Funding Nutrition: Building a Healthier Future in Uganda

The Value of Investing in Nutrition

Photo of a woman in a USAID/SPRING shirt sitting on a mat on the ground with a mother holding her child in her arms. The mother is feeding the child with a spoon.

Nutrition is vital for social and economic improvements in Uganda. Hence, critical actions are needed to strengthen policy and financing to improve nutrition.

  • 15% of child mortality is caused by malnutrition, and almost 82% of childhood undernutrition cases go untreated by the health care system in Uganda.
  • Childhood undernutrition and hunger cost Uganda up to 5.6% of the Gross Domestic Product (GDP) or UGX 1.8 trillion every year.
  • Stunted children have a higher risk of grade repetition, costing 19,655 million UGX in 2009 or 1.8% of the total national investment in education.
  • Greater dollars (or shillings) for nutrition will turn into gains in healthy and productive life years. Uganda’s Cost of Hunger study found that for every USD $1 spent on nutrition, Uganda can save USD $30 through improved health and economic benefits.

The Current Context

Between 2013 and 2015 the USAID-funded multisectoral SPRING project conducted a rigorous analysis of publicly available data on funding and expenditures for nutrition. The “Pathways to Better Nutrition” study revealed important details about the status of nutrition financing in Uganda.

Cut-out circle graph showing about 12 billion UGX, or 7%, Unconditional central transfers; 29 billion UGX, or 17%, Central Ministry Allocations, and 132 billion UGX, or 76%, Conditional Central Transfers.
*Footnote: SPRING was unable to validate the amount of unconditional funding allocated to nutrition, and therefore took the average of conditional transfers (13 percent).
Stacked graph showing 2014-15 allocation On-Budget GoU was just over 15 bilion UGX, 2014-15 allocation On-budget EDP was just under 30 billion UGX, 2014-15 expenditure on-budget GoU was 10 billion UGX, and 2014-15 expenditure on-budget EDP was just over 15 billion UGX.
  • Funding did not increase over time.
    • Despite a growing need for support, onbudget nutrition funding (managed by the Ministry of Finance, Planning and Economic Development.) stayed about the same (27.2 billion UGX in the 2013-2014 budget and 29.5 billion UGX in the 2014-2015 budget).
  • Nutrition funding was minimal compared to spending in other areas.
    • The government of Uganda spent $9 per child under 5 on nutrition-specific activities.
    • Nutrition funding was only 1% of nationallevel government budget (not including transfers to the district).
    • Nutrition funding made up 5% of the total development assistance to Uganda from external development partners.
  • Most nutrition funding was not provided by the government and was off-budget
    • 63% of the funds available for nutrition in 2014-2015 were provided by nongovernment actors and were not included in the government budgets or managed through the treasury.
  • The single largest contributions to on-budget nutrition funding were through central transfers.
    • However, there is significant confusion in how those funds were spent and how ministries contributed.
  • Government funding for nutrition was underspent
    • As illustrated in the graphic only around 50% to 60% of allocated government funding was spent each year, due to delayed release of funds or procurement delays. Onbudget spending by external development partners varied greatly from year to year.
  • Spending on nutrition at the district level is constrained - Only about 6% to 7% of spending in districts was on nutrition activities since the vast majority of district funds are earmarked at the national level.Spending on nutrition at the district level is constrained - Only about 6% to 7% of spending in districts was on nutrition activities since the vast majority of district funds are earmarked at the national level.

Strengthening the Power of Nutrition Funding in Uganda

There are a number of actions stakeholders can take to improve funding for nutrition:

  • Increase opportunities for nutrition staff and budget staff to communicate at the national level, within sectors, and at the district level to improve work planning and budgeting for nutrition.
  • Train district officials on why and how to include nutrition in district work plans, institutionalizing the National Nutrition Planning Guidelines for Uganda.
  • Reduce restrictions on district funding and improve reporting on the allocation of these funds.
  • Include nutrition as a priority in each sector’s investment and development plans, and within each district’s development plans.
  • Institutionalize nutrition funding into the Ugandan budget to allow for more consistent and transparent funding from year to year by-
    • including the new nutrition planning guidelines in the budget-call circulars each year
    • naming nutrition as a budget line
    • applying tracking codes across sectors
    • setting targets for the percentage of a sector’s yearly budget that should go toward nutrition.
  • Approve and implement the Uganda Nutrition Action Plan (UNAP) monitoring and evaluation framework, which includes nutrition-specific and sensitive indicators, o be able to track and compare progress.