Table 1

Quantity of change for material outcomes by stakeholder group

Stake holders	Outcomes	Indicator	Number	% change (Baseline–follow-up)	Financial proxy	Financial proxy (I$)	Source and justification	Impact	Dead weight	Attribution	Impact less externals
HCPs	Improved knowledge	Number of trained HCPs with improved knowledge after training	2482	83.7% of total HCPs trained	Tuition fee paid for obstetrics posting in Kenyan medical school	538.60	Websites of Kenyan medical schools†,‡,§	1 336 809.46	25%	0%	1 002 607.10
	Improved skill	Number of trained HCPs with improved skill after training	2941	99.2% of total HCPs trained	Salary of mid-level HCP in Kenya	651.70	Kenya Medical Practitioners Pharmacists and Dentists Union¶	1 916 635.99	25%	0%	1 437 477.00
	Improved attitude to patients	Number of women coming to MiH facilities for delivery (BEmOC+CEmOC)	56 532	11.2% increase in women	User fee paid to access care	0.09	Government of Kenya∗∗	5304.96	25%	0%	3978.72
	Increased workload	Number of women coming to MiH facilities for delivery (BEmOC)	14 632	26% of the additional women coming to MiH facilities	User fee paid to access care	0.09	Government of Kenya**	−1373.07	25%	0%	−1029.80
Women	Reduced maternal morbidity	Number of women who required and received EmOC	3982	20% increase compared with baseline	Cost of care and hospital stay in public hospital	351.90	Kenyatta National Hospital††	1 401 265.80	0%	0%	1 401 265.80
	Reduced obstetric fistula incidence	Number of fistula cases potentially avoided	3	–	Average cost of fistula surgery	309.12	Fistula Foundation‡‡	927.36	0%	0%	927.36
	Reduced maternal mortality	Maternal lives saved	138	23% decrease compared with baseline	Statistical value of life of a woman in Kenya	80 568.90	Journal of Transport Economics and Policy§§	11 118 508.06	0%	50%	5 559 254.03
Newborn babies	Reduced neonatal morbidity*	Obstetric related newborn complications successfully managed	2612	21% decrease compared with baseline	Cost of treating birth asphyxia*	–	Kenyatta National Hospital††	0.00	0%	0%	0.00
	Reduced stillbirths*	Stillbirths averted	1145	8% decrease compared with baseline	Cost of care and hospital stay in public hospital*	–	Kenyatta National Hospital††	0.00	0%	0%	0.00
	Reduced neonatal mortality	Newborn lives saved following resuscitation	1662	24% decrease compared with baseline	Cost of newborn care in the neonatal period	49.34	Market survey¶¶	81 997.06	0%	0%	81 997.06
							Total	15 862 821.77			9 486 477.27

Sources of financial proxies used in SROI model:
*Financial valuation of newborn outcomes already incorporated in value of maternal outcomes.
†Kenyatta University. Fee structure per programme. Kenyatta University Fee Structure 2016 (Internet). http://www.ku.ac.ke/schools/hospitality/images/stories/docs/kenyattta_University_Fee _Structure.pdf.
‡Moi University. Moi University Courses Internet. Academics 2016, (Internet): https://www.mu.ac.ke/index.php/academics/overview/moi-university-courses.
§University of Nairobi. Fees Degrees Admission Regular Medicine; (Internet): http://med-school.uonbi.ac.ke/admissions_degrees_display#.anchor_3.
¶Jamah A. Doctors in public hospitals sue government over salaries, allowances; (Internet): http://www.standardmedia.co.ke/health/article/2000166776/doctors-in-public-hospitals-sue-government-over-salaries-allowances.
**Chuma J, Maina T. Free maternal care and removal of user fees at primary-level facilities in Kenya: monitoring the implementation and impact—baseline report (Internet). Washington, DC: 2014. https://www.healthpolicyproject.com/pubs/400_KenyaUserFeesBaselineReportFINAL.pdf.
††KNH. Maternity fees (Internet). Nairobi: 2015. http://knh.or.ke/.
‡‡Fistula Foundation. Frequently Asked Questions Internet. Fast Facts FAQ 2016 (Internet): https://www.fistulafoundation.org/what-is-fistula/fast-facts-faq/.
§§Miller TR. Variations between Countries in Values of Statistical Life. J Transp Econ Policy 2000;34:169–88. https://www.jstor.org/stable/20053838.
¶¶Mengo B. Kenya’s mothers grapple with rising cost of babies items (Internet); 2012. http://news.xinhuanet.com/english/indepth/2012-05/13/c_131585150.htm.
BEmOC, Basic Emergency Obstetric Care; CEmOC, Comprehensive Emergency Obstetric Care; EmOC, emergency obstetric care; HCP, Health Care Provider; SROI, social return on investment.