A Good Start: Increasing newborn survival combined with implementation research to identify the most cost-effective service package for scale-up

This study which will be simply known as “A Good Start” aims to identify the most cost-effective service package for scaling-up essential newborn care in Tanzania.

In Tanzania, the National Road Map to improve maternal, newborn, child and adolescent health (One Plan III, 2021-2026) has prioritized newborn health and has included high-impact interventions for newborn health.

Supply and demand side interventions are being implemented by the government and partners including Essential newborn care (ENC), Kangaroo Mother Care (KMC), yet, according to a survey of 2018, KMC was only implemented in 25% of facilities and the Essential Newborn Care package in just 12% of health facilities. One of the reasons for these poor outcomes is the lack of necessary medical equipment and infrastructure at rural health facilities.

Other interventions being implemented include:

• Integrated Management of Newborn and Childhood Illnesses (IMNCI)
• Infection Prevention and Control (IPC)
• Helping Babies Breathe (HBB)
• Basic and Comprehensive Emergency Obstetric and Newborn Care (C/BEmONC)
• Integrated Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH)

The primary objective of this study is to identify the most cost-effective service package for scale-up in Tanzania.  Other objectives include:

• To investigate short-term maintenance of the impact of the interventions by follow-up of the newborn’s health at the facility and at the household within 28 days of life.
• o characterize the effect of each intervention package (IPC, HBB, KMC & NICE) for each healthcare facility to inform cost-effectiveness analysis.
• To identify and quantify financial and economic costs associated with the implementation of each intervention package (IPC, HBB, KMC & NICE) for each healthcare facility.

The study will target caregivers and their newborns in 3 health facilities namely; Mahenge District Hospital (Ulanga District Council), Kibaoni Health Center (Ifakara Town Council) and Morogoro Regional Referral Hospital (Morogoro Municipal Council).

The study duration is 2 years (July 2022-December 2024) with the implementation and data collection process divided in three phases.

This is a collaborative project involving five partners:
1.    Ifakara Health Institute
2.    SolidarMed – Tanzania
3.    Mahenge District Hospital (Ulanga District Council)
4.    Kibaoni Health Centre (Ifakara Town Council)
5.    Morogoro Regional Referral Hospital (Morogoro Municipal Council)

This project is funded by SolidarMed – a Swiss Organization for Health in Africa.