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- Framework and Tools
- List of Tools by Step
- Step 1. Engage Partners
- Step 2. Assess Needs
- Step 3. Examine Strengths and Capacity
- Step 4. Select Priorities
- Step 5. Set Performance Objectives
- Step 6. Develop Action Plan
- Step 7. Seek and Allocate Resources
- Step 8. Monitor Progress for Impact on Outcomes
- Step 9. Report Back to Partners
- State and Jurisdiction Links
7. Seek and Allocate Resources
Introduction
On Your Mark: Start Here with Grounding Concepts and the Evidence BaseFollowing the identification of program activities in step 6, is the allocation of resources. In step 7, the focus is on the funding of planned activities to address state priorities. Inputs include the five-year State Action Plan, current budgets, political priorities, and partnerships.
The anticipated outcome is the development of a program budget and plan that directs available resources towards the activities identified in step 6 as the most important for addressing the state or jurisdiction's priorities.
Importance of Seeking and Allocating Resources
Resource allocation is not just a bureaucratic exercise; it is a strategic process essential for maximizing the impact of MCH interventions and promoting the health and well-being of communities.
- Maximizing the impact of limited resources: Title V agencies often face limited funding and staffing, making it essential to allocate resources wisely. By conducting a thorough needs assessment and prioritizing interventions based on evidence, public health departments can ensure that their resources are used in the most effective way possible, maximizing their impact on the health of the community.
- Addressing the most pressing public health concerns: A well-structured resource allocation process ensures that the Title V agency and its partners focus on addressing the most significant health issues and disparities within their communities. By prioritizing interventions that target the most pressing health needs, a state or jurisdiction can make the greatest impact on improving community health outcomes.
- Promoting equity and reducing disparities: Resource allocation decisions should consider the health needs of all community members, including underserved populations. By prioritizing interventions that address the specific challenges faced by underserved groups, Title V can promote equity and reduce health disparities across the community.
- Enhancing accountability and transparency: Spending time on resource allocation demonstrates a commitment to accountability and transparency. By involving community partners in the allocation process and making decisions based on data and evidence, the Title V team can build trust with the community and ensure that resources are used responsibly.
- Facilitating long-term planning and evaluation: Effective resource allocation is essential for long-term planning and evaluation efforts. By tracking the impact of interventions and reallocating resources as needed, Title V can continuously improve their programs and ensure that they are achieving their desired outcomes.
Barriers to Seeking and Allocating Resources
There are a number of barriers that can make it difficult to seek and allocate resources. These include:
- Limited Resources and Capacity:
- Not enough staff or money to conduct thorough needs assessments and analyze data.
- Lack of expertise in resource allocation.
- Data and Information Challenges:
- Data on community health needs and intervention effectiveness is often incomplete or inaccessible.
- Data is spread across different departments and agencies, making it difficult to analyze.
- Real-time data is often unavailable.
- Organizational and Political Factors:
- Competing priorities make it difficult to prioritize resource allocation.
- Political pressures and stakeholder interests can influence resource allocation decisions.
- Lack of leadership and commitment to effective resource allocation.
The MCH Evidence Center has reviewed the literature to find strategies for seeking and evaluating resources:
- Baum, Nancy M. PhD; DesRoches, Catherine PhD; Campbell, Eric G. PhD; Goold, Susan Dorr MD, MHSA, MA. Resource Allocation in Public Health Practice: A National Survey of Local Public Health Officials. Journal of Public Health Management and Practice 17(3):p 265-274, May/June 2011. | DOI: 10.1097/PHH.0b013e318207599c
- Nichols, L.M. and Taylor, L.A., 2018. Social determinants as public goods: a new approach to financing key investments in healthy communities. Health Affairs, 37(8), pp.1223-1230.
