THE ANALYTICAL APPROACH

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THE ANALYTICAL APPROACH TOOLS USED IN PLANNING,
PRIORITISATION AND COSTING OF THE DRAFT NPAP
2006/07

• Presented
• By
• John Bosco Kavuma
• In
• The National Partnership Forum, Jan 30th - 1st
  Feb. 2006

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OUTLINE OF THE PRESENTATION

• Analytical approach used in planning and priority
  setting
• Systematic steps
• criteria
• Analytical tools used in planning and priority
  setting
• Matrix Score Card
• Logframework

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OUTLINE OF THE PRESENTATION Cont

• Analytical Approach tools used in Costing the
  Plan
• Illustrations of the costing
• Limitations
• Methodological
• Practical
• Conclusions

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PART II - APPROACH AND METHODOLOGY

• (1) APPROACH
• The Uganda NPAP 2006/07 was developed through a
  participatory and interactive process.
• Approaches used for data collection, and
  consensus building included
• Interviews and consultations
• Presentations for validation, feedback and inputs
  
• Literature review

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ANALYTICAL APPROACH TOOLS IN PLANNING, PRIORITY
SETTING COSTING NPAP

• A. Analytical Approach to Planning Priority
  setting
• Step 1 Identifying a set of Strategic objectives
  that could be costed - setting key deliverables
  or outputs by using NSF, HSSP JAR as a
  starting point.
• Step 2 Identifying the Priority Activities to
  attain the set objectives and targets
  prioritize the critical activities to ensure
  strategic orientation (again using NSF, HSSP and
  JAR recommendations as starting point).

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Analytical Approach to Planning Priority
setting Cont

• Step 3 Costing of the Priority Activities-
  estimating or assessing the resource requirements
  and attaching financial costs to those resources
  to ensure that the goals are financially
  affordable.
• Step 4 Logically linking identified Priority
  Activities (PAs) with the Objectives -
  assigning input, process and output indicators to
  each objective/activity as well as the key
  responsible actors

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Analytical Approach to Planning and Priority
Setting cont.

• Planning and Priority setting
• The analytical approach to planning and selection
  of priority action plans was guided by a number
  of questions
• (i) Why should we prioritise?
• (ii) What do we prioritise?
• (ii) For whom do we prioritise?
• (iii) For how long do we prioritise?
• (iv) How to we prioritise?

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Analytical Approach to Planning and Priority
Setting cont..

• Why should we prioritise? Why do we prioritise
  again when we already have the NSF?
• It will be unrealistic to assume that every
  single strategy/objective and every need
  prioritized in the NSF could be executed/ met in
  a period of one year (with slight exception of
  the activities for already on-going
  programme/projects) .

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Analytical Approach to Planning Priority
Setting Cont

• We therefore prioritise to select those
  strategies and action plans on which we can
  strategically focus the resources and efforts.
• Priority setting is not meant to eliminate any
  objective or strategy in the NSF on the basis of
  being least important but to select action plans
  that require urgent and immediate
  attention/action.

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Analytical Approach to Planning and Priority
Setting Cont

• HOW TO PRIORITISE?
• The underlying principles in prioritizing the
  strategic objectives were (1) keeping the number
  of objectives small not to lose the objective of
  strategic focus, and (2) set strategic objectives
  measurable targets (quantitatively) to be able to
  cost them and to monitor progress.
• To prioritise based on well standard criteria and
  using proven methodologies

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ANALYTICAL TOOLS IN PLANNING, PRIORITY SETTING

• Two planning, programming and priority setting
  techniques were used arrive at the priorities
• Logframework, and
• Matrix Score Card.
• The Matrix Score Card Technique was used to
  pre-qualify and re-prioritise the activities in
  the NSF based on the standard checklist.
• That is, each action plan in the NSF was
  assessed based on standard criteria/checklist

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CRITERIA FOR SELECTING PRIORITY ACTION
PLANS/ACTIVITIES

• Based on knowledge, skills and experience
  regarding national development planning in
  particular planning and costing for HIV/AIDS
  initiatives, Eight (8) criteria were used to
  assess, grade, and rank the priority activities
  for NPAP 2006/07.
• The extent of gap in national service coverage
• (ii) Consistency with the overall
  macroeconomic framework
• (iii) Magnitude of direct impact on
  HIV/AIDS epidemic
• (iv) Availability of the capacity to
  implement the activity

