The scale of the challenge in tackling child malnutrition is undeniable. Millions of children are malnourished because of who they are and where they live.
The scale of the challenge in tackling child malnutrition is undeniable. Millions of children are malnourished because of who they are and where they live. According to Global Hunger Index 2019, India’s ranked has slipped to 102 position of 117 countries. In the recent Lancet report which analysesstate level disease burden in India, malnutrition was the predominant risk factor for under-five mortality in every state of the country in 2017, accounting for 68·2% of the total under-5 deaths. In every state, where the disease burden is high, children are losing out either due to their ethnic background, their disabilities, their family’s low income, or by virtue of being migrant families.
The Indian Government is taking steps to tackle the continuing challenge of malnutrition and to keep to its national commitment of ending malnutrition by 2030 through the Sustainable Development Goals. However, the current progress does not reflect the change needed to meet this target, and resources required are far beyond the capabilities of the current funding paradigm. Much more needs to be done. Fundamental here is a realistic appraisal of how we need to finance nutrition – and by how much. Nutrition is inherently multi-sectoral, covering maternal and child health, infant and young child feeding, social protection, agriculture, WASH and many more sectors. That makes calculating the financing needs for SDG extraordinarily difficult.
The overarching message is clear and unequivocal: a step change in nutrition financing is urgently required. However, there are immediate challenges. THE STEP CHANGE
There are two elements to the step change required in nutrition financing.
First, nutrition financing sources must be diversified: A significant uplift in domestic resource mobilisation (DRM) is essential, focused on the most basic needs, and driven by widening the revenue base through progressive tax reform. Innovative financing must be brought to scale through expansion and reform of existing mechanisms, like the Global Financing Facility and Power of Nutrition, and through the creation of an enabling environment for new mechanisms to emerge. Finally, official development assistance (ODA) is vital, but limited – it should be focused on the most excluded children, and on catalysing new domestic resources.
Second, diversified and increased financing for nutrition should abide by four pillars:
• Supporting and funding national nutrition plans: these plans are the key to delivering sustainable, country-driven change, and offer a costed, multi-sectoral, multi-stakeholder strategy that identifies where funding is needed in the local context and the size of the local funding gap.
• Equity: nutrition financing must prioritise the ‘Leave No One Behind’ agenda, acknowledging the financial and social implications of this principle and moving away from the uneven picture of achievement that characterised the Millennium Development Goals.
• Transparency and accountability: all nutrition financing must be transparent and accountable, both domestically, through the timely release of allocations and disbursement, and globally, through the tracking of aid flows and pledges.
• Bridging the humanitarian/development divide: investment in flexible and shock responsive nutrition development work needs to be allied with sustained post-humanitarian response funding to lock in developmental gains and mitigate against recurrence.
Here are some recommendations, which could show some accelerated improvements –
INCREASE FINANCING FOR NUTRITION
• The existing funding paradigm is not capable of delivering the level of financing required. A new funding model is needed, based on the sustainable generation of increased domestic and innovative resources, which should be supported by, but not reliant upon, foreign aid.
• Innovative financing mechanisms for nutrition are vitally important but must ensure that they generate long-term, sustainable resources, drive funding towards national nutrition plans, embrace multi-stakeholder and multi-sectoral involvement, and avoid adding unmanageably to debt burdens.
JOINT ACCOUNTABILITY MECHANISM TO ENSURE EFFICIENT USE OF FUNDS
• All nutrition financing should be channelled into costed funding, equity-driven, multi-sectoral, and multi-stakeholder national nutrition plans. Where such a plan does not exist, the priority should be to create them
• Nutrition funding must be spent on either funding proven interventions in accordance with national nutrition plan or researching new ones, while always prioritising the Leave No One Behind principle, transparency and accountability.
IMPROVE TRACKING OF NUTRITION SPENDING
The tracking of nutrition spending must improve:
• A new nutrition-sensitive policy marker should be introduced.
• India should introduce nutrition-specific and sensitive budget lines and adequately spend across all related sectors. This should be tracked through independently delivered budget analysis. It will allow a comparison of the costed national nutrition plan with the total in-country disbursement, in order to establish the country-level funding gap.
In recent years, we have seen positive developments in policy, funding and outcomes on child nutrition, but as said many a times before, much more needs to be done.
Nevertheless, there are signs of hope and there is scope to step-up.
by Dr Antaryami Dash
Head- Nutrition, Save the Children
Read the full Economic Times article here.