Nutrition Budgets in Uganda: Research to Inform Implementation

Authors: Alexis D'Agostino, Amanda Pomeroy

Abstract:

Background: Resource availability is essential to effective implementation of national nutrition policies. To this end, the SPRING Project has collected and analyzed budget data from government ministries in Uganda, international donors, and other nutrition implementers to provide data for the first time on what funding is actually allocated to implement nutrition activities named in the national nutrition plan. Methodology: USAID’s SPRING Project used the Uganda Nutrition Action Plan (UNAP) as the starting point for budget analysis. Thorough desk reviews of public budgets from government, donors, and NGOs were mapped to activities named in the UNAP and validated by key informants (KIs) across the stakeholder groups. By relying on nationally-recognized and locally-created documents, SPRING provided a familiar basis for discussions to increase credibility and local ownership of findings. Among other things, the KIs validated the amount, source, and type (specific or sensitive) of funding. When only high-level budget data were available, KIs provided rough estimates of the percentage of allocations that were actually nutrition-relevant, allowing creation of confidence intervals around some funding estimates. Results: After validating data and narrowing in on estimates of funding to nutrition-relevant programming, researchers applied a formula to estimate overall nutrition allocations. In line with guidance by the SUN Movement and its three-step process, nutrition-specific funding was counted at 100% of its allocation amount, while nutrition sensitive funding was counted at 25%. The vast majority of nutrition funding in Uganda is off-budget, with over 90 percent of all nutrition funding is provided outside of the government system. Overall allocations are split nearly evenly between nutrition-specific and –sensitive activities. In FY 2013/14, the two-year study’s baseline year, on- and off-budget funding for nutrition was estimated to be around 60 million USD. While the 60 million USD allocations compare favorably to the 66 million USD estimate of the cost of the UNAP, not all activities are sufficiently funded. Those activities with a focus on behavior change were the most underfunded. In addition, accompanying qualitative research suggested that donor funding for nutrition activities may shift government funding into other areas of work, making it difficult to estimate the sustainability of current nutrition investments.Conclusions: Beyond providing figures, these estimates can be used together with the qualitative results of the study to explain how and why these amounts were allocated for particular activities and not others, examine the negotiation process that occurred, and suggest options for improving the flow of finances to UNAP activities for the remainder of the policy tenure. By the end of the PBN study, several years of nutrition budget estimates will be available to compare changes in funding over time. Halfway through SPRING’s work, there is evidence that country stakeholders have begun to feel ownership over the ultimate findings and some ministries are requesting increased technical assistance in nutrition budgeting. Ultimately, these data can be used within organization to advocate for more and improved nutrition funding and to improve targeting of nutrition allocations.

Keywords: budget, nutrition, financing, scale-up