Publication: Driving Nutrition Action Through the Budget: A Guide to Nutrition-Responsive Budgeting
Loading...
Published
2023-06-06
ISSN
Date
2023-06-06
Author(s)
Editor(s)
Abstract
Public resources are needed to finance nutrition interventions. Therefore, how well these resources are managed matters to how effective governments can be in addressing malnutrition. However, public financial management (PFM) systems are often not set up to serve the multi-sectoral needs that are required for an effective nutrition response. This guide identifies what makes a PFM system responsive to nutrition needs, and what actions can be taken to develop a reform program in a capacity constrained context. Following this guide will allow stakeholders to map priority interventions from strategic plans into the government budget, identify what interventions were approved in the budget, map out when budgets were released for these interventions and monitor spending and implementation. Together this creates the necessary foundation for matching spending data with outcome information to allow for evidence-based course correction. A nutrition responsive PFM reform leverages existing country systems at the margins to foster stewardship, oversight, and coordination, to strengthen the allocation and use of limited resources. At the same time this guide is designed to minimize disruptions to other ongoing reform efforts and avoid duplicating processes, or onerous data collection and reporting requirements.
Link to Data Set
Citation
“Subandoro, Ali Winoto; Piatti-Fünfkirchen, Moritz; Williamson, Timothy; Okamura, Kyoko Shibata. 2023. Driving Nutrition Action Through the Budget: A Guide to Nutrition-Responsive Budgeting. © World Bank. Health, Nutrition and Population Global Practice. http://hdl.handle.net/10986/39856 License: CC BY-NC 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Driving Nutrition Action Through the Budget(Washington, DC: World Bank, 2025-07-10)This guide identifies what makes a PFM system responsive to nutrition needs, and what actions can be taken to develop a reform program in a capacity constrained context. Across the stages in the budgetcycle it identifies basic requirements that are necessary for a nutrition responsive PFM reform and develops advanced options that could be pursued if context appropriate. Following this guide will allow stakeholders to map priority interventions from strategic plans into the government budget, identify what interventions were approved in the budget, map out when budgets were released for these interventions and monitor spending and implementation. Together this creates the necessary foundation for matching spending data with outcome information to allow for evidence-based course correction. A nutrition responsive PFM reform leverages existing country systems at the margins to foster stewardship, oversight, and coordination, to strengthen the allocation and use of limited resources. At the same time this guide is designed to minimize disruptions to other ongoing reform efforts and avoid duplicating processes, or onerous data collection and reporting requirements.Publication A Guiding Framework for Nutrition Public Expenditure Reviews(Washington, DC: World Bank, 2022-05-04)Nutrition investments affect human capital formation, which in turn affects economic growth. Malnutrition is intrinsically connected to human capital—undernutrition contributes to nearly half of child mortality, and stunting reduces productivity and earnings in adulthood. Improving nutrition requires a multisectoral effort, but it is difficult to identify and quantify the basic financing parameters as used in traditional sectors. What is being spent and by whom and on what? To address these questions, nutrition public expenditure reviews (NPERs) determine the level of a country’s overall nutrition public spending and assess whether its expenditure profile will enable the country to realize its nutrition goals and objectives. When done well, NPERs go beyond simply quantifying how much is spent on nutrition; they measure how well money is being spent to achieve nutrition outcomes and identify specific recommendations for improvement. A Guiding Framework for Nutrition Public Expenditure Reviews presents the key elements of an NPER and offers guidance, practical steps, and examples for carrying out an NPER. The book draws upon good practices from past NPERs as well as common practices and expertise from public expenditure reviews in other sectors. This handbook is intended for practitioners who are tasked with carrying out NPERs. Other target audiences include country nutrition policy makers, development partner officials, government technical staff, and nutrition advocates. The book presents data and analytical challenges faced by previous NPER teams and lays out the kinds of analyses that past NPERs have been able to carry out and those that they were unable to perform because of data or capacity constraints. It concludes with further work needed at the global and country levels to create the conditions necessary to conduct more comprehensive NPERs.Publication Budget Execution in Health(World Bank, Washington, DC, 2021-11-04)Most countries are committed to the provision of quality health services to all, without risk of financial hardship. Adequate budget provisions are an important, yet insufficient requirement in this pursuit. The budget also needs to be implemented in full and with regard to efficiency and accountability. While