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CRITERIA FOR SELECTING PRIORITY ACTION
PLANS/ACTIVITIES

• (v) Potential for funding
• (vi) Contribution of the activity to the
  coordination, harmonization and
  rationalization of HIV/AIDS
• (vii) Addressing issues of equity and
  vulnerability
• (viii) Magnitude of costs/damages in case of
  inaction

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ILLUSTRATION OF THE ASSESMENT OF NSF ACTIVITIES
USING MATRIX SCORE CARD
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COSTING THE PLAN ANALYTICAL APPROACH TOOLS

• 1. Analytical Approach to Costing
• The process of costing the Uganda NPAP 2006/07
  involved the following components
• Determining the unit cost required for delivering
  a particular service or implementing a given
  priority activity
• Determining the level of demand/need for
  particular services
• Determining the desired Scale-up levels

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DETERMINING UNIT COSTS

• To determine the unit costs, a Rapid Costing
  Assessment (RCA) approach was used.
• RCA assists in developing the unit costs for
  interventions included in NPAP

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STEP 1 DETERMINING UNIT COSTS

• In order to collect unit costs
• key informants in Uganda were interviewed and
  asked to define the resources requirement to
  provide particular services.
• Relevant local publications of various HIV
  programmes were also consulted.
• The derived unit costs were compared to global
  estimates and checked for consistency. The data
  in the Resource Needs for an Expanded Response to
  AIDS in Low- and Middle Income Countries (UNAIDS
  2005) was used as benchmarks.

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DETERMINING THE LEVEL OF DEMAND/NEED FOR SERVICES

• The level of demand for particulars services were
  assessed to help in estimating the levels for
  up-scaling in shortto-medium term period. The
  assessment of potential demand was based on
• Information in UNGASS report, Sero-surveys, UDS,
  UNHS.
• We looked at such information as
• (i) demographic information,
• (ii) current level of service coverage,
• (iii) epidemiological statistics,
• (iv) Poverty Eradication Action Plan Goals
• (v) Health Sector Strategic Plan (HSSP targets.
• (vi) NSF Goals

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DETERMINING THE DESIRED SCALE-UP LEVELS

• This costing exercise was not intended to
  estimate the resources required to meet every
  need. The idea was to try as much as possible to
  align this costing with the goals and objectives
  of the NSF, while developing a budget that is
  feasible yet adequately ambitious. This analysis
  was therefore based on certain assumptions about
  the level scaling up that would realistically
  be attained in one year (FY 2006/07).

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CHECKING FOR CONSISTENCY

• Having estimated the targets/intensity of
  activities (scale-up levels), the strategic
  objective/priority activities were costed and
  estimate of financial resources required to
  achieve this targets was provided.
• The costs for key priority acions were then
  analysed vis-à-vis the Total cost for the entire
  NPAP 2006/07 and the resource requirement for the
  implementation of the plan also analysed versus
  the current funding sources
• Unit costs for individual priority actions were
  with international benchmarks for consistency
• Finally the resource requirements for the NPAP
  will be analysed for consistency with the overall
  macroeconomic budgetary framework (MTEF ceiling)
  and estimates for Non-MTEF.
• Comments will be provided on implementation
  modalities (key actors and their roles) as well
  as on monitoring the progress of implementing the
  NPAP.

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AN ILLUSTRATION OF COST BUILD-UP
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LIMITATIONS

• Methodological Limitations
• Assigning scores using the Matrix Score Card
  Technique was subjects
• The different criteria chosen to assess and
  evaluate priority action plans were assumed to be
  of equal importance across the various activities
  ( No weight were attributed to different criteria
  to maintain simplicity)
• The unit costing technique could not assess the
  cost-effectiveness for priority actions.
  Financial costing intended to assessing the
  actual expenditure on activities or be
  executed/procured not the Economic Costs1,
  which reflect the true cost of these activities.

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LIMITATIONS

• (4) Units costs are optimal for planning purposes
  (including scaling up) but is not a budget and
  unit costs are no indication of cost
  effectiveness of the intervention
• (5) The financial costs assigned to resources
  needed to implement the action plans are not
  exact but close estimates. To date the unit cost
  for delivery of various HIV/AIDS services has not
  been established (no baseline).

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CONCLUSION

• The activity-based costing may not come up with
  accurate costs, particularly for a data poor and
  human resource constrained environment like that
  of Uganda. However, it is better to raise the
  right questions on setting priorities and
  articulating preferences and come up with rough
  budget estimates rather than focusing on detailed
  operational budgets of limited strategic value.
  Costing of this kind must be seen as a stepwise
  process which keeps improving over the years and
  that involves significant capacity building.