Environmental health services (EHS) are critical for safe and functional healthcare facilities (HCFs). Understanding costs is important for improving and sustaining access to EHS in HCFs, yet the understanding of costs is poor and no tools exist to specifically support costing EHS in HCFs in low- and middle-income countries. We developed a toolkit to guide the following steps of costing EHS in HCFs: defining costing goals, developing and executing a data collection plan, calculating costs, and disseminating findings. The costing toolkit is divided into eight step-by-step modules with instructions, fillable worksheets, and guidance for effective data collection. It is designed for use by diverse stakeholders involved in funding, implementation, and management of EHS in HCFs and can be used by stakeholders with no prior costing experience. This paper describes the development, structure, and functionality of the toolkit; provides guidance for its application; and identifies good practices for costing, including pilot testing data collection tools and iterating the data collection process, involving diverse stakeholders, considering long-term costs, and disaggregating environmental costs in records to facilitate future costing. The toolkit itself is provided in the Supplementary Material.

环境卫生服务 (EHS) 对安全和功能齐全的医疗保健设施 (HCF) 至关重要。了解成本对于改善和维持 HCF 获得 EHS 的机会很重要，但对成本的理解很差，并且不存在专门支持中低收入国家 HCF 的 EHS 成本计算的工具。我们开发了一个工具包来指导 HCF 中 EHS 成本计算的以下步骤：定义成本计算目标、制定和执行数据收集计划、计算成本和传播调查结果。成本计算工具包分为八个分步模块，包括说明、可填写的工作表和有效数据收集指南。它旨在供参与 HCF 的 EHS 融资、实施和管理的不同利益相关者使用，并且可供之前没有成本核算经验的利益相关者使用。本文描述了工具包的开发、结构和功能；为其应用提供指导；确定成本计算的良好做法，包括试点测试数据收集工具和迭代数据收集过程，涉及不同的利益相关者，考虑长期成本，并在记录中分解环境成本以促进未来的成本计算。工具包本身在补充材料中提供。