Malawi provides valuable experience on the advantages of a holistic approach when attempting reforms, and on how to manage longer reform programmes. Since 1995, the budget process has been based on the principles of the Medium-term Expenditure Framework. This article presents the findings of a comprehensive review of the MTEF in 1999/2000 which examined its strengths and weaknesses, the possible causes and the proposed reforms required. MTEF Phase II is targeted at strengthening the management and co-ordination of the budget process, ensuring that there is political leadership of the budget process, improving policy and budget scrutiny processes, and strengthening financial accountability systems. The article also draws on a review of the education sector for a line ministry perspective on whether and how budgetary reforms assist in improving service delivery.