BUDGET ANALYSIS

FOR NUTRITION
A guidance note for countries
 Budget Analysis for Nutrition
Guidance note for countries (update 2020)

Table of Contents
Conducting the nutrition budget analysis .................................................................................... 2
1. Define the scope and goals ............................................................................................. 2
2. Determine the best time to collect and report on the finance data ................................... 3
3. Define who should be involved in the nutrition budget analysis ....................................... 3
4. Identify the finance data source ....................................................................................... 4
5. Collect the finance data ................................................................................................... 5
Collect the finance data for the first time ............................................................................. 6
Repeat the finance data collection in a given year .............................................................. 9
6. Analyze and interpret the finance data ...........................................................................11
7. Use the finance data.......................................................................................................13
How to unpack essential data from the budget analysis .....................................................13
How to use the data for advocacy ......................................................................................14
Annex A: References ................................................................................................................. 0
Guidebook and E Learning Module ............................................................................................ 0
Annex B: Step 1 – Identification of budget line items .................................................................. 1
Annex C: Step 2 – Categorisation of budget line items............................................................... 3
Annex D: Step 3 – Weighting of budget line items (OPTIONAL) ................................................ 8
Annex E: Frequently Asked Questions ......................................................................................11
Annex F: Aid Management Program (AMP) Listing ...................................................................13
Annex G: Contact Points for SHA Methodology (Updated 2017) ...............................................16

Acknowledgments

The 2020 Budget Analysis guidance note builds on the 2015, 2016, 2017, and 2018 versions developed by Patrizia
Fracassi and William Knechtel (SUN Movement Secretariat) and Clara Picanyol (Oxford Policy Management). It has
benefitted from inputs and review by Amanda Pomeroy-Stevens (SPRING), Mary D’Alimonte (Results for
Development) and Richard Watts (Development Initiative). We are also grateful to Taryn Davis (Development
Gateway) for the information on the Aid Management Program and to Kaia Engesveen (WHO) for the information
inputs on the System Health Account (SHA).

Suggested citation: Fracassi P, Picanyol C, Knechtel W, D’Alimonte M, Gary A, Pomeroy-Stevens A, Watts R

“Budget Analysis for Nutrition: guidance note for countries (update 2020)”

1
Introduction
The Scaling Up Nutrition (SUN) Movement’s 2013 Progress Report pointed to the importance of
in-country resource availability and mobilization, and highlighted the challenges countries face in
tracking resources destined for nutrition. By 2020, 51 countries conducted an analysis of their
government budgets in the past 5 years, with 8 countries having performed the exercise three
times, and 5 countries conducting the exercise four times. These efforts show that it is feasible to
conduct a budget analysis but also that this process needs to be sustained and improved on a
continuous basis.

Better measurement of nutrition financing means better use of nutrition resources for reaching
the most vulnerable populations, and stronger advocacy cases. This is important, because as the
2016 Investment Framework for Nutrition (Shekar et al) notes, the current financing available for
nutrition is insufficient and/or not adequately used. Scaling up actions and interventions to
improve nutrition requires financial resources backed by individual, organization and system
capacity to plan for impact, refine interventions and expand coverage while maintaining quality
and ensure that no one is left behind.

This budget analysis guidance note provides further guidance on best practices emerging from
recent exercises, without losing sight of the fact that financing is just one component to scaling
up nutrition action (along with capacity and accountability).

This guidance note is developed to support SUN Government Focal Points and their in-country
partners, as they constitute the so-called national Multi-Stakeholder Platforms for Nutrition.
The SUN Government Focal Points and the members of the MSPs are loosely defined as “country
team” in this guidance note.

Conducting the nutrition budget analysis

1. Define the scope and goals
2. Determine the best time to collect and report on the finance data
3. Define who should be involved in the nutrition budget analysis
4. Identify the finance data source
5. Collect the finance data (first time and repeatedly)
6. Analyse and interpret the finance data
7. Use the finance data

1. Define the scope and goals

Having reliable finance data is essential to policy makers to prioritise, to plan, and to make
decisions on resource allocation, as well as to monitor and evaluate policy implementation.
Resource tracking is an important way of promoting transparency and can be used for advocacy
purposes.

When defining goals, it is important to be realistic and to time the data collection and analysis to
relevant events when data can be presented and used by decision makers to affect funding
allocations and expenditures.

The scope of the analysis should be adaptable to countries based on data and capacity available
in each system. Some countries may decide to start or stay focused by only looking at one sector
and a limited set of interventions, perhaps with more disaggregated data while other countries

2
may be ready to convene multiple sectors and use the budget analysis as an opportunity to
discuss nutrition in a coordinated way.

A consultation with the members of the Multi-Stakeholder Platform for Nutrition is

therefore essential to define the overall scope and goals of the budget analysis (i.e., for
advocacy, for monitoring, or for evaluation). To increase the success of the budget analysis it is
vital to include donors and representatives of the civil society organizations. The inclusion of the
private sector is encouraged in countries where they are active members of the Multi-Stakeholder
Platform.

The availability of a national plan and a clear understanding of the institutional framework can
help to guide the budget analysis – e.g. what types of services/programmes are delivered by who
at what level. Members of the Multi-Stakeholder Platform can already provide essential
information in the preparatory phase of the budget analysis.

Country teams that wish to better understand public finance management and how to engage in
budget cycles and processes can consult enhanced technical guidance notes such as the World
Health Organizations’ 2011 paper by Simson et all or UNICEF’s 2016 document produced by
Sophie Brown (see Reference List in Annex F).

2. Determine the best time to collect and report on the finance data
The data collection should build into the yearly work-planning schedule for health and other
engaged ministries (e.g. agriculture, social protection, WASH, education, etc.) to make it easier
to identify and track nutrition-relevant programmes.

The data analysis and reporting, however, should be timed with two critical moments with the
budgetary year: first when finance allocations are integrated into the country budget documents
and, second, when the budgets are approved by the Parliament (ACF 2017).

As part of the preparatory work, it is useful for the Multi-Stakeholder Platform to put together a
budget cycle document that identifies key opportunities to influence decision making through
advocacy work.

3. Define who should be involved in the nutrition budget analysis

The range of sectors and the potential programmes for inclusion depends very much on the scope
and defined goals of the budget analysis.

Members of the Multi-Stakeholder Platforms for Nutrition can help to define what to include
in the budget analysis and how to tie it to the national nutrition action plan, the common results
framework and other strategic documents (as available).

Starting small, if the goal is to influence decisions within one sectoral budget cycle, the country
team does not need to go beyond the specified ministry. However, if the scope is multi-sectoral,
available national action plans could be used as the starting point to define the range of sectors
and nutrition programmes. Global frameworks for actions on nutrition can be useful to inform the
consultation in the event that updated national plans are not available.

As country teams work advance with the preparation of their budget analysis, they can engage
other stakeholders to help with the process:

3
• Nutrition Technical Staff – in each engaged ministry (if more than one), the nutrition
technical staff can help to identify and/or confirm relevant programmes and nutrition-related
activities.

• Budget & Planning Staff – in each engaged ministry (including the Ministry of Finance or a
Planning Unit), the budget & planning staff can help to identify the relevant programmes and
nutrition-related activities in the yearly budget.

• External Support – There are several resources, including tools and guides, available from
the SUN Movement Secretariat and other technical assistance providers to help with this
process (see references at the end of the note). If these resources do not help, the country
team can contact the SUN Movement Secretariat and they will assist with guiding the
process through remote support and/or with engaging technical providers to help complete
this work through remote and in-country support. This assistance should focus on building the
technical capacity within the government to be able to reproduce the budget analysis beyond
the present year.

4. Identify the finance data source

This guidance note defines allocations and expenditures that are reported in official government
finance documents as “on-budget” finance data. These data can reflect both government and
donor funding streams:

• National government budget should be the first source you check for data. The
data might be already processed for easier analysis in one of the following formats:

▪ Country-specific financial management systems

▪ Ministry sub-sector analysis

This guidance note defines allocations and expenditures that are not in national government
finance documents as “off-budget” finance data. These data are harder to track, but you may
be able to find estimates of donor and/or implementing partner investments with the following
resources:

• Aid Management Program (AMP) (25 countries). If accessible, the AMP database
should be the first source for off-budget data, as they are endorsed by the Ministries
of Finance. Annex A provides a list of where AMPs are currently available and some
essential details.

▪ Development Assistance Committee (DAC) Creditor Reporting System (CRS) of

the Organisation for Economic Co-operation and Development (OECD). Available at:
https://stats.oecd.org/Index.aspx?DataSetCode=CRS1

Both AMP and DAC/CRS report aid data using Gregorian calendars, which should be
noted if your country has a unique fiscal year calendar.

