Hanoi University of Public Health, Hanoi, 11910, Vietnam.
Alive & Thrive, Global Nutrition, FHI 360, Hanoi, 11022, Vietnam.
Int Breastfeed J. 2024 Jul 6;19(1):47. doi: 10.1186/s13006-024-00657-6.
Breastfeeding is the biological norm for feeding infants and young children. When mothers' breastmilk is unavailable, donor human milk (DHM) from a human milk bank (HMB) becomes the next option for small vulnerable newborns. A comprehensive cost analysis is essential for understanding the investments needed to establish, operate, and scale up HMBs. This study aims to estimate and analyze such costs at the first facility established in Vietnam.
An activity-based costing ingredients (ABC-I) approach was employed, with the cost perspective from service provision agencies (specifically, the project conducted at Da Nang Hospital for Women and Children and Development Partners). Estimated financial costs, based on actual expenditures, were measured in 2023 local currency and then converted to 2023 US dollars (USD). We examined three scenarios: 1) direct start-up costs + indirect start-up costs + implementation costs, 2) direct start-up costs + implementation costs, and 3) capital costs + implementation costs over the 6.5 years of operation.
The total start-up cost was USD 616,263, with total expenditure on direct activities at USD 228,131 and indirect activities at USD 388,132. Investment in equipment accounted for the largest proportion (USD 84,213). The monthly costs of Da Nang HMB were USD 25,217, 14,565, and 9,326, corresponding to scenarios 1, 2, and 3, respectively. Over HMB's 6.5 years of operation, on average, the unit costs were USD 166, USD 96, and USD 62 for DHM received and USD 201, USD 116, and USD 74 for pasteurized DHM meeting specified criteria in the corresponding scenarios. Unit costs were highest in the initial six months, decreased, and reached their lowest levels after a year. Then, the unit costs experienced an increase in late 2020 and early 2021.
Although the unit cost of DHM in Da Nang HMB is comparable to that in certain neighboring countries, intentional measures to reduce disposal rates, improve HMB efficiency, motivate more community-based donors, and establish an HMB service network should be implemented to lower costs.
母乳喂养是喂养婴儿和幼儿的生理规范。当母亲的母乳无法供应时，人乳库（HMB）的捐赠母乳（DHM）成为小而脆弱新生儿的下一个选择。全面的成本分析对于了解建立、运营和扩大 HMB 所需的投资至关重要。本研究旨在估计和分析越南第一家 HMB 的相关成本。
采用基于活动的成本核算成分（ABC-I）方法，从服务提供机构（具体而言，是在岘港妇女儿童医院和发展伙伴进行的项目）的角度来看待成本。根据实际支出估算的财务成本，以 2023 年当地货币衡量，然后转换为 2023 年美元（USD）。我们考察了三种情况：1）直接启动成本+间接启动成本+实施成本，2）直接启动成本+实施成本，3）6.5 年运营期间的资本成本+实施成本。
总启动成本为 616,263 美元，直接活动支出为 228,131 美元，间接活动支出为 388,132 美元。设备投资占比最大（84,213 美元）。岘港 HMB 的每月成本分别为 25,217 美元、14,565 美元和 9,326 美元，分别对应于情况 1、2 和 3。在 HMB 的 6.5 年运营期间，DHM 的平均单位成本分别为 166 美元、96 美元和 62 美元，符合相应情况的巴氏消毒 DHM 的单位成本分别为 201 美元、116 美元和 74 美元。单位成本在最初的六个月最高，下降，然后在一年后达到最低水平。然后，在 2020 年末和 2021 年初，单位成本再次上升。
虽然岘港 HMB 的 DHM 单位成本与某些邻国相当，但应采取有针对性的措施降低处置率、提高 HMB 效率、激励更多基于社区的捐赠者，并建立 HMB 服务网络，以降低成本。
