Why an NPER?

WHY AN NPER?

When done well, an NPER goes beyond simply quantifying how much is allocated or spent on nutrition; it answers how well money is being spent to achieve nutrition outcomes and identifies specific recommendations for improvement. The NPER process involves identifying and analyzing nutrition-related expenditures through commonly accepted methodologies (for example, the SUN methodology) that are adapted to the country context.

An NPER is different from sector-specific PERs in that nutrition expenditures span many sectors. An NPER offers a quantitative evaluation of a country’s nutrition-related public expenditures through a multisectoral analysis of its financial data and investigates if the expenditures served to improve nutrition outcomes. Its ultimate utility lies in the ability to interpret the results of the analysis to guide policy making (Pradhan 1996). However, NPERs explore the association between financing and intended outcomes, not causality. This means that NPERs do not strive to determine the attribution of a specific intervention or program toward outcomes, which is the domain of impact evaluation studies.

Some expected benefits of NPERs:

• They provide an opportunity to extend the policy dialogue on nutrition by engaging ministries of finance or planning and key line ministries in multisectoral discussions on nutrition change policies and their fiscal implications. • They produce a clear analysis of the effectiveness, efficiency, and equity of public expenditures on nutrition to formulate evidence-based, actionable recommendations on strategic resource allocation or course corrections. • They provide an opportunity to develop or strengthen a country’s nutrition strategy and associated costed investment plans by illustrating how actual expenditures are supporting these strategies. • They promote transparency (through publication and consultation) in what constitutes nutrition spending and prevent overestimating by applying evidence-based weights to budget line items that are not sufficiently disaggregated in budget data. • They help mobilize domestic and external resources for the nutrition agenda by highlighting policy objectives that require additional financing. For external financing, the NPER informs the government’s dialogue with development partners on identifying development assistance priorities and areas in need of external financing. • They highlight the strengths and weaknesses of the institutional framework for addressing nutrition. • They become an entry point for future work on strengthening the overall

PFM cycle—budget tagging, tracking, and evaluation—to mainstream the tracking of nutrition expenditures.

Ultimately, NPERs aim to carry out an in-depth analysis of the effectiveness, efficiency, and equity of nutrition-related public spending to formulate evidence-based, actionable recommendations on strategic resource allocation or course corrections (box 1.1). The existing portfolio of NPERs is small (there have been only seven NPERs to date), and none of them has included an in-depth analysis of the effectiveness, efficiency, or equity of nutrition expenditures, mainly because of a lack of access to disaggregated data.