The main finance data source within the health sector is the System of Health Accounts 2011
(SHA), formerly known as the National Health Accounts (NHA), which track spending by disease.
Overall country health spending is distributed among five mutually exclusive categories—
infectious and parasitic diseases, reproductive health, nutrition deficiencies, noncommunicable
diseases, and injuries —using a top-down approach. Spending amounts include the full range of
provision costs—drugs, services and human resources—incurred at both the service delivery

4
point, where health care services are produced and consumed, and centrally for governance of
the system. Nutrition expenditures are tracked within the nutrition deficiency category, though
other categories also include expenditures that are either nutrition specific (e.g. maternal and child
health services, deworming, noncommunicable disease) or nutrition sensitive (e.g. WASH). The
SHA methods use audited budgets to capture government expenditures. In addition it uses
surveys and primary data collection to capture donor/NGO/insurance/household health
expenditures. The collection and reporting of data is aimed to be done on an annual basis.

It might be worth to also consider other sources, such as the Global Analysis Assessment of
Sanitation and drinking water (GLASS) for WASH financing UNESCO Institute of Statistics (UIS)
for education financing and WHO health specific reports (e.g. on Malaria/TB financing). Although
the data can be based on estimates/surveys and not available on an annual basis, it may help
inform or prove a reference point for the analysis of budget documents.

Considering the different finance data sources, it is important to understand where there is overlap
(double-counting) of finances and where there might be gaps in reporting (missing data).

This guidance note treats the national budget as the primary data source. However, a
country team may want to use additional sources to complement with missing data or to spot-
check, especially for expenditure data.

For off-budget donor data, it is safest to use only one source. The recommended data source is
the Aid Management Platform (if available and deemed of sufficient quality). Alternatively, the
DAC CRS country database could be used. This decision should be made on the quality and
completeness of the available data.

Decisions on additional data sources to supplement those data should be based on feasibility and
usefulness as well as considering risks of double-counting. For off-budget CSO/NGO funding,
there are no existing sources of data available that give a complete picture of this funding source.
In this case, a decision would need to be made on a case-by-case basis if a primary survey data
is required.

5. Collect the finance data

The proposed approach by the SUN Movement is based on two compulsory steps (Step 1 and
Step 2) and one optional step (Step 3).

• Step One: Identification (See Annex B for details) - Identify the relevant budget line items
(e.g. programmes or departments) based on the National Nutrition Plan (where available) and
through a search of key terms. The existence of a common results financial management
systems framework for nutrition can guide sectors to decide which budget line items to include
or not.
• Step Two: Categorisation (See Annex C for details) - Assess whether the programmes or
departments found fall under the category of “nutrition-specific” or “nutrition-sensitive”
investments. “Nutrition-specific” budget line items would be those that reflect a nutrition
department or a nutrition programme or a nutrition intervention. To be “nutrition-sensitive”, a
budget line item would need to include a programme that addresses underlying causes of
malnutrition and especially is beneficial to the most vulnerable population including children
and women.
• Step Three: Weighting or (Optional) (See Annex D for details) - Attribute a percentage of
the allocated budget to nutrition (weighting). This percentage should be based on the
categorisation (Step Two), but also on a judgement call by national experts to estimate

5
 investments towards nutrition components/activities in the program. There is a trade-off
between accuracy and replicability and transparency. A detailed review of each programme
can more accurately establish what proportion of it can be attributed to nutrition. This should
not come at the expense of replicability and transparency if the process is made complicated
and cumbersome. In its simplest form, countries may choose to allocate 100% of the amount
in the case of budget line items that have been categorized as “nutrition-specific” while a
reasonable amount decided by the stakeholders (e.g. 25%) would be allocated in the case of
budget line items that have been categorized as “nutrition-sensitive”.1 Whether or not a
“weight” is applied, consider how best to interpret this data and the policy implications.

National policies, strategies and plans, or else the existence of a common results
framework for nutrition agreed across the engaged sectors, should provide the main guidance
to inform the discussion about what to include (Step One) and how to categorize the identified
budget line items (Step Two).

Step One is part of the preparatory work exercise that can be done as a desk review while Step
Two requires close consultation with the experts that are familiar with the programmes. The final
results need to be validated through a meeting with the members of the SUN Multi-Stakeholder
Platform.

Collect the finance data for the first time

Country teams are free to use their own template and approach when undertaking the budget
analysis. However, if they wish to share their results with the SUN Movement Secretariat, they
are asked to provide the report as well as the raw data (in whatever format). If not using the SUN
template, please label all variables clearly with units (i.e., currency, millions)”.

The section below provides a description of the approach and template that is provided by the
SUN Movement Secretariat and that can be used by country teams undertaking the analysis for
the first time.

Country teams should identify one or two national persons to conduct the initial data
gathering and populate the Excel Template (see Figure 1) based on the agreed key terms to
do the search (Annex B) or on the list of agreed programmes by the SUN Government Focal
Point and the members of the Multi-Stakeholder Platform based on the national strategies, plans
or common results framework.

Ideally the people gathering and compiling the data should include technical persons, who are
familiar with the nutrition-related programmes and financial persons, who are familiar with the
national budget and public finance system of the country. Completing Step 1 is the most laborious
task of the budget analysis and will depend on the budget structure and level of details available.
Country teams that experiences problems to transfer data from the original source to the Excel
sheet can contact the SUN Movement Secretariat for support.

The SUN Movement Secretariat provides the Excel Template (figure 1), which allows the data
gatherer/s to code crucial pieces of information for each programme.

1
This is consistent with the attribution agreed by the Donor Network for programmes categorized under ‘nutrition-sensitive’.

6
7
Figure 1 (SUN Excel Template):

The Excel Template allows the data gatherer/s to identify information for each budget-line item.
Here are the types of questions and guidance that the data gather receives for populating the
template:

• MDA: Type the name of the Ministry, Department or Agency in which you found the budget
line-item
• Search term: Type the term you searched for, if you used a search term
• Name of budget line items: Write as it appears on the budget
• Budget line item description: Search for the programme in the budget speech or other
official documents and copy-paste initial sentences
• Funding source: Type in "Domestic resources" (funded by the budget from own funds)
or multi-donor trust fund, or specify development partners, if those are included. If
information is coming from DAC CRS or Aid Platform specify in the Data Source
• Data source: Type in the exact source. If it's in the national budget, it will be
http://www.mofep.gov.gh/?q=budget-statement/30-01-2016/budget-estimates-ministries-
departments-and-agencies-0
• Budget Year X (e.g. 2014): Type in the amount. You can add columns for Actual
Expenditure or another year if these are available
• Other relevant information: Add columns for additional details as deemed appropriate.
E.g. Programme or activity in the National Nutrition Plan that it contributes to
• Does the budget include personnel costs? Please, just answer Yes or No and we will
follow up with additional questions. See Annex E.

8
 • Does the budget include sub-national government allocations? Please, just answer
Yes or No and we will follow up with additional questions. See Annex E.
• Step 2: Categorization (specific or sensitive): Please, identify whether the budget-line
item is nutrition specific or nutrition sensitive. For more information consult Annex C: Step
2 – Categorisation of Budget Line Items found on page 21 of this document.
• Step 3: Weighting: please consult Annex D: Step 3 – Weighting of budget line items on
page 26 of this document. The step is optional, but information can be found here should
you wish to conduct the weighting of identified budget line items.

Once the Excel Template is populated, the document should be reviewed by a technical team
prior a more open consultation. The final product should then be sent to the SUN Movement
secretariat.

The Excel Template shown in Figure 1 one is adapted to the programme level as this is the most
common level of budget disaggregation. Countries that have a budgetary structure at the sub-
programme level are recommended to add one column for the ‘sub-programmes’ in the provided
template. Countries that are able to identify allocations and external expenditures from both
domestic and external funding sources for each budget-line item are encouraged to add columns.
In short, the template can be modified to accommodate additional details.

Box 1: FAQ - How do we capture external funding?

A budgetary analysis tracks funds that are included in government budget documents. This
includes domestic funds and also those donor funds that are reported through the national
budget.2

It is important that you specify the source of funding in the “Funding Source”: Type in
"Domestic resources" (funded by the budget from own funds) or “multi-donor trust fund”,
“development partners” if those are included. These are usually defined in the official budget
document and can be taken directly from that source. You can also specify the percentage
from domestic and external funding if this is available for a specific programme.

This also means that when available, you can include budget items from other data sources
such as donor mapping tools available in your country (e.g. Aid Management Portal). Please
make sure you complete the information in the “Data source”.

Repeat the finance data collection in a given year

The section explains what to do in the event the country team wants to change their reporting
scope from the previous baseline. For example, country teams may want to restrict their analysis
to fewer ministries and programmes if they realize that a narrower scope is more useful to their
advocacy and tracking work. In other cases, they may want to enlarge their analysis with
additional ministries and programmes to better reflect changes in their planning and budgeting
cycle. This section also explains how to report expenditures against allocations reported in the
previous year.

