Incremental costs of scaling up kangaroo mother care: Results from implementation research in Ethiopia and India

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.

A pilot study of Kangaroo mother care in early essential newborn care in resource-limited areas of China: the facilitators and barriers to implementation

“…In order to promote the incorporation of KMC into the routine clinical practice for preterm and low birth weight babies, the service cost and health insurance payment system must be optimised. A study found that the major cost driver of KMC is human resources, followed by training and supplies [ 34 ]. Considering the inadequacy of the present scope of health insurance and KMC cost-sharing mechanism, we recommend the government adjusting medical insurance coverage to better reflect the labour costs, investing in initial and recurrent KMC training for medical staff and providing assistance to the necessary hospital facility reforms.…”