trend analysis of health and nutrition budget in...

Tr e n d A n a l y s i s o f

HEALTH AND NUTRITION BUDGET IN NIGERIA

(2014 - 2018)

02 / Trend Analysis of Health and Nutrition budget in Nigeria

HIV Human Immunodeficiency Virus

FGD Focus Group Discussions FAO Food and Agriculture Organisation

FMoE Federal Ministry of Education

AIDS Acquired Immunodeficiency Syndrome CSO Civic Society Organisation

FGN Federal Government of Nigeria

FMoH Federal Ministry of HealthFMoWR Federal Ministry of Water ResourcesFMoBP Federal Ministry of Budget and Planning

STD Sexually Transmitted Diseases SUN Scaling Up Nutrition TB Tuberculosis UNICEF United Nations Children Emergency Fund

SAM Severe Acute Malnutrition

IYCF Infant and Young Child Feeding

WHA World Health Assembly

NGO Non-Governmental Organisations

WFP World Food Programme

MIMS Multiple Indicator Monitoring Survey

NSPAN National Strategic Plan of Action for Nutrition

MICS Multiple Indicator Cluster Survey

NASS National Assembly

KII Key Informant Interviews

SDG Sustainable Development Goal

WHO World Health Organisation

MDAs Ministries, Departments and Agencies

WASH Water Sanitation and Hygiene

INGO International Non-Governmental Organisations IEC Information Education and Communication

ABBREVIATIONA

BB

REV

IAT

ION


Nigeria is home to the third largest population of malnourished children in the world, with an

infant mortality rate of 70 per 1,000 live birth and an under-five mortality rate of

1120 deaths per 1,000 live births in 2017. The Sustainable Development Goal (SDG) 3 calls for the global community to ensure healthy lives and promote well-being for all at all ages. To fulfil this, SDG3 has set specific targets for all countries to complete by 2030.

These include reducing infant mortality to no more than 12 per 1,000 live births and under-five mortality to 25 per 1,000 live births. It also calls for the maternal mortality ratio to fall below 70 per 100,000 deaths. Nigeria's infant and under-five mortality rates are nearly six and five times higher, respectively than the 2030 goal.

A review of budgetary allocation in 2014, 2015, 2016, and 2017 shows that Nigeria also failed to honour its obligation. If the Abuja declaration was implemented, additional allocations of approximately N2.91 trillion should have been injected and spent on the health sector between 2014

The Federal government account for approximately 10 percent of health-related spending in Nigeria while the state and local government health expenditure was about 8 per cent and 4 per cent respectively. Relative to the size of the Federal government's spending plan for 2018, health sector allocation stands at 5.79 per cent which is relatively low when compared to the 15 per cent commitment made by the Nigerian government at the Abuja conference.

EXECUTIVE SUMMARY

and 2018.

At the sub-national level, Budgetary allocation seems to be improving. In Nasarawa, Budgetary allocation to the health sector account, when compared with the budget size, was 14.27 per cent, 11.81 per cent, 12.11 percent in the fiscal year 2017, 2016 and 2015 respectively. Kaduna state is planning to spend approximately N17.58 billion on health or 8.12 percent out of her expansive budget in the fiscal year 2018. Budgetary allocation to the health sector, when compared with the budget size, was 12.35percent, 7.57percent, 4.09 percent in the fiscal year 2017, 2016 and 2015 respectively. Kano state budgetary

allocations to the health sector in 2018 at N32.24 billion comes in at approximately 13.07 percent of total expenditure plan while budgetary allocation to the health sector in Lagos state, Nigeria's commercial hub, comes to approximately 8.86 per cent of her expansive budget of N1.046 trillion in 2018.

Also, an essential component of health, which is Nutrition, over the years has been neglected. Adequate nutrition is critical during early childhood as they are important for organs, immune system and neurological development. Despite being a Lower-Middle-Income Country,

2approximately 43.6 percent of children under the age of five in Nigeria are stunted. Even war-torn countries like

3Afghanistan are doing better than Nigeria.

The globally acceptable standard (Stunting rate) is in the region of 2.5percent meaning Nigeria will have to realign its

In Fiscal 2018, allocations

explicitly directed at addressing malnutrition

was reduced by 18.19percent

to N1.41 billion.

