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Marginal Budgeting for Bottlenecks (MBB) - P4H Network

Marginal Budgeting for Bottlenecks (MBB)

Short description
The Marginal Budgeting for Bottlenecks tool aims at estimating the potential impact, resources needs, costs and budgeting implications of country strategies to remove implementation constraints of the health system. It helps simulate the potential impact as well as cost and budget implications of alternative health service delivery strategies using different integrated production functions (community/family based, population/outreach based, or clinical based).


The purpose of this tool is to help

  • planning and forecasting the potential cost and impact of scaling up investments to increase the intake, coverage and quality of high impact health interventions;
  • preparing results oriented expenditures programs and health budgets.

Methodology and type of data required
The costing strategy and methods imply to identify tracer interventions as proxy for a set that face the same health system bottlenecks, identify current coverage of those tracers and the costs and health impact of possible ways to remove the bottlenecks they face.

Users/Target audience
Programmers and planners at national, sub-national and district levels

UNICEF, World Bank

Rudolf Knippenberg –, Susie Villeneuve –, Natsanet Walelign –, Agnes Soucat –


costing tool, impact and implications

MBB is integrated in the OneHealth tool and no further updates will be provided.