- O’Sullivan, L., Aldasoro, E., O’Brien, Á. et al. Ethical values and principles to guide the fair allocation of resources in response to a pandemic: a rapid systematic review. BMC Med Ethics 23, 70 (2022). https://doi.org/10.1186/s12910-022-00806-8
- Asamani JA, Alugsi SA, Ismaila H, Nabyonga-Orem J. Balancing Equity and Efficiency in the Allocation of Health Resources—Where Is the Middle Ground? Healthcare. 2021; 9(10):1257. https://doi.org/10.3390/healthcare9101257
- Seixas, B.V., Regier, D.A., Bryan, S. et al. Describing practices of priority setting and resource allocation in publicly funded health care systems of high-income countries. BMC Health Serv Res 21, 90 (2021). https://doi.org/10.1186/s12913-021-06078-z
- Ransom H, Olsson JM. Allocation of Health Care Resources: Principles for Decision-making. Pediatr Rev. 2017 Jul;38(7):320-329. doi: 10.1542/pir.2016-0012. PMID: 28667234.
Learn What Works
Get Ready: Immerse Yourself in Effective Strategies and Learn MoreThere are multiple evidence-based strategies for allocating resources as part of the five-year needs assessment:
- Prioritize interventions based on evidence and cost-effectiveness. Identify interventions with the strongest evidence of effectiveness and consider their cost-effectiveness to ensure efficient resource utilization.
- Utilize decision-support tools. Employ tools such as cost-benefit analysis, return on investment analysis, and multi-criteria decision analysis to systematically evaluate and compare resource allocation options.
- Incorporate equity considerations. Prioritize interventions that address health disparities and allocate resources equitably across population groups to promote health equity.
- Consider long-term sustainability. Allocate resources in a sustainable manner, ensuring that funding is available for ongoing implementation and maintenance of interventions.
- Adapt resource allocation strategies as needed. Regularly review and adjust resource allocation decisions based on emerging evidence, changing community needs, and evaluation findings.
- Communicate resource allocation decisions effectively. Clearly explain the rationale behind resource allocation decisions to partners and ensure transparency in the allocation process.
These trainings have been collected by the MCH Navigator:
- Budget Planning and Management. Source: South Central Public Health Partnership. Presenter(s): Andrew Rucks, PhD. Type: Video Course. Level: Intermediate. Length: 60 minutes.
- Financial Management. Source: University of Iowa College of Public Health's Institute for Public Health Practice. Presenter(s): Jeff Horne. Type: Online Course. Level: Intermediate. Length: Self-paced.
- Leadership and Management: Basic Budgeting Concepts. Developed: 2021. Source: North Dakota Public Health Training Network. Presenter(s): Terry L Dwelle, MD. Type: Video. Level: Introductory. Length: 42 minutes.
- Planning and Budgeting for Public Health: Part I - The Business Plan. Developed: 2013. Source: University of Minnesota School of Public Health. Presenter(s): Anne Barry, JD, MPH. Type: Online Course. Level: Introductory. Length: Self-paced.
- Public Health Financial Management. Source: South Central Public Health Partnership. Presenter(s): W. Jack Duncan, PhD. Type: Video Course. Level: Advanced Intermediate. Length: 420 minutes.
- Public Health Pronto-Financial Planning and Management Skills. Developed: 2016. Source: MCH Navigator. Presenter(s): Jennifer McKeever, MSW. Type: Video Podcast. Level: Introductory. Length: 5 minutes.
Tools to Try
Get Set: Use these Tools to Move from Knowledge to ImplementationThese tools and examples have been developed by the National MCH Workforce Development Center or collected by the MCH Digital Library:
- Balance of Petals. This tool can be used to clarify needs from and benefits to community partners. Knowing what you need from the partnerships you form, as well as what each partner stands to gain from your initiative is an important part of allocating resources. Use this tool to identify which partners need to be engaged for your initiative to succeed, what you need from each partner (including political support, data, funding, and/or effort), what each partner has to gain (and lose) from your initiative.
- Impact Matrix. A tool to help groups identify and achieve agreement on activities that can be implemented with maximum impact given the effort invested. This is an easy-to-facilitate tool that can be used when a team (including partners) has many ideas about potential courses of action and wants to consider the impact of all potential solutions before deciding on a course of action.