2 This does not imply that the funds are disbursed and managed through the government’s revenue funds:
they can be disbursed outside the treasury system but still be reported on the budget documents.

9
The overriding priority in moving forward is institutionalizing the budget analysis at the country
level. This priority is aided by the fact that the budget analysis is designed to be easily managed
after the initial round of data collection. Specifically, the information collected in the first year
of the exercise then serves as a baseline for the following years. This baseline allows country
teams to both easily update a new data point on allocations for existing programmes, and record
allocations for new programmes when they arise. In short, the information gained from the first
budget analysis becomes easier to identify and more credible to analyse with each subsequent
year.

Underlying the priority of institutionalizing the budget analysis is the replicability of the exercise.
Once a country team identifies a nutrition related programme it remains identified in subsequent
analyses repeated over the years. Maintaining the same denominator as a baseline is essential
for consistent data collection, recognition of efforts and accountability, and robust analysis of
trends across time. In addition, maintaining the baseline year after year makes it easier to identify
the new programmes that have been added and to further assess if this is a true indication of the
multi-sectoral approach for nutrition becoming entrenched in more ministries, agencies, and
departments.

For the replicability of the exercise, country teams participating in the exercise for a second or
third time should identify the person/s to update the Excel Template (Figure 1). Ideally the team
should be composed by the same people (technical and financial staff) year after year. The
finance person is required to identify the relevant programmes and nutrition-related activities in
the yearly budget and update allocation and expenditure figures for each budget line item. If the
country is moving toward more routine systems for nutrition financial tracking, then the country
team needs to be sure to include the essential information from the excel sheet into that new
system.

To repeat the finance data collection, each country team receives the following elements from the
SUN Movement Secretariat:
• The cover email which asks for specific pieces of information to update the data collection
(i.e. an additional data point and/or expenditures and/or missing information such as
sources of funding).
• The country-specific Excel Template with the data received from the previous year/s
(baseline).
• The Country Investment Snapshot based on the data from the previous year/s.

Country teams need to identify new programmes via email or directly in the Excel Template
through colour coding or writing the names of new programmes in a separate worksheet.
Terminated programmes also need to be identified either via email or directly in the Excel
Template through colour coding. This allows for a speedy identification of what is new and old
and what is terminated. At the same time, all active programmes that are still active should be
kept in the template and updated with the funding allocation for the most recent year. The amount
of zero should be indicated in the template if the active programme did not receive any funding
allocation for the most recent year.

Country teams can ask for additional support through the SUN Movement Secretariat.

10
6. Analyze and interpret the finance data
Each country should define what analysis is critical for their own work planning process, and what
will resonate with their decision makers. The SUN Secretariat or a chosen technical assistance
provider can assist in these discussions and provide tailor made options to the country teams.

To improve the analysis and interpretation of the finance data, the SUN Movement Secretariat
has summarized the findings into one profile for each participating country. These profiles can be
tailored to the specific needs of each country team based on the specific use.

Depending on the quantity and type of budgetary data provided, a Country Investment
Snapshot succinctly combines three levels of analysis: (1) nutrition-related allocations, (2)
temporal trends, (3) geographic variations.

The first level of analysis covers four primary elements:

• Nutrition relevant allocations across Ministries, Departments and Agencies (MDA’s);
• Nutrition specific and nutrition sensitive budget allocations;
• In-depth overview of nutrition specific programmes
• Nutrition relevant allocations across five sectors (Health, Agriculture, Education, Social
Protection and WASH).
• Overview of programmes that are main drivers of spending

These elements allow for a snap-shot picture of budgetary allocations and public investments
related to nutrition in a country.

The second level of analysis identifies financial trends over time. Utilizing a deflator to ensure that
trends overtime account for inflation, this analytical level is particularly useful for highlighting
longitudinal allocation patterns across Ministries, nutrition-specific and nutrition-sensitive
allocations, and financial allocations across sectors. When financing sources are available, the
country profiles also identify temporal variations in allocating patterns across domestic and
external funding sources.

The third level of analysis disaggregates the budgetary data found in the first and second levels’
across space. This analytical feature allows for a disaggregated picture of nutrition related
budgetary allocations by tracking geographical patterns of nutrition-related allocations. The data
can also be assessed across time which captures unique geo-temporal allocations patterns
across relevant MDA’s.

Combining these levels of analysis, the developed profiles offer a country by country snapshot of
public investments related to nutrition. These profiles have been used to inform the country visits
of the SUN Movement Coordinator and to inform other global partnerships (e.g. Sanitation and
Water for All, Global Food Fortification) on the types of investments that were identified in a
specific country. In addition, tailored country profiles were prepared and shared upon request with
the teams in Kenya and in Pakistan.

11
Figure 2: SUN Movement Country Investment Snapshot (Example)

12
7. Use the finance data
Following the conclusion of this exercise, the results can be used for improving decision making
on allocations and expenditures for nutrition.

The USAID-funded SPRING Project has gathered and synthesized information from 11 countries
to better understand how they have used findings from their budget analysis activities to improve
decision making regarding funding allocations and expenditures for nutrition. Their findings are
presented in Figure 3 below.

How to unpack essential data from the budget analysis

Making the case for “more money for high-impact nutrition-specific interventions”
The set of high-impact nutrition-specific interventions has been widely documented with the 2013
Lancet series on Maternal and Child Nutrition and most recently with the Investment Framework
for Nutrition (Shekar et al.), which also provides an overview of the unit costs for the interventions
in a number of countries.

Countries that have prioritized and costed high-impact nutrition-specific interventions in their
national plans can go one step further by analysing a sub-set of interventions from their budget
analysis that can be reasonably aligned to those planned interventions.

The review of the findings from the budget analysis shared by SUN countries over the past three
years show that, although not widely present, the following interventions were identifiable: Infant
and Young Child Feeding promotion, Vitamin A supplementation, Severe Acute Malnutrition
treatment, Iron and Folic Acid supplementation, Salt iodization and Food Fortification.

In order to compare costed and budgeted estimates, the level of disaggregation of the
finance data must be equivalent. This means that if a country team compares a costed nutrition-
specific intervention (e.g. promotion of IYCF) with a budgeted programme (e.g. integrated
maternal, new-born and child health care), the scale will be significantly different. Even if a weight
is applied, the comparison will still be inaccurate as it is impossible from the budget analysis alone
to exactly account for the portion of budget allocated to nutrition-specific interventions

Recommendations for the country team making the case for “more money for high-impact
nutrition-specific interventions” are to:
• Include only those interventions that are comparable in terms of costed and budget estimates.
• Expand the search for finance data by looking at complementary sources to the national
budgets including SHA reports and AMP and DAC/CRS datasets.
• Discuss the financing gap with donors and development partners to come up with an agreed
estimate to reach the nutrition targets. 3

Making the case for “more nutrition from big drivers of sectoral spending”
The review of the findings from the budget analysis shared by SUN countries over the past two
years shows that most of the domestic spending goes to investments that address underlying
determinants of nutrition. However, many of the so-called “nutrition-sensitive” investments are
too broad to really understand who the targeted beneficiaries are and even what types of

3 The Investment Framework for Nutrition (Shekar et al) provides a useful reference to compare current
funding with financial needs to reach the global targets for stunting, anemia, breastfeeding and wasting.

13
included activities could be nutrition-sensitive. In addition, the classification of nutrition-sensitive
investments should be done on a case by case basis.

If the aim is to make the case for more effective spending for nutrition, it is important to clearly
identify those programmes that will make the most significant difference if well designed with an
intent to improve nutrition.

Recommendations for the country team making the case for “more nutrition from big drivers of
sectoral spending” are to:
• Include only programmes that can be acted upon because of the level of sectoral
engagement for nutrition, including opportunities such as the mobilization of external
funding.
• Focus on those programmes that are drivers of spending in key sectors as they are more
likely to be sustained over the years.
• Introduce the discussion on what it takes to make these programmes more “nutrition-
sensitive”. This could imply changes in terms of targeting, implementation or even
integration of nutrition-specific interventions (Leroy et al 2017).

How to use the data for advocacy

Advocacy must be guided by facts generated by research and analysis if it is to command
credibility and add value. It is therefore essential to use robust data to inform compelling,
evidence-based arguments for increasing investment in nutrition. Existing investments need to be
clearly tracked and their benefits assessed, while gaps must be identified and their consequences
calculated. Transparency in the collation and presentation of figures is a precondition for the
accountability that accompanies budgetary responsibility. In all of this, the choice of the most
striking, validated facts is key.

Effective budget advocacy always needs to include a thoughtful media strategy. This is
essential for moving the discussion from budget analysis to engagement and action. That strategy
generally has two parts: knowing what message you need to communicate and finding ways to
draw media attention to that message. Messages should always be communicated to the media
in straightforward, accessible language. Both traditional and new media channels should be used
for communication (see Box 2). Parliamentarians are also key players to disseminate information
and ask questions.

