Requirements and Costs for Scaling Up Comprehensive Emergency Obstetric and Neonatal Care in Health Centres in Tanzania

The objective of this study was to identify and determine the costs of essential components of a resource package and strategies for scaling up comprehensive emergency obstetric and neonatal care services in Tanzania. Essential components were identified through lessons learned during implementation of comprehensive emergency obstetric and neonatal care and regular discussions with key stakeholders. The related costs were collected from the health centres, Tanzania Medical Store Department and nongovernmental organizations that had upgraded health centres for comprehensive emergency obstetric and neonatal care services provision. The results showed that the estimated costs of upgrading a health centre to provide comprehensive emergency obstetric and neonatal care services was $256,650 (USD) for infrastructure and equipment, $4,463 per person for upgrading skills in either in comprehensive emergency obstetric and neonatal care or anaesthesia for three months and $43,500 per year for medicines and supplies. The total cost for all components per health centre was estimated at $560,802. Scale up required many complementary strategies at all health system levels. Scale up of comprehensive emergency obstetric and neonatal care services in health ccentres in underserved areas is feasible and urgently needed in resource-limited countries.