Malnutrition is one of the world’s most serious but least-addressed development challenges. Its human and economic costs are enormous, falling hardest on poor people, especially women and children.
Almost 150 million children under five years old are stunted, which is a predictor of many developmental constraints, including cognitive deficits and less future economic opportunities. Forty percent of those live in Sub-Saharan Africa, where, despite all efforts, the number of stunted children continues to increase. Besides impacting individuals, malnutrition impedes a country’s ability to accumulate human capital.
Without urgent action, the SDG target to reach a 50% reduction in malnutrition by 2030 will not be reached. This has led to calls for commitments for more and better nutrition spending and the establishment of an annual Global Nutrition Report to monitor commitments across stakeholders.
Increased spending on nutrition is urgently needed
We know that more public resources are urgently needed to finance nutrition interventions. How well these resources are managed matters to how effective governments can be in addressing malnutrition. But public financial management (PFM) systems are often not set up to serve the multi-sectoral needs that are required for an effective nutrition response.
Our new report, Driving Nutrition Action through the Budget: A Guide to Nutrition-Responsive Budgeting, argues that a nutrition response requires effective government action, including sufficient allocation of public resources to priority and high-impact interventions, good management of those resources, and effective coordination of stakeholders. A nutrition-responsive PFM system needs to offer the right tools for effective management. Otherwise the SDG target will continue to be elusive.
Multi-sectoral coordination delivers better nutrition outcomes
Interventions from many sectors are required to address malnutrition. Agencies across health, water, education, agriculture, local government, and many more provide complementary services, but coordination is difficult, even when there is a dedicated agency in government with this mandate.
Because budgets are allocated according to sector, governance and management challenges arise when governments want to address cross-sectoral issues such as nutrition. Without adequate adjustments to PFM systems, managing an effective nutrition response can be hampered by questions about budget, accountability, implementation arrangements, and budget prioritization. This makes addressing malnutrition difficult and complicated, despite cost-effective and proven interventions that can make a big impact.
What is a nutrition responsive budget?
A nutrition responsive budget can help solve this challenge. The report offers specific guidance on how to transition toward such a system. Making the right adjustments will allow for identifying the right intervention and prioritization across sectors. It will allow oversight over what has been funded and where critical gaps remain. When funded, it will help government agencies to monitor implementation and hold stakeholders accountable for progress. It will allow triangulating expenditure data with outcome data to allow for evidence-based course correction.
All of this does not involve investing in new systems and technology. It merely leverages the given structures and institutions through minor adjustments in a way that facilitates stewardship, coordination and accountability for a more effective response.
Looking beyond nutrition
Nutrition-responsive budgeting is not a new concept. Addressing cross-sectoral challenges like nutrition has long been implemented for gender and climate. This has generated valuable lessons on what works, where, and under what circumstances. The governments of Rwanda and Indonesia have built on this experience to inform their nutrition governance reforms.
Practitioners have much to gain by looking beyond the field of nutrition. Governments may already have solutions in place that guide the management of resources to support the delivery of other global public goods. Building on these systems can expedite reform efforts, help identify champions in ministries of finance, and make a profound difference.
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