Table 3.
Financial and economic costs of resources and infrastructure improvements to prepare for immediate KMC (all costs in USD, 2020)
| Lifespan (years) | Hospital-1 | Hospital-2 | Hospital-3 | Hospital-4 | Hospital-5 | ALL HOSPITALS | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Total cost | Annualised cost | Total cost | Annualised cost | Total cost | Annualised cost | Total cost | Annualised cost | Total cost | Annualised cost | Total cost | Annualised cost | ||
| Financial costs | |||||||||||||
| Planning and design | |||||||||||||
| Tendering and contracting | 20 | 12,222 | 822 | 12,222 | 822 | 21,765 | 1,463 | 14,231 | 957 | 21,765 | 1,463 | 82,205 | 5,527 |
| Scoping of work | 20 | 5,016 | 337 | 5,016 | 337 | 1,005 | 68 | 1,005 | 68 | 1,005 | 68 | 13,047 | 878 |
| Design | 20 | 502 | 34 | 502 | 34 | 837 | 56 | 502 | 34 | 837 | 56 | 3,180 | 214 |
| Site survey and inspection | 20 | 1,507 | 101 | 1,507 | 101 | 1,507 | 101 | 1,507 | 101 | 1,507 | 101 | 7,535 | 505 |
| Meetings | 20 | 9,041 | 608 | 9,041 | 608 | 11,050 | 743 | 9,041 | 608 | 11,050 | 743 | 49,223 | 3,310 |
| Transportation for site visits | 20 | NA | NA | 3,156 | 212 | 2,569 | 173 | NA | NA | 2,128 | 143 | 7,853 | 528 |
| Sub-total (planning and design) | NA | 28,288 (29) | 1,902 (23) | 31,444 (30) | 2,114 (25) | 38,733 (39) | 2,604 (32) | 26,286 (58) | 1,768 (46) | 38,292 (34) | 2,574 (29) | 163,043 (35) | 10,962 (29) |
| Infrastructure improvements | |||||||||||||
| Construction of new neonatal unit | 20 | NA | NA | NA | NA | NA | NA | NA | NA | 47,045 | 3,162 | 47,045 | 3,162 |
| Extension/remodelling of existing neonatal unit | 20 | NA | NA | NA | NA | 30,881 | 2,076 | 1,142 | 77 | NA | NA | 32,023 | 2,153 |
| Repurposing of space for neonatal unit | 20 | 28,591 | 1,922 | 29,600 | 1,990 | NA | NA | NA | NA | NA | NA | 58,191 | 3,912 |
| Rental of office space | 20 | 144 | 10 | 144 | 10 | 144 | 10 | NA | NA | 144 | 10 | 576 | 40 |
| Sub-total (infrastructure improvements) | NA | 28,735 (29) | 1,932 (24) | 29,744 (29) | 2,000 (24) | 31,025 (31) | 2,086 (26) | 1,142 (3) | 77 (2) | 47,189 (41) | 3,172 (36) | 137,835 (30) | 9,267 (25) |
| Clinical equipmenta | |||||||||||||
| KMC adjustable bedb | 5 | 476 | 104 | 1,189 | 260 | 1,189 | 260 | 2,326 | 508 | 1,189 | 260 | 6,369 | 1,392 |
| Oxygen concentratorc | 3 | 1,224 | 433 | 1,224 | 433 | 1,224 | 433 | 1,386 | 490 | 1,224 | 433 | 6,282 | 2,222 |
| Masimo Rad-8© pulse oximeter | 7 | 7,225 | 1,160 | 4,516 | 725 | 5,419 | 870 | 0 | 0 | 4,516 | 725 | 21,676 | 3,480 |
| Masimo LNC-04 patient cable | 7 | 744 | 119 | 744 | 119 | 558 | 90 | 0 | 0 | 465 | 75 | 2,511 | 403 |
| Glucose meter | 3 | 30 | 11 | 30 | 11 | 30 | 11 | 0 | 0 | 30 | 11 | 120 | 44 |
| Digital baby weighing scaled | 3 | 857 | 303 | 857 | 303 | 854 | 302 | 0 | 0 | 857 | 303 | 3,425 | 1,211 |
| Neonatal measuring mate | 3 | 47 | 17 | 47 | 17 | 47 | 17 | 0 | 0 | 47 | 17 | 188 | 68 |