this is widely acknowledged, there is no systematic evidence on how well the health budget is implemented and literature remains thin on how budget execution practices relate to health financing functions and service delivery. This report is the first in a series of publications on the topic following an active World Health Organization and World Bank collaboration. It aims to define concepts, characteristics and trends in health sector budget execution. The report first calls for clarity in use of terminology. It helps to differentiate between ‘budget execution rates’ and ‘budget execution practices’. The former refers to the share of the budget being executed. The latter to processes on how well the budget is executed. Both aspects are equally important. Not implementing the budget in full is a lost opportunity, efficiency and accountability concern and undermines the health sector’s ability to deliver services. It also undermines prospects for increased fiscal space going forward. To identify trends and patterns in over and underspending, the report draws on previously unexplored PEFA annex and World Bank BOOST data. This reveals the following: Health budget execution rates are inversely related to levels of income and maturity of PFM systems. Health budget under-execution is particularly pervasive in LMICs where the budget is executed at around 85-90 percent. Some countries have chronic budget execution problems where the budget is executed at a rate below 85 percent across consecutive years. In LMICs, the health budget is systematically implemented at a lower rate than the general government budget. This means, that governments are effectively deprioritizing health during budget implementation. For Sub-Saharan Africa countries in the sample, the average health budget was 6.7 percent of the general government budget. Health spending as a share of general government spending was half a percentage point less at 6.2 percent. In some countries this is much more pronounced, where health is deprioritized by 2-3 percentage points of general government spending during implementation. The health budget was also implemented at a lower rate than the education budget in most countries at an average rate of 4 percentage points. Underspending in some categories often occurs concurrently with overspending on other expenditure items. While the wage and salary budget tend to be implemented in full, this is less so for goods and services or the capital budget. This can leave health workers without the necessary supplies or support infrastructure to provide quality services and invariably lead to inefficiencies.Publication Rwanda Nutrition Expenditure and Institutional Review 2020(World Bank, Washington, DC, 2020-11-03)This report provides recommendations to further develop the methodology for nutrition expenditure analysis. This report carefully reviewed all available nutrition expenditure analyses available and drew methodological conclusions. Findings include a need for a standardized way of classifying nutrition-related spending to be applied, of which the 2013 Lancet Framework lends itself well. Government spending should be mapped against this framework to the extent possible. Government expenditure data as available from the FMIS should be used. Coding for nutrition should be done against activity descriptions in the budget. Merely looking at spending agencies or programs/subprograms is unlikely to be sufficiently precise to be helpful for an analysis and should only be used if the former not be available. Weighting nutrition spending tends to be subjective and should not be used for comparison. It is important to consider the adequacy of the institutional and public financial management environment. This can provide for actionable recommendations on how to improve the management of nutrition across governments, strengthen accountability, and help adjust spending toward high impact interventions. Optima can be used to inform allocative efficiency. It should however be interpreted with care if the unit cost estimates cannot be fully derived from Government and donor expenditure reports of all high impact interventions.Publication Following the Government Playbook? Channeling Development Assistance for Health through Country Systems(World Bank, Washington, DC, 2021-10-21)Development partners (DPs) contribute to a significant share of total health financing, especially in low-income countries, and support the achievement of universal health coverage (UHC). However, if DP support is not well aligned with government systems, it can lead to inefficiencies, such as poor prioritization, fragmentation, and duplication of activities, and inhibit the government’s ability to maintain effective stewardship over sector activities. This note develops a comprehensive interpretation of the term ‘country systems’ in a public financial management (PFM) environment along with a checklist across the budget cycle that can be used to assess whether DPs in a given country are aligned to various PFM aspects. Undertaking an assessment is expected to have the following benefits: to provide a better understanding of the DP financial architecture and contribute to the literature of DP alignment and aid effectiveness; to articulate a clear baseline of DP financing modalities to allow for establishing a logical framework that will help articulate a reform program and strengthen mutual accountability. to foster learning across countries and DPs.