Engaging with civil society

Nutrition budget advocacy is about lobbying and campaigning to change the way public resources
are used to deliver nutrition services to the most nutritionally vulnerable population. By analysing
how nutrition is funded and how budgets are constructed, civil society groups will have more
opportunity to support governments in how they direct nutrition spending. They will also stand a
better chance of holding governments to account regarding their policies, as well as their
achievements vis-à-vis their plans.

At both the national and local levels, civil society organizations can play an important role in
ensuring transparency and accountability for nutrition spending. Nationally, they can get involved
in defining priority areas and planning processes, provide neutral platforms for sharing this
information, and engage parliamentarians or other influencers who could potentially help
champion nutrition. They can also join the efforts of staff in ministries by advocating for appropriate
and timely disbursed funds.

14
At the local level, they can oversee and monitor expenditures, and use ground level findings to
call for changes in budget allocations and planning priorities. They can also ensure the link with
communities.

Box 2: The essentials of good communication

The following check list was developed by SUN countries during the regional workshops on
public financing:
.
- If you cannot communicate a clear, concise and compelling message in less than one
minute, you risk losing the other person’s attention.
- The message is the overarching theme that holds an entire campaign together.
- It is not easy to reduce complex issues such as nutrition to one simple statement. But this
needs to be done, because complex and overly technical messages do not get attention.
- Problems do not get support– solutions get support.
- Lead with something positive.
- Meet your audience where they are.
- Specify your “ask”.

15
Figure 3. Results of an 11-Country Study on the Use of Budget Analysis Findings by the SPRING Project
Source: SPRING. 2017. Putting Budget Data to Work for Nutrition. Arlington, VA: Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) project.
https://www.spring-nutrition.org/technical-areas/systems/budgeting
Annex A: References
ACF (2017) “Le playdoier budgétaire pur la nutrition: manual destine aux acterus de la société
civil” (forthcoming English version and link)

Brown S (2016). “How to Engage in Budget Cycles and Processes to Leverage Government
Budgets for Children”. United Nations Children’s Fund. Available at:
https://www.unicef.org/socialpolicy/files/Engaging_in_Budget_Cycles_and_Processes_FINAL.p
df

D’Alimonte M, Rogers H, and de Ferranti D (2016). “Ch. 7 Financing the Global Nutrition
Targets” An Investment Framework for Nutrition: Reaching the Global Targets for Stunting,
Anemia, Breastfeeding, and Wasting. World Bank Group. Available at
https://openknowledge.worldbank.org/handle/10986/26069

Leroy J, Olney D, Ruel M (2017) “Evaluating Nutrition Sensitive Programs: Challenges, Methods
and Opportunities” in Plney, Leroy and Ruel (forthcoming). Article available at:
http://ebrary.ifpri.org/utils/getfile/collection/p15738coll2/id/130766/filename/130977.pdf

R4D (2016). “Nutrition Financing in Rajasthan: Trends and Gaps in 2016-17” Available at
http://www.r4d.org/knowledge-center/tracking-nutrition-financing-rajasthan

Simson R, Sharma N, and Aziz I (2011).” A guide to public financial management literature For
practitioners in developing countries”. World Health Organization. Available at
http://www.who.int/pmnch/media/events/2013/pfm_literature.pdf

SPRING 2017. Putting Budget Data to Work for Nutrition. Arlington VA:Strengthening
Partnerships, results, and innovations in nutrition globally (SPRING) project.

Guidebook and E Learning Module

Action Against Hunger, Save the Children UK and the SUN CSN Senegal platform, in
partnership with the SUN Civil Society Network are pleased to announce the launch of an
Handbook on budget advocacy (available in English, French version is still under design). A E
Learning module accompanies the guidebook, and will be made available in March 2018 in the
SUN CSN website.

The objective of these two advocacy tools is to provide civil society actors as well as other
actors (such as members of multi-stakeholders platforms for nutrition) who are active or
interested in budget analysis and/or advocacy with a comprehensive document and E learning
that gathers the main elements of budget analysis and advocacy on nutrition, including the
budget process, development of budget advocacy strategy, and practical cases. In addition,
Interviews of key players in budget advocacy were conducted, including that of Patrizia
Fracassi, Senior Nutrition Analyst and Strategy Advisor in the SUN Movement Secretariat.

Emphasis was placed on the difficulties encountered by previous actors and how to overcome
them, as well as key steps in budget analysis and advocacy. This manual aims to empower civil
society actors who would like to embark on budget advocacy by providing them with the keys to
successful advocacy. It will also allow all actors who have already carried out budget analysis
and advocacy activities to guide their choices for future budget advocacy for nutrition.

Annex B: Step 1 – Identification of budget line items

The first milestone is to share the national budget or the official financial documents that are
going to be used for the exercise.

The second milestone is to provide a list of key sectoral domains that will be included in the
exercise:

• The Ministries of Health, Agriculture and Education are clearly identifiable in all national
budgets.
• The functional areas of social protection, WASH and gender may be in the in the title of
different ministries depending on the country.

Please, clearly list all the Ministries you want to include using the same title as indicated in the
national budgets or the financial documents.

The third milestone is to carry out the search of key terms.

The basic key-word search will be done using the word ‘nutrition’ to identify ‘nutrition’ budget
line items (i.e. programmes, departments, interventions, etc.).

The advanced search of key terms will be done based on the findings from the 30 countries
that carried out the exercise in 2015.

• How do we decide which “terms” to look for?

The starting point to identify key terms should be the National Nutrition Plan or the Common
Results Framework. This assumes that the budget derives from the plan.

Based on the findings from the 30 countries that carried out the exercise in 2015 and international
experience and literature (e.g. Geir et al., SUN Donor Financial Tracking methodology, 2013
Lancet Series, 2010 SUN Framework of Actions, WHA Global Monitoring Framework), we provide
an initial list. However, this list should be adapted by the country based on their national nutrition
plan or, where available, common results framework.

Sectoral Key terms

domain

Health: maternal, neonatal, child and adolescent health, overweight, obesity, non-
communicable diseases, hygiene, micro nutrients, feeding practices, malnutrition,
family planning or reproductive health, HIV/AIDS and TB, sanitation, child
immunization, education, food safety, baby-friendly

Agriculture: women, staples (grains, roots, cereals), legumes, pulses, nuts, fruits and vegetables,
animal sources / livestock, fishery sources, extension services, cooperatives,
smallholders, food aid, relief, family farming, food, food security, hunger, agriculture

1
 production, rural development, bio fortification, food-safety, food quality, aflatoxin,
trade, food fortification, markets.

Note: differentiate what is done to enhance domestic vs. export markets

Education: female education, rural education, female secondary education, school feeding /
meals, early child education / development, WASH, hygiene, hand-washing, adult
literacy, education equity

Social women, children, safety net programs, cash and voucher transfers, orphan and
protection vulnerable children (OVC), pension, insurance, welfare services, emergency,
humanitarian, relief, maternity leave, pro-poor

WASH: drinking water supplies, environment, sanitation, sewages, rural / urban areas,
hygiene, latrines, community-led total sanitation (CLTS)

• What should we include?

In order to include a budget line item as part of Step One, it has to fulfil the following essential
criteria:

• The budget line item clearly reflects a sectoral priority that is included in multi-sectoral
planning efforts for nutrition.

• It is possible to identify the target population in terms of direct and indirect beneficiaries.
▪ Direct beneficiaries: 1000 days window of opportunity (pregnant and lactation women
and under 2s children), children adolescents and women of reproductive age.
▪ Indirect beneficiaries: households and communities at risk of malnutrition
(segmentation by livelihoods, vulnerability, etc.)
• It is possible to define a measurable outcome, recognize where this outcome stands within
the nutrition impact pathways and monitor this outcome using existing information
systems. Examples include: increased coverage of DPT3 immunization, increased
coverage of drinking water sources, etc.4
If information on target population or measurable outcome is not available, it is deemed better to
exclude the budget line item from the analysis.

4An exhaustive set of indicators is available in the Country Profile Indicators Table developed by the Independent Expert Group of the
Global Nutrition Report http://globalnutritionreport.org/files/2014/07/Country-Profile-Indicators-Table.pdf

2
Annex C: Step 2 – Categorisation of budget line items
Step Two asks in-country teams to categorize the identified budget line items into two main
headings:

“SPECIFIC” refers to high-impact nutrition actions as described in the 2013 Lancet nutrition
series (see Figure 2). These are sometimes referred to as “direct” interventions. Budget items
that are specific to nutrition (so-called “nutrition budget lines”) would be those that include a
nutrition department, a nutrition programme, a nutrition intervention or a nutrition activity
depending on the structure of the budget.

