended pregnanciesBenin: 42.4% of health spending, 36.9% of unintended pregnanciesBurkina Faso: 43.8% of health spending, 40.6% of unintended pregnanciesBangladesh: 79.3% of health spending, 60.1% of unintended pregnanciesBulgaria: 35.5% of health spending, 35.7% of unintended pregnanciesBosnia and Herzegovina: 31% of health spending, 57.3% of unintended pregnanciesBelarus: 28.5% of health spending, 56% of unintended pregnanciesBelize: 26.8% of health spending, 45.2% of unintended pregnanciesBolivia: 27.3% of health spending, 36.3% of unintended pregnanciesBrazil: 26.2% of health spending, 48.4% of unintended pregnanciesBarbados: 49.5% of health spending, 58% of unintended pregnanciesBhutan: 25.5% of health spending, 67.9% of unintended pregnanciesBotswana: 4.26% of health spending, 32.2% of unintended pregnanciesCentral African Republic: 45% of health spending, 30% of unintended pregnanciesCanada: 15.3% of health spending, 36.8% of unintended pregnanciesSwitzerland: 22% of health spending, 25.5% of unintended pregnanciesChile: 39.1% of health spending, 52.5% of unintended pregnanciesChina: 32.2% of health spending, 77.9% of unintended pregnanciesCote d'Ivoire: 32% of health spending, 36.7% of unintended pregnanciesCameroon: 67.7% of health spending, 40.7% of unintended pregnanciesCongo, Dem. Rep.: 38% of health spending, 27.9% of unintended pregnanciesCongo, Rep.: 28% of health spending, 42.6% of unintended pregnanciesColombia: 14.7% of health spending, 43.2% of unintended pregnanciesComoros: 56.6% of health spending, 32.4% of unintended pregnanciesCabo Verde: 25.7% of health spending, 48.6% of unintended pregnanciesCosta Rica: 24.1% of health spending, 41% of unintended pregnanciesCzechia: 14.1% of health spending, 19.7% of unintended pregnanciesGermany: 10.7% of health spending, 27.1% of unintended pregnanciesDjibouti: 28.8% of health spending, 41.4% of unintended pregnanciesDenmark: 13.9% of health spending, 38.9% of unintended pregnanciesDominican Republic: 25.1% of health spending, 44% of unintended pregnanciesEcuador: 30.9% of health spending, 35.1% of unintended pregnanciesSpain: 20.9% of health spending, 43.1% of unintended pregnanciesEstonia: 21.4% of health spending, 41.7% of unintended pregnanciesEthiopia: 46.3% of health spending, 31% of unintended pregnanciesFinland: 14.1% of health spending, 24.8% of unintended pregnanciesFrance: 9.23% of health spending, 49.5% of unintended pregnanciesGabon: 17.3% of health spending, 36.8% of unintended pregnanciesUnited Kingdom: 14.6% of health spending, 36.2% of unintended pregnanciesGeorgia: 58.8% of health spending, 86.1% of unintended pregnanciesGhana: 26.7% of health spending, 35.9% of unintended pregnanciesGuinea: 54.4% of health spending, 38.1% of unintended pregnanciesGambia, The: 33.8% of health spending, 31.1% of unintended pregnanciesGuinea-Bissau: 61.6% of health spending, 58.5% of unintended pregnanciesGreece: 34.3% of health spending, 45.8% of unintended pregnanciesGuatemala: 57.2% of health spending, 30.1% of unintended pregnanciesGuyana: 26.3% of health spending, 47.5% of unintended pregnanciesHonduras: 53.1% of health spending, 30.6% of unintended pregnanciesCroatia: 9.38% of health spending, 49.9% of unintended pregnanciesHaiti: 52.4% of health spending, 35.5% of unintended pregnanciesHungary: 23.1% of health spending, 49.4% of unintended pregnanciesIndonesia: 31.1% of health spending, 63% of unintended pregnanciesIndia: 43.9% of health spending, 77.1% of unintended pregnanciesIceland: 14.9% of health spending, 39.1% of unintended pregnanciesItaly: 22.3% of health spending, 67.1% of unintended pregnanciesJamaica: 20.2% of health spending, 43.9% of unintended pregnanciesJapan: 12.2% of health spending, 30.1% of unintended pregnanciesKazakhstan: 27.6% of health spending, 82.1% of unintended pregnanciesKenya: 24.2% of health spending, 38% of unintended pregnanciesKyrgyz Republic: 42.3% of health spending, 79.2% of unintended pregnanciesCambodia: 60.6% of health spending, 65.3% of unintended pregnanciesKorea, Rep.: 33.7% of health spending, 61.9% of unintended pregnanciesLao PDR: 44.8% of health spending, 68.3% of unintended pregnanciesLiberia: 63.2% of health spending, 40.4% of unintended pregnanciesSt. Lucia: 37.1% of health spending, 54.6% of unintended pregnanciesSri Lanka: 54.8% of health spending, 72.3% of unintended pregnanciesLesotho: 13.2% of health spending, 23.9% of unintended pregnanciesLithuania: 31.4% of health