Transcript The United Nations’ MDG Strategy

UNDP RBA MDG Based
National Development Planning Workshop
MDG Needs Assessments: Adapting other
models
Chandrika Bahadur
UN Millennium Project
February 27-March 3, 2006
Agenda
1.
Review of needs assessment tools
2.
Adapting tools to assess MDG needs
3.
Country examples
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Alternative needs assessment tools

Education for All (UNESCO)

Cape Town model for HIV/AIDS

Mother Baby package (WHO)

Marginal Budgeting for Bottlenecks (WB/UNICEF/WHO)

Planning frameworks developed by governments
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Education for All (UNESCO)

Created for assessing resource needs for EFA (and
especially Fast Track Initiative)

Focused on all EFA goals
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Early childhood development
Universal completion
Appropriate learning
Adult literacy
Gender parity
Quality education
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Typically used by line ministries

Calculates annual, incremental costs covering both
capital and recurrent expenditures
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Cape Town Model

Developed to cost ARV treatment by estimating the
number of people in need of antiretroviral therapy each
year
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Required inputs:
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epidemiological data
antiretroviral drug regimens
laboratory testing schedules
cost of antiretroviral drugs
cost of laboratory tests
cost of primary care

Tool can be adapted to countries’ needs, but requires
modification

Tool does not estimate investment needs for prevention
or human resource development
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WHO Mother-Baby package

Original WHO model has been adapted for MDGs by UN
Millennium Project (available on website)

Detailed interventions-based costing tool for maternal
health and antenatal care interventions

Calculates the cost of all inputs (infrastructure, drugs,
equipment) needed to reach specified coverage targets

Part of broader set of needs assessment tools to support
the scaling up of health systems
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Marginal Budgeting for Bottlenecks
(MBB)
MBB was developed by UNICEF and World Bank
 MBB takes an incremental approach rather than a goalbased approach and assesses how best to spend additional
increases in health funding (based on cost-effectiveness of
interventions)
 MBB calculates how much it would take to overcome
barriers or bottlenecks to service delivery (in the areas of
availability, accessibility, utilization, continuity, and quality)
 MBB uses three levels of service delivery:
community/family, outreach, and clinical care--always
beginning with the lowest level of service
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Marginal Budgeting for Bottlenecks
(MBB)
• MBB can be made to calculate the costs of reaching
goals, but assumptions (on coverage, service package, etc.)
have to be carefully reviewed
• MBB requires several weeks/months of on-the-ground
work to estimate the costs of overcoming barriers
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Agenda
1.
Review of needs assessment tools
2.
Adapting tools to assess MDG needs
3.
Country examples
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www.unmillenniumproject.org
Adapting Tools to Quantify
MDG Needs
Y
E
S
Can the costing
methodology be used
for MDG-based
planning?
Select a new costing
methodology
Are the interventions
and coverage targets
ambitious enough to
achieve the MDGs?
Revise the model to build in the intervention and
coverage target assumptions necessary to achieve
the MDGs
Use the costing
methodology
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Making Tools MDG Consistent
Tools that use methodologies that can be used to
estimate MDG resource needs share common
characteristics:
 Intervention
 Cost
based approach
estimation done annually
 Capital
and recurrent costs included
 Outcome
targets explicitly specified and linked to input
coverage targets
 Results
can be compared to other sector results and
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aggregated accordingly
Making Tools MDG Consistent (3)
Revise assumptions to make the tools MDG consistent

Ambition: Ensure that long term and intermediate targets in
line with the MDG goals

Scope: Ensure that all of the relevant sectors are covered in
the analysis

Rigor: Base all costs on interventions based, outcome driven
needs assessment

Timeframe: Extend the analysis to 2015

Financing: Add a consolidated financing framework to the tool
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Agenda
1.
Review of needs assessment tools
2.
Adapting tools to assess MDG needs
3.
Country examples
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Some country examples

EFA model from Yemen

Education sector costing from Ethiopia

Marginal Budgeting for Bottlenecks
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