The Lancet definition of nutrition-specific actions is as follows: “Nutrition-specific interventions and

programmes address the immediate determinants of foetal and child nutrition and development –
adequate food and nutrient intake, feeding, caregiving and parenting practices, and low burden
of infectious diseases.”

“SENSITIVE” refers to actions that address the underlying determinant of malnutrition as

originally set out in the UNICEF conceptual framework. These were further adjusted in the 2013
Lancet nutrition series (see Figure 2).They include actions from a range of sectors including:
health; agriculture and food systems; water, sanitation and hygiene promotion (WASH);
education; and social protection. Budget items that are sensitive to nutrition are those that clearly
mention a nutrition-relevant objective and/or outcome and/or action as part of an integrated
programme or as part of a department mandate.

The Lancet definition of nutrition-sensitive actions is as follows: “Nutrition-sensitive interventions

and programmes address the underlying determinants of foetal and child nutrition and
development – food security; adequate caregiving resources at the maternal, household and
community levels; and access to health services and a safe and hygienic environment – and
incorporate specific nutrition goals and actions. Nutrition-sensitive programmes can serve as
delivery platforms for nutrition-specific interventions, potentially increasing their scale, coverage,
and effectiveness.”

The feedback from countries that used the 3-Step Approach in 2015 revealed the need to provide
further guidance to standardise budget allocations into “nutrition-specific” and “nutrition-sensitive”
interventions. The conclusions are the following:

• The 2013 Lancet Framework was agreed as the starting-point.

• For “nutrition-specific” interventions, emphasis was placed on the importance of the
continuum of care targeting the First 1,000 Days (pregnant and lactating women and
children under two years) and women in reproductive age, including adolescent girls.
• There was considerable discussion about whether the following interventions should be
regarded as “nutrition-specific” or “nutrition-sensitive”: overweight; obesity and Non-
Communicable Diseases (NCD) management; HIV/TB and malaria management; food
safety; reproductive health services; and child immunization.
• When it was not obvious from the programme name or description, two criteria were
identified as useful for taking decisions on the categorization: 1) Defining the expected
outcomes (e.g. child nutrition status or an immediate or underlying determinant of child
nutrition status); and, 2) Identifying the targeted population (direct and indirect
beneficiaries of a given action).

3
Figure 2. Framework for actions to achieve optimum foetal and child nutrition development
(LANCET 2013)

The table below presents the specific examples from the 30 countries that carried out the budget
analysis in 2015, broken down by nutrition-specific and nutrition-sensitive budget lines and by
sector. These can be further sub-categorised by typology, which in turn allow us to decide whether
they are nutrition-sensitive or nutrition-specific.

Table 1: Examples of budget line items categorized as “nutrition-specific”

Sector Typology Example
Budget line item
Health High-impact stand-alone nutrition Supplementation of Vitamin A (Burundi)
intervention or programme Supplementation of Iron and Vitamin A to
young children (Peru)
Health and Stand-alone nutrition intervention or PRONANUT (Congo DRC)
other sectors programme Nutrition Program (Mauritania, Ministry of
Social Affairs)

Health Integrated health programme Management of safe delivery without

complications, which includes early
initiation of breastfeeding (Peru)
Non-health Integrated non-health programme Training and capacity building of farmers
and extension workers on food based
nutrition and health across age groups
along with participatory field monitoring
and evaluation (Bangladesh)

4
 Table 2: Examples of budget line items categorized as “nutrition-sensitive”

Thematic Typology Example

Sector Budget line item Explanatory note provided
Health Food safety Food Safety and Hygiene This budget-line item of Government
(Vietnam) management supports all activities and
research for the Programme of Food Safety
Child Surveillance and Implementation of immunization and
immunisation Immunization (Indonesia) surveillance
Integrated Maternal Reduce maternal, neonatal Improve governance and strengthen efficiency
and Child Health and child health morbidity and effectiveness in health service delivery;
Care5 and mortality Budget-line item related to the Program
(Ghana) “Health Service Delivery - Strategy formulation
and operational coordination”
Reproductive Increase Advocacy and IEC IEC for improving the Family Planning
health care Program (Indonesia) Program recipient
Health & Nutrition Mass media (Tajikistan) Organization and regulation of broadcasting
education and publishing events. Operation and support
of broadcasting services. Expenses, including
transfers, loans or other types of support for
the construction or acquisition of conditions for
TV broadcasting, production of broadcasting
material and its preparation for presentation.
Management, operation and support of
publishing services. Costs, including loans,
transfers and other forms of support for the
construction and acquisition of plant,
equipment and material for newspapers,
magazines and book publishing, news and
information gathering and dissemination of
published work.
Overweight, Non-communicable diseases This budget line item supports all activities for
obesity and NCD (Vietnam) prevention of cancer, diabetes, and high blood
pressure
Infectious diseases Programme National de lutte
(HIV/AIDS, TB and contre le paludisme /
Malaria) National Program against
Malaria (Chad)
Basic health care Clinical services (Kenya)
(generic)
Education Early child The provision of early To ensure accessibility of early childhood
development childhood services education related to food nutrition and
(Indonesia) parenting

Education – Establishment of Girls

closing gender gap Degree Colleges in Sindh
(Pakistan)

5
Most of the integrated Maternal and Child Health Care Programmes have been classified as “nutrition-specific” budget line
items

5
Thematic Typology Example
Sector Budget line item Explanatory note provided
Education – Revised English Literacy Improve quality of teaching and learning for the
access to all curriculum and Instructional Program “Non-formal Education”
Materials (Ghana)
School meals Provide Feeding for SHS Increase equitable access to and participation
Students (Ghana) in education at all levels for the Program
“Management and Administration - Pre-
Tertiary Education Management”
Health education in Healthy Schools (Guatemala) Promoting Health and Nutrition in Schools
schools
Education Planning and budgeting This contains generic spending that related to
(generic) department (South Sudan) different types of activities including (but not
specified to) school feeding, M&E and
improvement of education quality
Agriculture Food safety Aquatic animal health and To reduce health risks associated with
Post-Harvest management fisheries exploitation, production and utilization
(Ghana) along the value chain. To ensure safe and
quality in fish product processing.
Agriculture Agriculture Extension
services Services (Nepal)
Food security Food Security and This programme seeks to ensure the food
Development in agriculture security
(Vietnam)

Rural development Agriculture and rural

development (Vietnam)
Livestock Appui au développement de
l'aviculture moderne (Benin)
Fishery Fish Health System
Development and Fish
Farming (Indonesia)

Agriculture Increased Growth Income Build capacity of peri-urban vegetable

production – non- (Ghana) producers in good agricultural practices
staples (GAPs)
Agriculture Production Management of To increase productivity of Cereals
production Cereals and Various Crops
development (Indonesia)
(generic)
Social Welfare services Centre Mère et Enfants de
protection Maternal & Child Kinshasa-Ngaba (DRC)

Palnaghar (creches) and Palnaghar/ Creches initiated and implemented

mothers meeting in 6 high burden tribal districts. Will also be
(Maharsastra) implemented at the aganwadi level with the
support of DWCD staff.
Welfare services Street children rehabilitation
Orphans and center (Kenya)
Vulnerable
Children (OVC)
Welfare services Social welfare (Kenya)
(generic)

6
Thematic Typology Example
Sector Budget line item Explanatory note provided
Humanitarian / Disaster preparedness and
emergency relief response (Kenya)
Cash transfers / Social Welfare Assurance To support the implementation of Conditional
safety nets (Conditional Cash Transfer / Cash Transfers for Very Poor Households (
PKH) Rumah Tangga Sangat Miskin )
(Indonesia)
Social protection Child Protection Child protection
children (Indonesia)
Social protection Preparation and To increase woman participation in policy-
women harmonization of policies on planning, politics and decision-making.
women's participation in
politics and decision-making
(Indonesia)
Baby-care for working
mothers (South Sudan)
Social protection Project and Control Program
(generic) Against Poverty and the
Legacy of Slavery
(Mauritania)
WASH Sanitation only Regulating, Development, To support the wastewater infrastructure;
Supervision urban drainage infrastructure; Waste
and Implementation of Infrastructure place of final processing;
Sanitation Infrastructure Integrated Waste Processing / 3R
and Solid Waste infrastructure
(Indonesia)
Promotion of Programme de promotion de
sanitation and l'hygiène et de
hygiene l'assainissement
(Benin)
Drinking water Establishment of Drinking
supply Water Hubs (Phase-I,II,III,IV)
(Pakistan)
Water and Water Supply & Sanitation
Sanitation (Pakistan)
(WATSAN)
Water supply National Water Conservation
(generic) and Pipeline Corporation
(Kenya)

7
Annex D: Step 3 – Weighting of budget line items (OPTIONAL)
Some nutrition-specific budget line items are straightforward to track. They may include a
specified activity of an integrated programme or a specified intervention/activity that clearly refers
to high-impact nutrition actions as described in the 2013 Lancet Nutrition Series. The weighting
is never required when national budgets are disaggregated to a sufficient level to allow a clear
delineation of the budget amounts contributing to nutrition outcomes (e.g. Guatemala, Peru).
When this is the case, the breakdown of budget line items provides enough detail to attribute a
budget line item as nutrition-specific or nutrition-sensitive.

