1. UNDP RBA Workshop On MDG-Based National Development Strategies Module 8: Adapting Models for MDG Needs Assessments UN Millennium Project February 27-March 3, 2006

2. 2 www.unmillenniumproject.org Agenda 1. Review of needs assessment tools 2. Adapting tools to assess MDG needs 3. Country examples

3. 3 www.unmillenniumproject.org 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

4. 4 www.unmillenniumproject.org Education for All (UNESCO)  Created for assessing resource needs for EFA (and especially Fast Track Initiative)  Focused on the six EFA goals 1.Early childhood development 2.Universal completion 3.Appropriate learning 4.Adult literacy 5.Gender parity 6.Quality education  Typically used by education line ministries  Calculates annual, incremental costs covering both capital and recurrent expenditures

5. 5 www.unmillenniumproject.org Cape Town Model  Developed to cost anti-retroviral AIDS treatment by estimating the number of people in need of antiretroviral therapy each year  Required inputs: –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

6. 6 www.unmillenniumproject.org 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

7. 7 www.unmillenniumproject.org Marginal Budgeting for Bottlenecks (MBB)  Developed by UNICEF and World Bank  Based on incremental (instead of goal-based) approach to assesses how best to spend additional health funding based on cost-effectiveness of interventions  Focuses on bottlenecks to service delivery (availability, accessibility, utilization, continuity, and quality)  Uses three levels of service delivery (community/family, outreach, clinical care) always starting with the lowest level of service  Can be used for MDG needs assessment, but assumptions have to be carefully reviewed  Implementation requires many weeks

8. 8 www.unmillenniumproject.org Agenda 1. Review of needs assessment tools 2. Adapting tools to assess MDG needs 3. Country examples

9. 9 www.unmillenniumproject.org Adapting Tools to Quantify MDG Needs Can the costing methodology be used for MDG-based planning? Are the interventions and coverage targets ambitious enough to achieve the MDGs? Use the costing methodology Revise the model to build in the intervention and coverage target assumptions necessary to achieve the MDGs YESYES Select different methodology

10. 10 www.unmillenniumproject.org Features of Models That Can Be Used for MDG Needs Assessments 1. Intervention based approach 2. Estimation of annual costs 3. Inclusion of capital and recurrent costs 4. Explicit specification of outcome targets and link to input coverage targets 5. Possible to aggregate results across multiple sectors covering the MDGs

11. 11 www.unmillenniumproject.org Revising Assumptions to Make Tools MDG Consistent  Ambition: Long-term and intermediate targets in line with MDGs  Scope: All relevant sectors covered in the analysis  Rigor: All costs derived from interventions-based, outcome driven needs assessment  Timeframe: Analysis extended through to 2015  Financing: Consolidated financing analysis

12. 12 www.unmillenniumproject.org Agenda 1. Review of needs assessment tools 2. Adapting tools to assess MDG needs 3. Country examples

13. 13 www.unmillenniumproject.org Some Country Examples  EFA model from Yemen  Education sector costing from Ethiopia  Marginal Budgeting for Bottlenecks