spending, 27.7% of unintended pregnanciesLatvia: 35.1% of health spending, 30.2% of unintended pregnanciesMoldova: 27.5% of health spending, 70.6% of unintended pregnanciesMadagascar: 27.4% of health spending, 62.8% of unintended pregnanciesMaldives: 18% of health spending, 70.5% of unintended pregnanciesMexico: 41.2% of health spending, 50.9% of unintended pregnanciesNorth Macedonia: 39.6% of health spending, 63.4% of unintended pregnanciesMali: 47.2% of health spending, 33.5% of unintended pregnanciesMyanmar: 71.1% of health spending, 74.2% of unintended pregnanciesMontenegro: 26.3% of health spending, 54.2% of unintended pregnanciesMongolia: 48.8% of health spending, 65.7% of unintended pregnanciesMozambique: 10.4% of health spending, 46.7% of unintended pregnanciesMauritania: 43.8% of health spending, 25.4% of unintended pregnanciesMalawi: 12% of health spending, 27.4% of unintended pregnanciesNamibia: 7.49% of health spending, 27.9% of unintended pregnanciesNiger: 51.5% of health spending, 31.3% of unintended pregnanciesNigeria: 71.9% of health spending, 48.2% of unintended pregnanciesNicaragua: 37.6% of health spending, 27.5% of unintended pregnanciesNetherlands: 11.8% of health spending, 40.8% of unintended pregnanciesNorway: 13.7% of health spending, 31.7% of unintended pregnanciesNepal: 59.4% of health spending, 69.4% of unintended pregnanciesNew Zealand: 12.7% of health spending, 29.3% of unintended pregnanciesPakistan: 52.9% of health spending, 60.9% of unintended pregnanciesPanama: 40.5% of health spending, 41.3% of unintended pregnanciesPeru: 27% of health spending, 47.5% of unintended pregnanciesPhilippines: 44.4% of health spending, 50.5% of unintended pregnanciesPapua New Guinea: 8.55% of health spending, 46.3% of unintended pregnanciesPoland: 16.2% of health spending, 36.6% of unintended pregnanciesPortugal: 28.2% of health spending, 32.4% of unintended pregnanciesParaguay: 36.3% of health spending, 51% of unintended pregnanciesRomania: 23% of health spending, 71.2% of unintended pregnanciesRussian Federation: 28.4% of health spending, 71.8% of unintended pregnanciesRwanda: 4.1% of health spending, 28.7% of unintended pregnanciesSenegal: 44.3% of health spending, 25.1% of unintended pregnanciesSingapore: 25.4% of health spending, 27.5% of unintended pregnanciesSolomon Islands: 3.16% of health spending, 28% of unintended pregnanciesSierra Leone: 54.5% of health spending, 51.5% of unintended pregnanciesEl Salvador: 32.5% of health spending, 41.5% of unintended pregnanciesSomalia, Fed. Rep.: 30.8% of health spending, 29.2% of unintended pregnanciesSerbia: 32.1% of health spending, 60.8% of unintended pregnanciesSao Tome and Principe: 16.7% of health spending, 29.6% of unintended pregnanciesSuriname: 19.7% of health spending, 46.5% of unintended pregnanciesSlovak Republic: 20.2% of health spending, 26.2% of unintended pregnanciesSlovenia: 11.7% of health spending, 24.4% of unintended pregnanciesSweden: 13.4% of health spending, 48.3% of unintended pregnanciesEswatini: 11% of health spending, 26.5% of unintended pregnanciesChad: 51.7% of health spending, 29.5% of unintended pregnanciesTogo: 64.3% of health spending, 32.2% of unintended pregnanciesThailand: 9.93% of health spending, 64.4% of unintended pregnanciesTajikistan: 62.4% of health spending, 71% of unintended pregnanciesTurkmenistan: 77.4% of health spending, 83.4% of unintended pregnanciesTimor-Leste: 6.99% of health spending, 67.8% of unintended pregnanciesTonga: 5.86% of health spending, 52% of unintended pregnanciesTrinidad and Tobago: 45.3% of health spending, 58% of unintended pregnanciesTanzania: 27.9% of health spending, 35.9% of unintended pregnanciesUganda: 32.2% of health spending, 29.7% of unintended pregnanciesUkraine: 45.3% of health spending, 75.9% of unintended pregnanciesUruguay: 17.1% of health spending, 27.6% of unintended pregnanciesUnited States: 10.9% of health spending, 34.2% of unintended pregnanciesUzbekistan: 64.1% of health spending, 80.2% of unintended pregnanciesViet Nam: 39.2% of health spending, 74.5% of unintended pregnanciesVanuatu: 8.38% of health spending, 45.4% of unintended pregnanciesSamoa: 13.4% of health spending, 64.5% of unintended pregnanciesSouth Africa: 6.69% of health spending, 36.6% of unintended pregnanciesZambia: 10.3% of health spending, 28.2% of unintended pregnanciesZimbabwe: 10.6% of health spending, 24.8% of unintended pregnanciesARMCMRCZEGEOGTMKAZRWASLBTGOTHATKMTLS

