Marginal budgeting for bottlenecks

The marginal budgeting for bottlenecks tool (MBB) is an analytical costing and budgeting tool that helps countries develop their health plans by taking into account the most effective interventions, cost and budget marginal allocations of their implementation to health services and assess their potential impact on health coverage, Health related Millennium Development Goals (MDGs) and health outcomes of the poor.[1] It builds on the High Impact Interventions to reduce mortality as published in various scientific articles including The Lancet series on Child, Maternal and neonatal survival. The tool has been developed in the context of Highly Indebted Poor Country Initiative and Poverty Reduction Strategy Papers

Concept

The MBB mainly addresses the following six questions:

It builds on theoretical knowledge:

Development

It has initially been developed by teams from the World Bank's Africa Region, South Asia region and Health Nutrition and Population Anchor, jointly with UNICEF and the World Health Organization. It is a development of health systems performance monitoring tools that were used in the West African Region in the nineties. At a certain point, WHO left the boat to develop their own approach. Since 2008, the MBB has the possibility to use the LiST tool to calculate impacts.[4] Currently, there are discussions going on to produce an integrated model that would reunify different models proposed by different agencies (UNICEF, WHO, UNAIDS? UNFPA into one comprehensive planning and budgeting tool. Since 2008, the tool is available in three languages.

Until now, the tool runs on Excel ₢ which makes it vulnerable to users' ability to correctly input data. (MBB 5, the current version, runs on Excel 2007 ₢ or later[5]). DevInfo has been tasked to provide support to users; they have developed an online support platform where the latest version can be downloaded along with on-the-job support.[6]

Use

Since its inception in 2002, the tool has been used at country and sub-country level in more than 17 countries across Africa and Asia. It has been used to prepare mid-term expenditures frameworks, investment cases, child survival strategic plans, national health plans,....

Key steps

The MBB consists of five key steps:[7]

External links

References

  1. The oldest – although unpublished – concept note available on the topic: MARGINAL BUDGETING FOR BOTTLENECKS: A NEW COSTING AND RESOURCE ALLOCATION PRACTICE TO BUY HEALTH RESULTS
    Using health sector’s budget expansion to progress towards the Millennium Development Goals in Sub-Saharan Africa; A Soucat, W Van Lerberghe, F Diop, S N Nguyen and R Knippenberg
    Draft version: November 2002, please do not quote http://www.gavialliance.org/resources/14_MBB_Concept_paper.pdf
  2. Tanahashi 1978 bulletin of WHO_1978_56(2)_295-303 http://whqlibdoc.who.int/bulletin/1978/Vol56-No2/bulletin_1978_56%282%29_295-303.pdf
  3. How many child deaths can we prevent this year?, Dr Gareth Jones PhD,Richard W Steketee MD,Prof Robert E Black MD,Prof Zulfiqar A Bhutta PhD,Saul S Morris PhD,The Bellagio Child Survival Study Group, The Lancet – 5 July 2003 ( Vol. 362, Issue 9377, Pages 65–71 ), doi:10.1016/S0140-6736(03)13811-1 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2803%2913811-1/fulltext
  4. Lives Save Tools developed by Johns Hopkins University see http://www.jhsph.edu/dept/ih/IIP/list/index.html
  5. as of July 2012
  6. "DevInfo MBB support website".
  7. The State of the World Children 2008 : Child Survival, p 70 http://www.unicef.org/sowc08/
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