However, this level of disaggregated data is often unavailable in many national budgets or not
easily accessible. Most often, the budget line items will reflect a broader intervention such as an
integrated programme for Maternal and Child Health. In these cases, we can assign a ‘weight’ as
a proxy of the proportion of a particular budget line item that is contributing to nutrition outcomes.
The way to estimate the ’weight’ is based on its activity breakdown, which is determined through
document review, key informant interview, etc. Disaggregating data for nutrition-specific budget
line items is particularly important for defining the financial gap for high-impact interventions to
achieve the six Global Nutrition Targets.

If a budget line item cannot be broken down into separate activities, you can apply a weight based
on your own judgement. The main aim of weighting is to increase consistency when reporting the
findings. The weighting does not automatically translate into actual allocations, it is a proxy on
how much is estimated to be allocated to activities contributing to nutrition outcomes. Ending up
with a report that includes a significant proportion of nutrition-sensitive budget line items that are
given the lowest weight (e.g. 1%) because of lack of information is not the most practical way to
then move further with the tracking of the expenditures.

In 2015, half of the countries went through Step 3, using different types of weighting schemes:

• Method One: A dual weighting system based on the donor methodology (100% highest, 25%
lowest);
• Method Two: quadruple system (100%, 75%, 50 % and 25%);
• Method Three: a range (100% highest and 1% lowest).
• In addition, few countries also applied a weight to nutrition-specific allocations.

The table 3 below is based on the weight applied by countries to most commonly found types of
nutrition-sensitive budget line items. Results show that, with few exceptions, the median for most
of the weighted budget line items is 25% even when the countries are using a flexible
method.

The table 3 shows that there is a wide range in the applied weights. The budget line items that
have been given the largest weight (e.g. 75% or 100%) could be isolated and further discussed
with the national sectoral experts to better understand what makes them out-standing. This could
be helpful to gain important insights on how programmes can be better designed for improved
nutrition impact.

8
 Table 3: Applied weight for nutrition-sensitive budget line items looking at the classified
typologies of interventions

Number of countries Budget lines Reported weights

Thematic In With In With

Typology Smallest Largest Mean Median
sector dataset weights dataset weights

Agriculture Agriculture 23 14 745 341 1% 100% 29% 25%

Agriculture Production Development 15 10 231 111 5% 75% 30% 25%

Agriculture Production Non-Staples 8 5 40 14 10% 75% 35% 25%

Agriculture Services 8 5 30 14 5% 50% 18% 10%

Fishery 10 5 95 30 5% 50% 27% 25%

Food Safety 6 3 23 10 25% 75% 50% 50%

Food Security 18 11 150 80 1% 100% 33% 25%

Livestock 11 8 143 59 5% 75% 26% 25%

Other 1 0 1 0 N/A N/A N/A N/A

Rural Development 10 7 32 23 3% 25% 22% 25%

Education Education 18 10 131 52 5% 100% 38% 25%

Early Child Development 5 3 9 5 10% 50% 24% 25%

Education Access for All 6 2 19 10 N/A N/A N/A N/A

Education Closing Gender Gap 3 0 35 0 N/A N/A N/A N/A

Education Generic 2 2 5 3 N/A N/A N/A N/A

Health & Nutrition Education 5 2 8 4 N/A N/A N/A N/A

Other 2 1 5 1 N/A N/A N/A N/A

School Meals 9 5 50 29 25% 100% 46% 25%

Health Health 24 14 421 170 5% 100% 34% 25%

Basic Health Care Generic 13 7 81 48 6% 25% 21% 25%

Food Safety 5 4 21 6 5% 25% 22% 25%

Health & Nutrition Education 4 1 9 1 N/A N/A N/A N/A

Immunization 10 7 21 16 25% 100% 66% 63%

Infectious Diseases 16 10 119 54 5% 75% 27% 25%

Integrated M&CHC (Mother & Child
6 3 97 8 25% 75% 38% 25%
Health Care)

Non Communicable Diseases 6 5 10 9 10% 25% 23% 25%

Other 3 1 10 2 N/A N/A N/A N/A

Reproductive Health 11 7 43 26 25% 100% 52% 50%

Other Other 7 4 27 10 1% 25% 16% 18%

Governance 1 0 12 0 N/A N/A N/A N/A

Other 7 4 15 10 1% 25% 16% 18%

9
 Number of countries Budget lines Reported weights

Thematic In With In With

Typology Smallest Largest Mean Median
sector dataset weights dataset weights

Social
20 11 248 126 1% 100% 25% 25%
Protection Social Protection

Cash Transfer/ Safety Nets 10 4 39 13 5% 50% 18% 25%

Humanitarian / Emergency Relief 5 4 16 10 10% 50% 30% 25%

Other 1 0 1 0 N/A N/A N/A N/A

Social Protection Children 5 3 14 5 5% 50% 20% 20%

Social Protection Generic 14 10 89 46 5% 100% 30% 25%

Social Protection Women 12 7 53 30 1% 50% 24% 25%

Welfare Services Generic 3 2 4 3 N/A N/A N/A N/A

Welfare Services M&C 4 1 10 4 N/A N/A N/A N/A

Welfare Services OVC 7 6 22 15 5% 50% 26% 25%

WASH WASH 21 12 260 170 3% 100% 22% 25%

Drinking Water Supply 13 9 73 50 10% 100% 26% 25%

Promotion of Sanitation and
5 5 16 14 5% 25% 19% 25%
Hygiene

Sanitation Only 5 2 15 6 N/A N/A N/A N/A

Water Supply Generic 11 7 67 41 3% 50% 16% 10%

WATSAN 14 9 89 59 10% 50% 26% 25%

Grand Total 25 14 1832 869 1% 100% 29% 25%

10
Annex E: Frequently Asked Questions
1. How do we capture capital costs?

Some budget line items represent capital costs and are sector-wide in nature (e.g. drinking water
supply or rural infrastructures). They have the potential to address key underlying determinants
of malnutrition, but it is not possible to determine this with certainty, as no information is provided
as to who will benefit from these allocations (e.g. whether these are the people who need the
intervention and receive it). If information on reach, coverage or potential outcome is not available,
it was deemed better to exclude the budget line item from the analysis.

2. How do we capture personnel costs?

Data analysts led by the SUN Movement Secretariat will assist you with this process. Please fill
in Column “Does the budget include personnel costs? (Yes/No”) in the Excel Template.

One of the challenges in conducting a budget analysis that seeks to account for nutrition-related
expenditures is how to identify and assess personnel costs such as salaries, benefits and
overheads. What is the most adequate human capital in the design and delivery of nutrition
interventions? And where do we find this human capital within a national budget – i.e. which
budget lines contain the personnel costs of this human capital?

In general, we can assume that frontline workers in key sectors (health, agriculture & food
systems, water supply, education and social protection) are the core of the human capital for
nutrition. In most cases, the associated personnel costs are likely to be presented at ministry-
wide level, meaning that it is not possible to know which personnel are allocated to which
programme or service delivery channel. In some cases, there might be disaggregation at the
departmental or programme level.

In each case, one would take the most disaggregated level and estimate the proportion or
personnel time dedicated to nutrition-related programmes. If there is disaggregation up to
programme level, we would need to estimate the additional personnel costs for administration
and management not included in the programme, e.g., time from the ministry’s core personnel.

This means that in order to adequately identify personnel allocations, countries would need to first
decide which of the ministries’ core personnel from key sectors are assigned to nutrition, and,
second, review the functions of these personnel and understand how much time is allocated to
identified nutrition-related interventions. This will involve making assumptions concerning the
proportion of the time spent on nutrition interventions by frontline workers in each sector.

3. How do we capture sub-national government expenditure?

Data analysts led by the SUN Movement Secretariat will assist you with this process. Please fill
in Column “Does the budget include sub-national government allocations? (Yes/No”) in the
Excel Template.

First of all, you need to identify the levels of government in order to be clear on who is responsible
for public spending. Most countries have two or three tiers of government.

11
Identify the assignment of responsibilities across levels of government, primarily in the sectors of
importance for nutrition – public health, education, agriculture, WASH, social protection. Many
countries are undergoing a process of devolution where service delivery is being transferred to
regional and/or local governments. Responsibilities are generally defined in the Constitution and
in basic laws of decentralization but the practice may differ from the legal context.

