Reviewing public expenditure on nutrition in Bangladesh

The Government of Bangladesh (GoB) has made nutrition a priority and taken steps to ensure that strong policy framework is in place through developing the National Nutrition Policy (2015) and the Second National Plan of Action for Nutrition 2016-2025 (NPAN2). The GoB also recognises that ensuring existing funding is being spent efficiently in line with NPAN2 can potentially provide a further boost in reaching nutrition goals. Having reliable financial data, including on budget allocations and expenditure is essential for policy makers to be able to prioritise, plan, and make decisions on resource allocation, as well as to monitor and evaluate proper and efficient use of these resources in line with the NPAN2.

The objectives of this study included:

• Analysing the level and composition of public expenditure in nutrition over the past three fiscal years (2014/15 – 2016/17) and the budget for 2017-18;
• Providing a baseline against which developments in nutrition budget allocations and execution to effectively monitor progress towards the achievement of the nationally set goals for nutrition; and
• Assessing the institutional mechanisms for the management of public finances for nutrition.

Challenges

Two main challenges are recognised in tracking financial investments on nutrition:

(1) the misalignment between plans and budgets, which does not give us a clear and comprehensive framework on what to track; and

(2) the fact that addressing malnutrition requires multi-sectoral and multi-stakeholder efforts, making the boundaries harder to establish. 

In addition, as numerous reporting methods are being carried out in parallel with overlapping coverage, this poses a significant challenge in terms of time and costs to the staff needing to complete necessary reporting templates. A typical challenge is how to reconcile reporting formats with Government and development partners’ requirements.

Specific limitations:

• With the upgrade of Integrated Budget and Accounting System (iBAS++) it was not possible to use the segment on location as it was not transferred into the new system hence, this PER-N could not present findings by location.
• The existing datasets used for donor investment analysis in this PER-N do not capture funds from foundations and private sources channelled to NGOs. Hence, it does not give a complete picture of available funding for nutrition outside of the government system in Bangladesh. 
• Part of nutrition investments might be carried out by semi-autonomous state-owned entities, for which iBAS++ does not provide enough level of detail. These are not included in PER-N.
• Any nutrition expenditure made by the 11 City Corporations in Bangladesh from their own resources are not captured in iBAS++. This PER-N presents a description of finances and nutrition relevant programmes from one City Corporation (Dhaka South) to provide an indication of the relevance of these entities to nutrition.

Our approach

A thorough methodology and its rationale was adapted by our team following international best practice from the SUN Movement based on similar exercises carried out in other countries.

Methods used to conduct the study included:

• All relevant high-level policy and planning documents were reviewed to inform an understanding of nutrition goals and governance in Bangladesh;
• All potential quantitative data sources for the PER were screened, selected and analysed on the basis of their relevance, comprehensiveness and reliability to be used in the analysis; and
• Key informant interviews with government representatives and development partners were undertaken  

Four interrelated areas were analysed including policy and institutional framework, level and composition of nutrition investments, budget processes and performance and lastly, efficiency and equity of spending.  Several data sources were used from iBAS++ to Food Planning and Monitoring Unit (FPMU) to provide specific recommendations to improve nutrition expenditures and budget management performance going forward.

Outcomes

For the first time expenditure for all ministries under NPAN2 were identified and classified. This study provided an understanding of how public expenditure is used to meet nutrition goals and served as a baseline to operationalise NPAN2.

In 2016-17, the Government of Bangladesh spent BDT 23,210 crore (USD 2.7 billion) in nutrition relevant interventions, representing around 1% of GDP and around 9% of the national budget. Nutrition budget allocations and actual expenditure has remained relatively stable in relative terms. With improvements in budget processes and performance, execution rates could be improved so actual expenditure is closer to the original budget. There is no pattern affecting nutrition expenditures as nutrition-related rates are similar to ministry-level ones.

Expenditure is spread across 15 ministries/divisions and almost 300 projects or operational lines. About 80% of nutrition expenditure is accounted for by four ministries: Ministry of Food (34%), Ministry of Health and Family Welfare (23%), Primary and Mass Education Ministry (13%), and Ministry of Women and Children Affairs (7%).

The vast majority is spent on nutrition-sensitive interventions (98%) and a significant amount is on non-development operational lines. The distribution of allocation across NPAN2 themes shows how almost all expenditure can be classified under the three main NPAN2 themes: agriculture and diet diversification and locally adapted recipes (62%), nutrition for all following lifecycle approach (31%), and social protection (7%) themes. The districts that appear to have highest per capita expenditure across health project/operational lines analysed were: Rangamati, Khagrachhari, Bandarban, Rangpur, and Bagerhat. At the other end of the spectrum, the districts that appear to have the lowest per capita expenditure were: Gazipur, Narayanganj, Chittagong, and Noakhali.

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