Table 2 Summary and data sources for small and sick newborn care scale-up per scenario

Setup Costs

Infrastructure

Government newborn floor plans:

-DH: 40-bed unit capacity.

-RRH: 80-bed capacity.

Costed approved newborn unit floor plans:

-DH: approximately US$ 358,000

-RRH: approximately US$ 1.6 million

Building all new (171) health facilities.

Building half new structures (86) and half renovating. The renovation cost was assumed to be 20% cost of a new structure.

Ward Furniture & Fixtures

-DH: List of 18 items.

-RRH: List of 18 items.

Median unit cost from local supplier’s price list.

Purchase all items new for all health facilities.

Acquire half of new items for all health facilities and use half of the existing items.

Devices

DH: A default list of 16 items

RRH: DH items plus 14 more (Additional file 1).

Price list (2022) –MSD

Purchase all items new for all health facilities.

Acquire half of new items for all health facilities and use half of the existing items.

Running Costs

Human Resource

Additional newborn ward personnel, organised by cadre were defined from Tanzania NEST360 HFA reports (Table 3) [23] working document on government recommended staff-to-baby ratio and refined by expert opinion.

Tanzania's health worker service scheme and national salary pay scale (2021).

Refer to Table 4.

Refer to Table 4.

- All costed personnel were assumed to have at least 5 years of work experience.

- The number of ward staff was calculated based on an 8-hour shift.

- The incremental quantities accounted for maternity cover and annual leave.

- Hospital management or non-newborn specific staff time was not costed.

Medical Supplies & Device Consumables

List of items identified from Tanzania NEST360 program data and expert opinion.

Quantities were average yearly consumption estimates based on unit capacity per level of care and number of devices (Additional file 1).

Current market prices were obtained from the MSD, the UNICEF supply catalogue, and the MSH International Medical Products Price Guide.

Purchase all items for all health facilities

Acquire half new items and use half of the existing items for all health facilities

A 10% mark-up over the economic order quantity was added.

Neonatal Medicines

-Tanzania National Neonatal Care guideline [24]

-NEST360 Neonatal Inpatient Dataset [25].

- Expert consultation

Quantities based on unit capacity, neonatal condition on admission, and medicine proportions.

Prevailing price from government procurement agency (MSD) and MSH International Medical Products Price Guide.

Purchase all items on the list for all health facilities.

Acquire half new items and use half of the existing items for all health facilities.

Assumed a 7-day admission

Data & Quality Improvement system

Tanzania NEST360 alliance data and expert opinion.

Median local supplier’s unit cost.

Purchase all items on the list for all health facilities

Acquire half new items and use half of the existing items for all health facilities.

- Data clerk will support data collection at the newborn unit. Shared resources e.g., television screen between routine data and quality improvement sessions.

- Onsite mentoring will be supported by the health facility, excluded from costs.

- Data storage was within the government routine data systems. e.g., DHIS-2, excluded from the costs.

Maintenance

Infrastructure, ward furniture and fixtures and neonatal devices.

Calculated at 3% of the set up costs.

Onsite maintenance by a government biomedical professional