best-fit line line after adjusting

Four ways to measure the link

MethodrpCountries
Standard (Pearson), not adjusted+0.3931.6e-6140
By rank (Spearman), not adjusted+0.3413.7e-5140
Standard (Pearson), adjusted for national income+0.4551.9e-8140
By rank (Spearman), adjusted for national income+0.4029.6e-7140

The rank version uses only each country’s place in line, from lowest to highest, so a few extreme countries count for less. The adjusted and unadjusted versions use the same 140 countries: those that report both measures and GDP per person. So the gap between them comes from the adjustment, not from a change in which countries are counted. Drop in the size of r after adjusting: -0.062 (a minus sign means it grew).

How solid is it?

Leaving out one country at a time, r ranges from +0.430 (without TKM) to +0.482 (without TLS). The bar above shows that range on a scale from −1 to +1, with the solid line at the full result. The single country that moves r most: TLS (+0.027).

Within each region

Countries are not separate, unrelated cases, and neighbors share a lot. A link that holds inside each region is far more believable than one that shows up only when comparing regions.

nr
East Asia & Pacific20+0.57
Europe & Central Asia43+0.39
Latin America & Caribbean25+0.17
Sub-Saharan Africa42+0.32

By income third

If the link shows up only in the richest third of countries, it is a feature of rich countries, not a general pattern.

nr
Poorest third47+0.28
Middle third46+0.54
Richest third47+0.38

By largest religious group

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
Christians95+0.31
Muslims27+0.41

By last european coloniser

Countries grouped by a label they share, such as main religion, rather than by a number. Groups of fewer than twelve countries are not shown. These groups differ in income, region and history all at once. So a gap between them is a place to start asking questions, not an answer.

nr
France21-0.01
Never a European colony16+0.59
Spain17+0.09
United Kingdom38+0.61

Without outliers (countries far outside the middle half of countries on either measure, by more than one and a half times the width of that middle half): r = +0.455 after dropping 0 countries.

