1.1 NPERs and their role in promoting policy dialogue

BOX 1.1

NPERs and their role in promoting policy dialogue

Nutrition public expenditure reviews (NPERs) are fairly new public expenditure tools (the oldest NPER was published in 2018). To date, NPERs have been completed in Bangladesh (Finance Division, Government of the Republic of Bangladesh and UNICEF 2019), Bhutan (Ahmed et al. 2020), Indonesia (World Bank 2020a), Nepal (World Bank 2019), Rwanda (Piatti-Fünfkirchen et al. 2020), Sri Lanka (World Bank 2020b), and Tanzania (Tanzania MoFP and UNICEF 2018) (see appendix C for a complete list).

NPERs are being used as entry points for broadening the policy dialogue on nutrition in their respective countries to strengthen public financial management and achieve better nutrition results:

• In Bangladesh, the NPER facilitated a major policy shift to focus on aligning program design for improving nutrition in key sectors. For instance, the Bangladesh National Nutrition Council and the Cabinet Division (under the Prime Minister’s office responsible for overall coordination among all ministries) have carried out a review of major social safety net programs to make them nutrition and gender sensitive, and they have agreed to include a nutrition chapter in the upcoming revision of the

National Social Security Strategy. • In Indonesia, the findings from the NPER informed the policy dialogue on addressing several systemic challenges in public financial management, such as delays in fund transfers and a weak focus on results in the planning and budgeting process, which results in spending inefficiency. The NPER also highlighted challenges with tracking subnational spending due to the lack of a standardized chart of account across districts. • In Rwanda, the NPER contributed to advancing the dialogue with the Ministry of Finance to strengthen nutrition-responsive budgeting and adopt policy reforms related to budget tagging, tracking, and evaluation, which in turn will enable the government to oversee nutrition-related activities across all agency budgets and levels of government.

NPERs also shed light on institutional aspects that may affect nutrition outcomes. This role is particularly important for a multisectoral agenda such as nutrition, which is often seen as “somebody else’s agenda.” NPERs describe the flow of funds to public nutrition-related interventions and identify bottlenecks that may be preventing the country’s PFM systems from optimizing planning, budgeting, and spending for nutrition. For example, in Rwanda, the findings from the NPER informed the scope of additional work on strengthening the nutrition-responsive PFM system. This work included the issuance of a Ministerial Instruction by the Ministry of Finance during the planning and budgeting phase to (1) instruct relevant ministries and agencies to consider early childhood development throughout the budget process, and (2) ensure that activities are prioritized and aligned with the National Early Childhood Development Program, which coordinates all nutrition activities in the country.

The COvID-19 (coronavirus) pandemic has served as a reminder that the ability to track and measure the impact of public spending on nutrition is important during economic or social crises. During such crises, governments often struggle to balance the implementation of urgent, short-term emergency response measures with maintaining medium- to long-term policies aimed at protecting the vulnerable from the impact of malnutrition and human capital loss. NPERs can help governments identify, track, evaluate, and plan public spending on key nutrition measures and assist efforts to hold both financiers and implementers accountable.