Cost Analysis on the Large-Scale Implementation of the ‘Helping Babies Breathe’ Newborn Resuscitation Training Program in Tanzania

Presenter: Sumona Chaudhury, Harvard University T.H. Chan School of Public Health

Background: ‘Helping Babies Breathe’ (HBB) has become the gold standard globally for training birth-attendants in neonatal resuscitation in low-resource settings and has been shown to be effective in reducing early neonatal mortality and fresh stillborn rates.

Methodology: We conducted a cost-analysis of the implementation of the HBB training program at scale in Tanzania, based on current implementation costs in the Mbeya Region of Tanzania, by employing a micro-costing, bottom-up approach combining activity-based costing (ABC), an ingredients approach, and budget expense data.

Results: Total costs for the Mbeya Region were $202,237, with the highest proportion due to initial training (45.2%), followed by central program administration (37.2%), and follow-up visits (17.6%). The total economic cost of the HBB program expansion across the 25 regions of mainland Tanzania is projected to be around $4,000,000. Following sensitivity analyses, the estimated total for all Tanzania roll out lies between $2,934,793 and $4,309,595.

Conclusions: HBB implementation is a relatively low-cost intervention with potential for high impact on neonatal mortality in resource-poor settings. It is shown here that nationwide expansion of this program across the range of health provision levels and regions of Tanzania would be feasible. This study provides policy makers and investors with the relevant cost-estimation for national roll out of this critical neonatal life-saving intervention.