RESUMEN
Background: Data on abortion procedures costs are scarce in low- and middle-income countries. In Mexico, the only known study was conducted more than a decade ago, with data from years before the abortion legislation. This study estimated the costs, from the health system's perspective, of surgical and medical abortion methods commonly used by women who undergo first-trimester abortion in Mexico. Methods: Data were collected on staff time, salaries, medications, consumables, equipment, imaging, and lab studies, at 5 public general hospitals. A bottom-up micro-costing approach was used. Results: Surgical abortion costs were US$201 for manual vacuum aspiration and US$298 for sharp curettage. The cost of medical abortion with misoprostol was US$85. The use of cervical ripening increases the costs by up to 18%. Staff comprised up to 72% of total costs in surgical abortions. Hospitalization was the area where most of the spending occurred, due to the staff and post-surgical surveillance required. Conclusions: Our estimates reflect the costs of "real-life" implementation and highlight the impact on costs of the overuse of resources not routinely recommended by clinical guidelines, such as cervical ripening for surgical abortion. This information will help decision-makers to generate policies that contribute to more efficient use of resources.
RESUMEN
Spent coffee grounds (SCG) hydrochar is a second-generation solid waste obtained by hydrothermal carbonization (HTC). Two washed hydrochars from SCG (175 and 185 °C; 12 MPa of N2) were tested as organic amendments of an agricultural soil (Cambic Calcisol), at doses of 1 and 2.5%, in an in vitro assay using Lactuca sativa as a crop plant. The washed hydrochars differ from the SCG in organic carbon (OC) (56 vs 47%), C/N ratio (29 vs 24), polyphenols (186 vs 77 mg GAE/g), pH (4.1 vs 5.8), assimilable P (186 vs 1274 ppm) and K (32 vs 2475 ppm). The particles of washed hydrochars have a lower size and a more porous structure than SCG particles. Higher HTC temperatures generate greater differences with SCG. The effects on the soil of washed hydrochars are similar to SCG, regarding OC, total N, C/N ratio, available K and P contents. The influence of SCG and washed hydrochars on lettuces is also similar: both give rise to plant growth inhibition and increase in the contents of Ca, Mg, Cu, Fe and Mn. Nevertheless, washed hydrochars seem to be more effective in the mobilization of elements in the soil than SCG, which could be attributed to their higher content of polyphenols. For example: Ca (139 mg/100 g with SCG and 160 mg/100 g with hydrochar) and Fe (0.742 mg/100 g with SCG and 1.45 mg/100 g with hydrochar). Therefore, it can be concluded that SCG hydrochars could be used as organic amendments with similar limitations and advantages to SCG.