Users also downloaded
Showing related downloaded files
Publication Business Ready 2024(Washington, DC: World Bank, 2024-10-03)Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.Publication Classroom Assessment to Support Foundational Literacy(Washington, DC: World Bank, 2025-03-21)This document focuses primarily on how classroom assessment activities can measure students’ literacy skills as they progress along a learning trajectory towards reading fluently and with comprehension by the end of primary school grades. The document addresses considerations regarding the design and implementation of early grade reading classroom assessment, provides examples of assessment activities from a variety of countries and contexts, and discusses the importance of incorporating classroom assessment practices into teacher training and professional development opportunities for teachers. The structure of the document is as follows. The first section presents definitions and addresses basic questions on classroom assessment. Section 2 covers the intersection between assessment and early grade reading by discussing how learning assessment can measure early grade reading skills following the reading learning trajectory. Section 3 compares some of the most common early grade literacy assessment tools with respect to the early grade reading skills and developmental phases. Section 4 of the document addresses teacher training considerations in developing, scoring, and using early grade reading assessment. Additional issues in assessing reading skills in the classroom and using assessment results to improve teaching and learning are reviewed in section 5. Throughout the document, country cases are presented to demonstrate how assessment activities can be implemented in the classroom in different contexts.Publication Nepal Country Climate and Development Report(World Bank, Washington, DC, 2022-09)This Country Climate and Development Report (CCDR) identifies ways that Nepal can achieve its overall development objectives while fostering its strategic ambition to transition to a greener, more resilient, and inclusive development pathway. This report is organized as follows: Chapter 1 captures the current situation in the country with respect to climate impacts and risks, emission sources, and opportunities for integrated climate change adaptation and mitigation. Chapter 2 describes the government’s response, through sectoral and economywide commitments, laws, and regulations. Chapter 3 assesses the impacts of climate change on the macroeconomy and road transport systems, given their critical role to connectivity. It also analyzes the links between climate change and air pollution, poverty, health, social inclusion, and community resilience. Chapter 4 presents pathways to transition to resilience, looking at integrated management of landscape systems comprising water, agriculture, and forests as well as strengthening climate and disaster risk management governance. Chapter 5 analyzes pathways to transition to decarbonization, primarily the potential for hydropower expansion domestically and in the region. It also looks at transport and urban opportunities to reduce emissions while enhancing resilience and adaptation co-benefits. Chapter 6 discusses how to scale up financing for resilience, hydropower, and other opportunities, given the limitations of the country’s fiscal space. Chapter 7 presents a prioritization framework for the most transformational climate action with seven ‘policy packages’—one for each priority transition and each key enabler—that contain specific recommendations for how to move from analysis to action.Publication South Asia Development Update, April 2025: Taxing Times(Washington, DC: World Bank, 2025-04-23)Growth prospects for South Asia have dimmed. The global economic environment has become more challenging and is a source of heightened downside risks. After a decade of repeated disruptions, South Asia’s buffers to cushion new shocks are slim. Tackling some of its greatest inefficiencies and vulnerabilities could help South Asia navigate this unusually uncertain outlook: unproductive agricultural sectors, dependence on energy imports, pressures from rising global temperatures, and fragile fiscal positions. For most South Asian countries, increased revenue mobilization is a prerequisite for strengthening fiscal positions. Even taking into account the particular challenges of collecting taxes in South Asian economies—such as widespread informal economic activity and large agriculture sectors—South Asian economies face larger tax gaps than the average emerging market and developing economy (EMDE). This suggests the need for improved tax policy and administration. Until fiscal positions have strengthened, the burden of climate adaptation will disproportionately fall on the private sector. If allowed sufficient flexibility, private sector adaptation could offset about one-third of the likely climate damage by 2050. This may, however, require governments to remove obstacles that prevent workers and firms from moving across locations and activities. As growth prospects dim, the challenge grows to create jobs for South Asia’s rapidly expanding working-age population. South Asia’s large diasporas could become a source of strength if their knowledge, networks, and other resources can be better tapped for investment and trade.Publication Digital Progress and Trends Report 2023(Washington, DC: World Bank, 2024-03-05)Digitalization is the transformational opportunity of our time. The digital sector has become a powerhouse of innovation, economic growth, and job creation. Value added in the IT services sector grew at 8 percent annually during 2000–22, nearly twice as fast as the global economy. Employment growth in IT services reached 7 percent annually, six times higher than total employment growth. The diffusion and adoption of digital technologies are just as critical as their invention. Digital uptake has accelerated since the COVID-19 pandemic, with 1.5 billion new internet users added from 2018 to 2022. The share of firms investing in digital solutions around the world has more than doubled from 2020 to 2022. Low-income countries, vulnerable populations, and small firms, however, have been falling behind, while transformative digital innovations such as artificial intelligence (AI) have been accelerating in higher-income countries. Although more than 90 percent of the population in high-income countries was online in 2022, only one in four people in low-income countries used the internet, and the speed of their connection was typically only a small fraction of that in wealthier countries. As businesses in technologically advanced countries integrate generative AI into their products and services, less than half of the businesses in many low- and middle-income countries have an internet connection. The growing digital divide is exacerbating the poverty and productivity gaps between richer and poorer economies. The Digital Progress and Trends Report series will track global digitalization progress and highlight policy trends, debates, and implications for low- and middle-income countries. The series adds to the global efforts to study the progress and trends of digitalization in two main ways: · By compiling, curating, and analyzing data from diverse sources to present a comprehensive picture of digitalization in low- and middle-income countries, including in-depth analyses on understudied topics. · By developing insights on policy opportunities, challenges, and debates and reflecting the perspectives of various stakeholders and the World Bank’s operational experiences. This report, the first in the series, aims to inform evidence-based policy making and motivate action among internal and external audiences and stakeholders. The report will bring global attention to high-performing countries that have valuable experience to share as well as to areas where efforts will need to be redoubled.