- Facilitation guide
- Tool template: PDF | Word document (editable)
- Prioritization Matrix. The last phase of the CAST-5 Process highlights selecting priorities. This document provides an overview and tool for Prioritizing Needs.
- Program Budgeting and Marginal Analysis (PBMA). A process that helps decision-makers maximize the impact of healthcare resources on the health needs of a local population. Program budgeting is an appraisal of past resource allocation in specified programs, with a view to tracking future resource allocation in those same programs. Marginal analysis is the appraisal of the added benefits and added costs of a proposed investment (or the lost benefits and lower costs of a proposed disinvestment). About PBMA | Implementing PBMA.
- Resource Allocation Tool. Health Equity Guide. This tool presents nine actions to allocate resources to advance equity and related case studies.
- Return on Investment (ROI). ROI is a tool used to evaluate the efficiency of an investment or compare the efficiency of several investments. The use of ROI can help guide the allocation of resources. This guidebook is designed to assist local health department staff assess the value of their contributions, with a particular focus on population-based prevention interventions.
- Poster: Using “Return on Investment” Analysis Helps Drive Quality Improvement
- ROI Calculator for Partnerships to Address the Social Determinants of Health. The Commonwealth Fund. This calculator is designed to help community-based organizations and their health system partners plan sustainable financial arrangements to fund the delivery of social services to high-need, high-cost (HNHC) patients.
These resources have been collected by the MCH Digital Library:
- What Is Resource Allocation? How to Allocate Resources for Projects. This article from the trade organization Project Manager, explores what resource allocation is, why it’s so important for project management, and what tools one can use to better allocate project resources.
- Principles of Resource Allocation. This chapter of the Oxford Academic textbook, Who Should We Treat? Rights, Rationing and Resources in the NHS (2nd ed.) discusses the ways in which limited health resources should be allocated.
- Resource Allocation. This summary page from the Health Equity & Policy Lab describes what resource allocation is, why it's important, what it looks like, and how to perform related tasks.
- Five ways US public health investment can improve health care delivery. This article provides five strategies for government and public health services to invest in to transform current operating models, technology, infrastructure, trust, and equality.
Title V Tools and Examples
Go: Learn from Your Peers Across the CountryTools
These tools have been collected by AMCHP and the MCH Evidence Center:
- Maternal and Child Health Services Title V Block Grant. Georgia provides information on their website regarding how they have allocated their Title V Resources.
- Advancing Equity in Maternal and Child Health Grant Program. Wisconsin lists current funding opportunities available for communities to apply.
Stories and Strategies for Peer-to-Peer Learning
These stories and strategies have been collected by AMCHP and the MCH Evidence Center related to Step 7:
- Colorado: State and Title V Needs Assessment Coordination. In Colorado, the Title V needs assessment and the state health department's five-year health and environmental assessment are coordinated, leading to more efficient processes and better informed results. To date, the MCH needs assessment project manager has participated on the steering and advisory committees for the statewide assessment, and the MCH program has provided funding for community members and rural partners to join the advisory committee. The MCH and state assessment teams have also shared resources, methods and tools to implement best practice assessments. In the future, the MCH Team will use the quantitative data compiled through the statewide assessment as well as priority issues identified to further explore the impact and relevance among MCH.
- South Dakota: Our program has a series of meetings scheduled for November to look at survey results with our stakeholders.
- Hawaii: We contracted with UAB to lead our needs assessment. Best TA advice we received! The experience and capacity of UAB is amazing. They are very familiar with title V. BG and experience assisting other states and their needs assessment. Know what you don't know and ask for help.
- Commonwealth of the Northern Mariana Islands: Partner engagement. Ensure population representation. Keep partners in the loop (informed) of every stage of the NA process.
Share Your Stories and Strategies
Please take a moment to share your stories and strategies related to Step 7 of your needs assessment that you would like highlighted on this page. By sharing your stories, you help to document the needs assessment process for use by other Title V agencies during this cycle and will help preserve this knowledge for needs assessment processes in the future.