| Neonatal ventilation bag and mask | 3 | 23 | 8 | 23 | 8 | 23 | 8 | 23 | 8 | 0 | 0 | 92 | 32 |
| Digital axillary thermometer | 3 | 9 | 3 | 9 | 3 | 9 | 3 | 0 | 0 | 9 | 3 | 36 | 12 |
| Paediatric stethoscope | 3 | 175 | 62 | 175 | 62 | 175 | 62 | 0 | 0 | 175 | 62 | 700 | 248 |
| Training on KMC and clinical guidelines | 35 | 306 | 14 | 1,336 | 62 | 1,374 | 64 | 0 | 0 | 1,803 | 84 | 4,819 | 224 |
| Neonatal resuscitator | 5 | 23 | 5 | 23 | 5 | 23 | 5 | 23 | 5 | 0 | 0 | 92 | 20 |
| Penguin newborn suction | 3 | 10 | 4 | 10 | 4 | 10 | 4 | 10 | 4 | 0 | 0 | 40 | 16 |
| NeoNatalie© manikinf | 3 | 92 | 33 | 92 | 33 | 92 | 33 | 92 | 33 | 0 | 0 | 368 | 132 |
| PreemieNatalie© manikinf | 3 | 66 | 23 | 66 | 23 | 66 | 23 | 66 | 23 | 0 | 0 | 264 | 92 |
| Sub-total (clinical equipment) | NA | 11,307 (11) | 2,299 (28) | 10,341 (10) | 2,068 (25) | 11,093 (11) | 2,185 (27) | 3,926 (9) | 1,071 (28) | 10,315 (9) | 1,973 (22) | 46,982 (10) | 9,596 (26) |
| Sub-total (financial cost) | NA | 68,330 (69) | 6,133 (75) | 71,529 (69) | 6,182 (74) | 80,851 (81) | 6,875 (85) | 31,354 (70) | 2,916 (76) | 95,796 (84) | 7,719 (86) | 347,860 (75) | 29,825 (80) |
| Additional economic costs | |||||||||||||
| Planning and designg | 20 | 8,232 | 553 | 11,388 | 765 | 11,522 | 774 | 7,048 | 474 | 11,081 | 745 | 49,271 | 3,311 |
| Trainingh | 20 | 6,649 | 447 | 7,175 | 482 | 7,077 | 476 | 6,649 | 447 | 7,004 | 471 | 34,554 | 2,323 |
| Donated spacei | 20 | 16,219 | 1,090 | 13,392 | 900 | 0 | 0 | 0 | 0 | 0 | 0 | 29,611 | 1,990 |
| Sub-total (additional economic costs) | NA | 31,100 (31) | 2,090 (25) | 31,955 (31) | 2,147 (26) | 18,599 (19) | 1,250 (15) | 13,697 (30) | 921 (24) | 18,085 (16) | 1,216 (14) | 113,436 (25) | 7,624 (20) |
| Total economic cost | NA | 99,430 | 8,223 | 103,484 | 8,329 | 99,450 | 8,125 | 45,051 | 3,837 | 113,881 | 8,935 | 461,296 | 37,449 |
KMC Kangaroo mother care, NA Not applicable, USD United States Dollars. Costs were annualised using a discount rate of 3%, [24] and assumptions about the lifespan of capital improvements, equipment, and activities. Column percentages indicate the proportion of total economic costs for each hospital
aClinical equipment and durable goods that were essential to allow safe implementation of immediate KMC, in accordance with the OMWaNA trial protocol [16]
bE3A India Narag adjustable bed, Crown Health Care Ltd., Kampala, Uganda
cUSA Airsep oxygen concentrator, Crown Health Care Ltd., Kampala, Uganda
dSeca 384 digital weighing scale
eSeca 210 neonatal measuring mat
fLeardal NeoNatalie© and PreemieNatalie© neonatal resuscitation manikins
gTime spent by hospital staff away from normal duties to attend meetings or inspect the study sites
hTime spent by the trainers away from normal duties to conduct staff training
iCalculated as the difference between financial costs of renovations and economic costs to construct a new space of equivalent size, estimated using the unit financial cost of improvements at Hospital-5