Allocation and spending at lower government levels are often not included in the main national
budget document. If transfers from the national government are in the form of block grants or
similar, the budget data will not provide details on sector or programme spending. Public spending
in health or in water supply might be higher at local level. In water & sanitation, public spending
is mostly decentralized to the county/municipal budget.

Despite decentralization and apart from Federal States, national governments in many cases
remain responsible for the largest part of government spending. Careful investigation and
engagement at multiple levels might be useful in the beginning, especially for advocacy purposes.
However, tracking of budget allocations and expenditures at national and sub-national level might
require a focus on a priority set of MDAs and budget items to be tenable in the long term.

4. Can we use a system similar to the National Health Accounts to track all resources on
nutrition?

The experience of Côte d’Ivoire shows that it is indeed feasible to extend the process that
countries carry out to produce NHAs to estimate non-health nutrition expenditures. We have
received very positive feedback on the experience and it has provided Côte d’Ivoire with a very
comprehensive picture of all resources for nutrition broken down into various dimensions, and
including public, private, household, NGO and donor expenditure. Their experience is currently
being documented and we hope to be able to share more information soon on how other countries
may want to apply it.

Some of the preliminary limitations identified are similar to any resource tracking mechanisms,
i.e., relate to the level of detail in the data. Spending on activities to prevent or treat any form of
malnutrition or nutrition-related risk factor will be distributed across several diseases/conditions
within the NHA. Thus, dissecting these expenditures depends on the level of detail that countries
use when reporting spending on different activities. Some of the possible advantages include: the
use of assumptions to split expenditure across categories where there is limited level of
disaggregation; its possibility to include both budget allocations and actual expenditure so it is
also forward looking and linked to the annual budget cycle; and, the resources required to carry
out the exercise.

Ultimately it is up to countries to choose how best to track its resources. If the NHA is fully
institutionalised in your country you may consider taking advantage of this already ongoing activity
to - at the first level - make the case for finer granularity in coding for nutrition within Dis.3 and
other disease categories and for extending data collection surveys to NGOs and donors active in
nutrition. At the second level, if you have the resources to extend the process to include non-
health nutrition expenditures, this might be the most suitable mechanism in your case.

Annex G provides the list of contact points for SHA.

12
 Annex F: Aid Management Program (AMP) Listing
Type of
Funding
Included
Country Start (Government,
Public? URL Point of Contact Name & Email
Name Date On-Budget
Donor, Off-
Budget Donor,
NGO/CSO)
Since 2005, the Aid Management Program (AMP) has been an industry-leading online software
application build by Development Gateway for tracking and monitoring development programs. From
Aid
project planning through implementation, both government and donors use AMP to enter data, report
Management
on indicators, generate graphs and maps, and produce reports on public development spending. AMP
Program
has now been implemented in over 25 countries, with ongoing maintenance and support projects in
(AMP)
several countries that include the launch of public portals and faster, more stable and more user friendly
functionalities. Learn more at developmentgateway.org
On-Budget
AMP Burkina http://pga.finances.go Donor, Off- Alimatou Zongo
2008 Partially
Faso v.bf Budget Donor, [email protected]
Government

On-Budget
http://tchad.ampdev. Donor, Off- Mr. Oumar Thiam
AMP Chad 2014 Yes
net Budget Donor, [email protected]
Government

On-Budget
AMP Cote http://cotedivoire.am Donor, Off- Mr. Adama Sall
2014 Partially
d'Ivoire psite.net Budget Donor, [email protected]
Government

Off-Budget
AMP DRC 2008 Yes http://www.pgai.cd/
Donor No public point of contact
Government
Public
Investment
AMP Ethiopia No amp.mofed.gov.et Projects, Donor
On-Budget,
Donor Off-
Budget No public point of contact
On-Budget
http://gambia.ampsite Lamin Bojang
AMP Gambia 2015 Yes Donor;
.net [email protected]
Government

On-Budget
AMP Guinea Moussa Alceiny Barry
2015 No Donor,
Bissau [email protected]
Government

13
 Type of
Funding
Included
Country Start (Government,
Public? URL Point of Contact Name & Email
Name Date On-Budget
Donor, Off-
Budget Donor,
NGO/CSO)
On-Budget
https://haiti.ampsite.n Marc Anglade
AMP Haiti 2009 Yes Donor, Off-
et [email protected]
Budget Donor
PNUD: Mayella Abudo/ GoH: Marilyn
On-Budget
AMP Molina
2011 Yes http://pgc.sre.gob.hn Donor, Off-
Honduras [email protected]/molina.sr
Budget Donor
[email protected]
Government,
On-Budget
AMP Kosovo 2009 Yes http://amp-mei.net http://amp-mei.net/portal/contac
Donor, Off-
Budget Donor
Government
Public
Investment
AMP
2013 Partially http://amp.gov.kg/ Projects, Donor
Kyrgyzstan
On-Budget,
Donor Off-
Budget (partial) No public point of contact
Donor On-
http://ppamp.mpi.gov Dr. Arounyadeth Rasphone
AMP Laos 2010 Yes Budget, Donor
.la/ [email protected]
Off-Budget

Donor On-
http://41.86.8.147/po
AMP Liberia 2008 Yes Budget, Donor
rtal
Off-Budget
http://41.86.8.147/portal/contact
Government,
AMP http://www.amp- On-Budget Zefania
2009 Yes
Madagascar madagascar.gov.mg Donor, Off- [email protected]
Budget Donor
Tiya Kanthambi, Jane Mbughi,
Donor On- Chinsinsi Phiri
http://amp.finance.go
AMP Malawi 2008 Yes Budget, Donor [email protected],
v.mw
Off-Budget [email protected],
[email protected]

Donor On-
Budget, Donor
AMP Moldova 2013 Yes http://amp.gov.md Off-Budget, no public contact
Government
co-funding

14
 Type of
Funding
Included
Country Start (Government,
Public? URL Point of Contact Name & Email
Name Date On-Budget
Donor, Off-
Budget Donor,
NGO/CSO)
Donor On-
http://amis.mof.gov.n Budget, Donor Tilak Bhandari
AMP Nepal 2009 Yes
p Off-Budget, [email protected]
INGO

Government
Public
Investment
http://pga.gouv.ne/po Seydou Yayé
AMP Niger Yes Projects, Donor
rtal/ [email protected]
On-Budget,
Donor Off-
Budget

Government
Public
http://pgfe.finances.g André Ndecky
AMP Senegal 2009 Yes Investment
ouv.sn [email protected]
Projects, Donor
On-Budget

AMP South http://ssudan.ampsite

2010 No
Sudan .net
Alex Mwakisu, MoFP, External
Finance; Alex Mpangala, MoFP,
External Finance; Salumu Bakari,
Donor On- MoFP, Zanzibar; Christian Shingiro,
AMP Tanzania 2007 Partially http://amp.mof.go.tz Budget, Donor DPG Secretariat
Off-Budget [email protected],
[email protected],
[email protected],
[email protected]
Donor On-
AMP Timor-
2011 Yes aidtransparency.gov.tl Budget, Donor
Leste https://aidtransparency.gov.tl/portal
Off-Budget
/contact
Donor On-
http://togo.ampsite.n
AMP Togo 2011 Partially Budget, Donor
et Christophe Akpoto
Off-Budget
[email protected]
Donor On-
http://154.72.196.89/
AMP Uganda 2011 Yes Budget, Donor
portal/
Off-Budget
http://154.72.196.89/portal/contact

15
Annex G: Contact Points for SHA Methodology (Updated 2017)

Country Name Official Focal Point

Ashadul Islam, Director General, Health Economics Unit, Ministry of Health and Family Welfare, 14/2 Topkhana Road (3rd Floor),
Bangladesh Dhaka 1000. Bangladesh., e-mail: [email protected]
Benin Not available
Mrs Jane Moshosho Alfred
Health Economist (MoH)
+2673632824
Botswana [email protected] and [email protected]
Monsieur Jean Edouard O. DOAMBA
Point focal principal
Ministère de la Santé
[email protected]
+226 70 72 00 66

Monsieur Nassa Tchichihouenichidah

Point focal secondaire
Mnistère de la Santé
[email protected]
Burkina Faso +226 72 17 32 68
1. Monsieur Sublime NKINDIYABARIMAKURINDA
Ministre de la Santé Publique et de la Lutte contre le Sida
Email: [email protected], [email protected], [email protected]
+25779/78368992