Two series, one country

Both measures over the years for one country you pick. The two charts are stacked so they share only the years along the bottom.

Loading…

Over time, within countries

Everything above compares countries with each other at one moment. This section compares each country only with itself over 0years. So a link here can’t come from anything about a country that stays the same, such as its history, geography, institutions or culture.

Not enough history inside each country to look at this over time. That needs countries measured for several years in a row, and at least one of these measures is measured too rarely.

The data


% of health spending
% of unintended pregnancies		Years
Armenia ARM80.5%81.8%2023, 2019
Bangladesh BGD79.3%60.1%2023, 2019
Turkmenistan TKM77.4%83.4%2023, 2019
Nigeria NGA71.9%48.2%2023, 2019
Myanmar MMR71.1%74.2%2023, 2019
Cameroon CMR67.7%40.7%2023, 2019
Azerbaijan AZE64.6%77.6%2023, 2019
Togo TGO64.3%32.2%2023, 2019
Uzbekistan UZB64.1%80.2%2023, 2019
Liberia LBR63.2%40.4%2023, 2019
Tajikistan TJK62.4%71%2023, 2019
Guinea-Bissau GNB61.6%58.5%2023, 2019
Cambodia KHM60.6%65.3%2023, 2019
Nepal NPL59.4%69.4%2023, 2019
Georgia GEO58.8%86.1%2023, 2019

World Bank, World Development Indicators
Bearak, J. M., Popinchalk, A., Beavin, C. et al. (2022), 'Country-specific estimates of unintended pregnancy and abortion incidence: a global comparative analysis of levels in 2015-2019', BMJ Global Health 7(3), e007151. Guttmacher Institute. Supplementary appendix, tables A3-A5.

Sources

Out-of-pocket health spending

Out-of-pocket expenditure (% of current health expenditure)

World Health Organization Global Health Expenditure Database · CC BY 4.0 · updated quarterly

The share of a country's health spending paid by patients themselves when they get care. Health spending as a share of GDP is already on the site and shows how much is spent. This shows who pays.

Unintended pregnancies ending in abortion

Share of unintended pregnancies ending in abortion (model estimate, 2015-2019)

Guttmacher Institute (Bearak et al. 2022, BMJ Global Health) · CC BY-NC 4.0 · updated one edition (2015-2019 estimates, published 2022)

Of the unintended pregnancies in the abortion rate's model, the share that ended in abortion, averaged over 2015-2019 (Guttmacher Institute). The rest ended in a birth or a miscarriage. Like the other two, it is an estimate with a range. No "better" direction is set.

How this was computed

Data used: most recent value in 2010-2025; values come from 2019–2024. To adjust for income, each measure is first predicted from GDP per person (in percentage terms, on a log scale) with a straight-line fit. Only what is left over is then compared. This is called a partial correlation. The line is drawn the standard way (ordinary least squares), which picks the line that comes closest to all the countries at once. The error margins allow for countries in the same region resembling each other, using 7 World Bank regions. The q-value corrects for testing all 14,952 pairs at once, using the Benjamini–Hochberg method. Underlying data last updated DYB 2024. How the country data works · explore Out-of-pocket health spending and Unintended pregnancies ending in abortion

This page shows that two measures go together. It does not show that Out-of-pocket health spending changes Unintended pregnancies ending in abortion, or the reverse. These figures also describe countries, not individual people. See the ecological fallacy.

More links with Out-of-pocket health spending or Unintended pregnancies ending in abortion