The Global Nutrition Report 2015: Actions and accountability to advance nutrition and sustainable development, has as a key theme the notion of tracking progress on tackling undernutrition as an important factor in holding donors, governments and other institutions to account. The data in the report itself plays a role in monitoring progress. At present, data allowing the monitoring of impact and reach of nutrition-specific interventions is limited. Lack of consensus on data, metrics and methods make monitoring difficult to undertake, analyse and compare, although improvements are being seen in actions to track nutrition.
Approaches to tackling undernutrition need to be multi-sectoral, which makes tracking both nutrition spending and progress towards targets difficult. As the Global Nutrition Report 2015 states, countries make progress when actions from multiple levels converge and reinforce each other in a virtuous circle. Nutrition-sensitive approaches, which seek to both reach a direct nutrition goal as well as address the factors underlying undernutrition, further complicate accurate measurement and monitoring.
Ickes et al (2015) calculated, based on data from the Organization for Economic Co-Operation and Development, estimates of nutrition aid received by countries with a high burden of undernutrition as well as investigated the relationship between this funding and nutrition measurements such as national stunting prevalence, stunting burden, and under-five mortality. In 2010, some US$379.4 million was given to nutrition specific projects and programmes and US$1.79 billion was committed to nutrition sensitive spending. The 25 highest burden countries accounted for 85% and 82% of this funding, respectively. The main areas of nutrition-sensitive spending were Reproductive Health Care (30.4%), Food Aid/Food Security Programs (14.1%), Emergency Food Aid (13.2%), and Basic Health Care (5.0%). The amount of nutrition sensitive and total nutrition Official Development Assistance was significantly correlated with stunting prevalence while the total number of stunted children in a country’s population was correlated with the amount of nutrition specific ODA. These results indicate not only the importance of nutrition-related funding in reducing stunting but also the importance of reliable estimates for nutrition spending for planning.
International funding for nutrition has, over the last five years, significantly increased. This rise has stimulated demand for greater accountability in the distribution of resources. As said, tracking nutrition expenditures is made difficult because nutrition spans several Ministries and involves multiple stakeholders. An Oxford Policy Management working paper by Picanyol et al (2015) entitled, Tracking Investments in Nutrition in Africa, reviews the experience of four countries (Tanzania, Madagascar, Ethiopia and Malawi) in tracking nutrition spending using different methods. Authors outline multiple ways in which nutrition spending can be tracked: through budgetary analysis, public expenditure reviews, National health accounts, the Clinton Health Access Initiative (CHAI) resource mapping tool, the OECD Development Assistance Committee (OECD/DAC) Credit Reporting System (CRS) online database. The report also introduces suggested desirable characteristics of tracking mechanisms, based on standard principles of good practice in public financial management and aid effectiveness (OECD, 2008; World Bank, 1998): [Read more…]