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The increasing disease burden in many developing countries due to high poverty levels has recently influenced development and adoption of new planning initiatives which promote long term result oriented planning. With increasing scientific evidence that planning specific interventions can improve health outcomes, Zambia in 2006 adopted the marginal budgeting for bottlenecks (MBB) as a health services planning tool and piloted it in nine districts. According to World Bank, few countries have used this tool in their planning and especially at district level.
A qualitative study in two selected districts was conducted involving District Health Management Team programme managers to evaluate factors associated with implementation of the MBB tool and to determine its effectiveness and applicability at district level. From the study, it is clear that the MBB tool influenced achievement of health targets in health interventions where it has been applied. It can also be concluded that MBB can be a useful tool to strengthen and enhance effective achievement of health outcomes. Respondents felt that health plans based on MBB would attract donor funding; however, successful implementation requires addressing key issues highlighted by respondents. These include: 1) community involvement in planning; 2) adequate funding; 3) adequate staffing at facility level; 4) harmonization of MBB with existing planning processes; 5) adequate capacities/competencies in the MBB concept by district staff; and 6) stakeholders’ involvement and support.
This session will provide lessons learned for future planning approaches at district level. Participants will seek to learn from each other on what works well in different environments and how to address similar challenges highlighted in the study. It is expected that participants in this session will have been involved in implementing similar approaches in their countries, and have documented evidence on how such approaches have influenced public health outcomes in their countries.
Learning Objectives: 1) Provide lessons learned for future planning approaches at district level. 2) Learn from other participants on what works well in different environments and how to address similar challenges highlighted in the study. 3) Advise on implementing similar approaches in their countries, and have documented evidence on how such approaches have influenced public health outcomes in their countries.