Having appropriate budget support is necessary for planned activities to meet their intended goals. The budgeting process allows policymakers, implementers, and decisionmakers to prioritize areas they view as important. Figure 1 outlines the basic budget process, which often begins well before a budget is finalized and continues throughout the budget cycle.
Knowledge and understanding of a budget and budget development process is an important part of this activity, which is why you should have someone on your team with a good understanding of the budgets you will be analyzing. To familiarize yourself with the budgeting process and documents in your ministry, read “Get to know your budget!” (Box 3) and consider the questions below. Use this information to define who should participate in the budget analysis process and how you can collect appropriate data. Try to understand how the generic budget cycle in Figure 1 looks in your situation.
Box 3. Get to know your budget!
The International Budget Partnership (IBP) has a list of 20 key questions about your country budget that are a good starting point (IBP 2014).
For more information on budgets and how they work, see IBP’s A Guide to Budget Work for NGOs (IBP 2001). Chapter 4 is a great introduction to the basics of budgeting, and includes a full list of resources at the end of the document.
- Who from your ministry is involved in each stage of the budget cycle?
- What budget documents are used for planning within your ministry?
- How is the budget structured? What challenges might you face in identifying budget lines that are nutrition-relevant?
- At what point in the budget cycle do nutrition advocates have an opportunity to push for additional funding or attention for nutrition?
The analysis conducted with the Budget Analysis Tool will help you understand where nutrition money sits in your budget and how much exists. These findings can also inform nutrition stakeholders who are advocating for adequate resources. “Digging into budgets” (Box 4) has more ideas about how to use data analysis to explore nutrition throughout the budget process.
Box 4. Digging into budgets
There are several ways to collect and analyze data related to budgets, but this tool focuses on budget tracking. We have included additional references here for readers interested in learning more about costing, expenditure tracking, or audits. Deciding which of these types of analysis is most appropriate for your intended goals is an important first step. Each of the processes listed below explores different parts of the budget cycle (Figure 1).
- Costing: Estimate the amount of money necessary to meeting national nutrition goals (completed before or during budget planning). The OneHealth Tool, developed by the UN Inter-Agency Working Group on Costing, is a good example of a widely-used costing tool for health interventions. The World Bank also authored a report that looks at the issue of costing specifically for nutrition: Scaling Up Nutrition: What Will it Cost?
- Budget Tracking: Analyze the amount of money allocated to implement nutrition activities (completed before or during budget negotiation)
- Expenditure Tracking: Identify the amount of allocated money that was actually spent on nutrition activities. Note that if expenditure figures are recorded, you may be able to adapt SPRING's tool to conduct expenditure tracking (completed during or after budget implementation). A common tool for both tracking and auditing expenditures is a Public Expenditure Review (PER). Tanzania was the first country to have a PER for nutrition. National Health Accounts look at expenditures within the health sector. Public Expenditure Tracking Surveys (PETS) can also be adapted to conduct an expenditure tracking or audit of nutrition funds.
- Audit: Track why nutrition funds did not reach their intended destination (completed during budget review). Public Expenditure Tracking Surveys was designed by the World Bank to inform public financial management practices and can be used to audit spending of nutrition funds (The World Bank n.d.).
Stunting and wasting are universal measures of undernutrition. In their seminal framework identifying the causes of undernutrition (Figure 2), UNICEF identified three underlying causes: inadequate care and feeding practices, household food insecurity, and an unhealthy household environment and inadequate health services (UNICEF 1990). These are shaped by the context of each country (basic causes) and impact dietary intake and disease, which are considered immediate causes of undernutrition.
Given the complex causes of malnutrition, efforts to reduce it are also complex, and must address many different factors that influence nutrition. The 2013 Lancet series on maternal and child nutrition outlines key actions to be taken to achieve optimal nutrition. These interventions fall into two categories, which you will use for data extraction in Step 4 of the budget analysis process: those that directly affect nutrition (nutrition-specific) and those with an indirect effect on nutrition (nutrition-sensitive).
The challenge with these actions when it comes to calculating how much is allocated to and spent on nutrition, through a budget analysis exercise, is that they are most likely spread across budget lines and sectors. A comprehensive effort to identify, validate, and analyze relevant activities, as described here, will require a great deal of interaction with day-to-day implementers and planners.
Box 5. Looking for more details on nutrition?
The 2008 Lancet series and 2013 Lancet series on nutrition are great summaries of the current state of nutrition thinking. In addition, the SUN website is the home to information about current country efforts to reduce malnutrition. Finally, ask if your country has a national nutrition plan, nutrition strategy, or any nutrition reports available – these can be great sources for country specific information.