2.Jacqueline Niyungeko
Email: [email protected]
Burundi +25779/976694
Cambodia Dr.Ros Chhun Eang, email <[email protected]>
Mr Benjamin KAMENI LELE
Chef de la Cellule des Informations Sanitaires
Ministère de la Santé Publique
+237 99 65 48 14
Cameroon [email protected]
Central African
Republic Not available
Moussa ISSAYE
Point focal CNS principal
Ministère de la Santé
Directeur de la Planification
Tel (235) 99 50 98 55
Tel (235) 63 40 36 36
Chad [email protected]
SAID HAMIDOU BOUNOU
Ministère de la Santé, de la Solidarité, de la Cohésion Sociale et de la Promotion du Genre
[email protected]
Comoros +269 3346812
Mr AKOLI IBOUGNA
Congo [email protected]
Fernando Llorca: [email protected]
Costa Rica Vera Leiva: [email protected]
Madame Gbayoro Christelle
Sous Directrice des études économiques à la Direction des affaires financiières du Ministère de la santé et de la Luttre contre le Sida
[email protected]
+225 02 271 331

Mr Rodrique Ake Sotchi M'bo

Comptable à l'Institut National de la Statistique
[email protected]
Côte d'Ivoire +225 07 906 432

16
 Mr A.G. ELOKO EYA MATANGELO Gérard
Directeur du Programme National des Comptes Nationaux de la Santé (PNCNS)
Ministère de la Santé Publique
Tél (portable) 00243 99 99 055 06 / 81 015 99 89
E-mail : [email protected]

Democratic Mr MONGANI MPOTONGWE EDDY

Republic of the Chef de Service NTIC et Gestionnaire de la Nase de données CNS
Congo [email protected]
El Salvador Gerardo Alfaro Advisor, Health Systems and Services [email protected]
Last name BEKELE
First name EYERUSALEM
Title SENIOR PUBLIC HEALTH SPECIALIST
Position PARTNERSHIP COORDINATION CASE TEAM COORDINOTOR
Email [email protected]
Ethiopia Phone number +251-927604659
Dr Jean-Damascène KHOUILLA
Directeur Général de la Santé, [email protected]

Gabon Dr Ange MIBINDZOU Responsable du secrétariat permanent, [email protected]

Mr Omar Bun Njie
[email protected]

Mr Gibril Jarjue
Gambia [email protected] and [email protected]
Mr Emmanuel Kwakye Kontor
+233 208 240 265
[email protected]

Ms Rahilu Haruna
+233 271 919 783
Ghana [email protected]
Jorge Rodrigo Recinos Diéguez (Coordinador de SIGSA)

Guatemala Edwin Rolando García Caal (experto en estadisticas de varaibles macroeconomicas de SIGSA)
M. Aboubacar Kaba, Directeur du Bureau de stratégie de Developpement au Ministère de la santé [email protected]

Dr Ouy Kindi Diallo, Chef de service Planification au Bureau de stratégie de Developpement au Ministère de la santé :
Guinea [email protected]
Mr Alfa Umaro Djalo
Point focal CNS
Ministère de la Santé
[email protected]
Guinea-Bissau +245 521 97 38
Jean Yonel Antoine [email protected]

Haiti Jacky Perrier <[email protected]>

Dr Ms Prastuti Soewondo, NHA team, University of Indonesia. email: [email protected]; +62 818 700009;
Dr.Kalsum Komaryani, Head-Health Planning division, Center for Health Financing and Insurance, MoH, email:
Indonesia <[email protected]>, +62 812 1325 108
Dr Peter Kimuu
Head, Department of Policy Planning and Health Care Financing
Cell 0729676174
Kenya [email protected]
1. Akbaev A.J. – chief specialist of Administration of economics and finance at MHIF, Nur Akbaev <[email protected]>;
Kyrgyzstan 2. Zulpukarov A.P. – head of unit on accounting and reporting in Osh territorial administration of MHIF, [email protected].
Lao People's
Democratic Dr.Suphab Panyakeo, Chief-Division of Health Financing Policy, MoH. email <[email protected]>
Republic Dr.Kotsaythoune Phimmasone, Deputy Director of Department of Finance, email <[email protected]>
Lesotho Not available
Liberia Not available
Madagascar Not available
Mr Dominic Nkhoma
Malawi Health Economist

17
 Department: Planning and Policy Development
Ministry of Health,
PO Box 30377, Lilongwe 3
Email: [email protected]
M Drissa Sanogo
Chef de l'Unité Informatique
[email protected]
76 47 40 99

Mme Toure Bintou kone

Chef de l'Unité Progrommation Suivi-Evaluation
[email protected]
Mali 66 78 36 74
Mauritania Not available
Mozambique Not available
Dr.Thant Sin Htoo, Dy Director (Planning),
email <[email protected]>, Phone : ++95 67 431078
Myanmar Mrs.Htay Htay Win, Dy Director, Department of Public Health
Ms. Bertha Katjivena
[email protected]

Mr Thomas Mbeeli
Namibia [email protected]
Mr Dhruba Raj Ghimire, Director
Health Ecnomics and Financing Unit, MoH
Ramshah Path, Kathmandu, Nepal
Mobile No. + 977 9851191018, Email: [email protected]
Mr Suresh Sharma, Accounts officer
Finance Section, MoH
Ramshah Path, Kathmandu, Nepal
Nepal Mobile No. + 977 9851181174, Email: [email protected]
Niger Not available
Dr Francis Nwachukwu Ukwuije
[email protected]
234 803 47 55 925

Mrs Vashti Said

[email protected]
Nigeria 234 806 84 73 226
Name: Dr Malik Muhammad Safi
Title: Director
Position: Ministry of National Health Services, Regulations and Coordination (NHSR&C), LG & RD Complex, Sector G-5/2, Islamabad,
Pakistan
Email: [email protected]
Telephone: +92 51 924 5576

Name: Mr Attiq-ur-Rehman
Title: Director
Position: Pakistan Bureau of Statistics (Statistics House), Plot No. 21, Mauve Area, Sector G-9/1, Islamabad, Pakistan
Email: [email protected]
Pakistan Telephone: +92 51 910 6553
Mr.Navy Moulu, Technical Advisor, Health Economics Unit, National Department of Health, Ministry of Health, EMAIL
<muloun1234@gmail>, Phone : 675-3013638;
Mr. James Noah, Economist (PIP) Coordinator, Health Economics Unit, National Department of Health, Email:
Papua New Guinea [email protected], Fax: (675) 3239670, Office phone: (675) 3013878
Ingeniera Edna Roxana Ortiz Onofre
Especialista en Estadistica
Ministerio de Salud
Tel.: +51 986 633 456
email: [email protected]

Licenciado Luis Felipe Coca Silva

Coordinator II
Peru Ministerio de Salud

18
 Tel.: +51 997 720 152
email: [email protected]
Ms.Rosa Gonzales, Chief Health Program Officer, Phone: 632 - 6517800 ext 1329 / 632 - 7814362, email : <[email protected]>
Ms.Lorita Mendoza, Planning Officer IV, Phone : 632 - 6517800 ext 1329 / 632 - 7814362, email : <[email protected]>,
Philippines
Rwanda Not available
Senegal Not available
Mr. Abou Bakarr Kamara
Ministry of Health
Director, Policy, Planning and Information
[email protected]
+232 76 279 775

Mr. Sorie Kamara

Ministry of Health
Director, Financial Resources
[email protected]
Sierra Leone +232 76 653 484
Somalia Not available
South Sudan Duja Michael [email protected]
Dr.P.G.Mahipala
Director-General, Health Services
Email: [email protected], Phone : 0094 11 2694860, 0094 71 4290220
Dr.S.C.Wickramasinghe, Director-Health Information
Sri Lanka Email : [email protected]; Phone: 0094 11 2693297
Sudan Not available
Mr Sibusiso Boris Sibandze
Senior Planner
Ministry of Health
Email: [email protected]

Mr Sifiso MAVUSO
[email protected]

Mr Dumisani Shongwe
Planning Officer - Ministry of Health & Social Welfare
[email protected]
Swaziland [email protected]
1. Mrs Gazieva
MOH
Email: [email protected]

2. Mr Umed Nazarov
Tajikistan Email: [email protected]
Madame Professeur Ahoefa Vovor : directrice générale des études, de la planification et de l'inforrmation sanitaire, email :
[email protected] ; [email protected]

Togo Monsieur Kossi Tchalla: chef du service Budget, email : [email protected]

Mr Candia Tom Aliti

Uganda [email protected] and [email protected]

Ms Mariam Ally
Head of Health Care financing and Senior Economist
Ministry of Health and Social Welfare
P.O. Box 9083, Dar es Salaam
Phone: +255 754 436472
United Republic of Email: [email protected]
Tanzania
Ms.Dang NGA THI PHUONG, PLANNING AND FINANCE DEPARTMENT, <[email protected]>, Ph: +84 0903299088
Viet Nam Ms.Vu NGA THI, PLANNING AND FINANCE DEPARTMENT, <[email protected]>, Ph : '+84 0945331088
Yemen Not available

19
 Mr Patrick Banda
Chief Planner - Planning and Budgeting
Zambia [email protected]
Mr Gwati Gwati
Zimbabwe [email protected]

20