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Incremental costs of scaling up kangaroo mother care: Results from implementation research in Ethiopia and India
Mony PK, Tadele H, Gobezayehu AG, Chan GJ, Kumar A, Mazumder S, Beyene SA, Jayanna K, Kassa DH, Mohammed HA, Estifanos AS, Kumar P, Jadaun AS, Hailu Abay T, Washington M, W/Gebriel F, Alamineh L, Fikre A, Kumar A, Trikha S, Ashebir Gebregizabher F, Kar A, Bilal SM, Belew ML, Debere MK, Krishna R, Dalpath SK, Amare SY, Mohan HL, Brune T, Sibley LM, Tariku A, Sahu A, Kumar T, Hadush MY, Gowda PD, Aziz K, Duguma D, Singh PK, Darmstadt GL, Agarwal R, Gebremariam DS, Martines J, Portela A, Jaiswal HV, Bahl R, Rao Pn S, Tadesse BT, Cranmer JN, Hailemariam D, Kumar V, Bhandari N, Medhanyie AA Abstract
Aim
To estimate incremental costs of an implementation model for scaling up Kangaroo Mother Care (KMC) for neonates with birthweight <2000 g.
Methods
Seven sites across Ethiopia and India collected data for 2018–19 to calculate incremental recurrent costs (of health worker time, supplies, and operations) and start-up costs for KMC scale up. The costs were estimated per live newborn <2000 g eligible for KMC identified in the study population.
Results
Scaling up KMC in study districts required average incremental costs of US$59 (95% CI US$ 52–67) in Ethiopia and US$72 (95% CI US$ 41–103) in India per eligible newborn in the population. Most of these costs were recurrent; the annualised start-up costs per eligible newborn ranged from 12%–25% of total costs in Ethiopia and 9%–16% in India. The major cost driver was human resources, followed by initial and recurrent training, supplies, and communications costs. Incremental infrastructure costs were only 2%–6% of total costs in both countries. Most of the costs were for activities at the KMC implementing facility, accounting for 79%–88% of the total costs in Ethiopia and 89%–93% of those in India.
Conclusion
The costs for successful scale up of KMC seem affordable but must be included in programme budgets.