N1.41bn

1 NBS Dataset : STATISTICAL REPORT ON WOMEN AND MEN IN NIGERIA (2017) Retrieved from http://nigerianstat.gov.ng/download/784 2 Dataset Archives - UNICEF DATA. (2018). Retrieved from https://data.unicef.org/resources/resource-type/dataset3 Dataset Archives - UNICEF DATA. (2018). Retrieved from https://data.unicef.org/resources/resource-type/dataset


The National Strategic Plan of Action for Nutrition (NSPAN) assumes that the FG will provide $10million annually for 2014-2018. This would have been N3.5 billion for nutrition-related costs in 2018, the allocation undernutrition specific intervention in 2018 was only N1.38 billion. This means that the provision in the budget

In Fiscal 2018, allocations explicitly directed at addressing malnutrition was reduced by 18.19percent to N1.41 billion. Provision made for the procurement of RUTF was slashed from N1.2billion to N400million. Federal funding for Nutrition related investments required to reverse the trend of malnutrition are grossly inadequate.

cannot cater to the approximately 3.5 million children under the age of five who are suffering some form of malnutrition. For instance, at the national level, only 43.40% of the amount budgeted for health was utilised. At the sub-national level, budgetary provisions for the key

plan and see to its implementation- as recent data shows things are not working. In sub-Saharan Africa, the percentage of children below the age of five that are stunted is approximately 30.3percent which is relatively better than Nigeria's figure of 43.6percent. Nigeria is unlikely to achieve these SDG targets without allocating and spending sufficient funds for programs that support their achievement.

Actual spending on Nutrition related interventions dropped from 2014 level of N2.5 billion to N470 million in fiscal year 2016 before rising to N1.51 billion in fiscal year 2017. Public Spendings on the key nutrition related interventions remain lower than 2014 level but rising. Also, the State government have spent less than half of the budgeted amounts, with spending rates varying significantly.

As such federal funding for the health sector is tracked beyond the Ministry of Health and its agencies at the national level to include other health-related items within other government agencies that have direct input into the health sector.

Health Sector Allocation - Federal Government

nutrition interventions are also low despite some marginal growth in the last two years. In Nasarawa State, When nutrition related spending was adjusted for inflation,

In computing the health sector allocation, careful consideration was also taken to capture health-related appropriations made to agencies outside the Ministry of Health. There has been a history of federal agencies outside the ministry of health implementing programs and managing health-related services.

Year Budget Size

2014

2016

2015

2017

2018

4,695.19

5,067.90

6,060.48

7,441.18

339.38 704.28

347.26 760.19

353.54 909.07

380.16 1,116.18

Health Sector Budget (Federal Government)

15 percent of Budget Size

Gaps (Amount needed to meet Abuja declaration

of 2001 ( 15 percent of Budget Size)

9,120.33 528.14 1368.05

364.90

412.93

555.53

736.02

839.91

Table 3: FGN's Budgetary Allocation to the health sector(Amount in N'bn)

Source: Budget office of the Federation

A review of budgetary allocation in 2014, 2015, 2016, 2017 and 2018 shows Nigeria has failed to honour its obligation. Relative to the size of the federal government's spending plan, health sector allocation stands at 5.79 percent which is low when compared to the 15 percent commitment made by the Nigerian government at the Abuja conference.

If the Abuja declaration was implemented, additional allocations of N2.91 trillion should have been injected into the health sector between 2014 and 2018.Relative to the size of the federal government's spending plan, health sector allocation stands at 5.79 percent which is relatively low when compared to the 15 percent commitment made by the Nigerian government at the Abuja

4conference.

4 http://www.who.int/healthsystems/publications/Abuja10.pdf

TREND IN NUTRITION ALLOCATION IN NIGERIA (2014 - 2018)

From the 2018 Federal government Budget, the total number of programmes identified as potentially having allocations towards nutrition outcomes increased to 71 up from 2017 count of 33. The sum of the budget allocations to these programmes was N3.76 billion and N5.24 billion in 2018 and 2017 respectively.

The Federal Government The sharp decline in 2018 budgetary allocation when compared with 2017 votes can be directly attributed to the sharp cut in budgetary allocation for the procurement of ready-to-use therapeutic food (RUTF).

In the fiscal year 2016, 2015 and 2014, a total of 16, 27 and 25 nutrition-related line items with carriage value of N710.27 million, N891.78 million and N1.27 billion were identified in the budget respectively.

2014

32

1,795,675,130

2015

25

885,892,912

2016

36

1,762,434,089

2017

38

2018

79

Federal Government: Analysis of the 2014 - 2018 Nutrition Budget ( Amount in Naira)

Number of Identified Nutrition Related Line items

Value of Identified Nutrition Related Line items 5,744,486,757 4,481,085,091


NUTRITION- SPECIFIC INTERVENTIONSFEDERAL GOVERNMENT

Out of the 32 line items identified in the 2014 Federal government Budget, 9 were categorised as nutrition-specific. A total of N534.44 million was allocated to the identified Nutrition specific interventions which are approximately 0.16 percent of total budgetary allocation to the health sector by the Federal government.

Year Budget Size

2014

2016

2015

2017

2018

4,695.19

5,067.90

6,060.48

7,441.18

339.38

347.26

353.54

380.16

Health Sector Budget (Federal Government)

Budgetary Allocation: Nutrition Specific

Interventions (N'bn)

Allocation for Nutrition Specific intervention as

a percentage of total budget

9,120.33 528.14


Comparison: Budgetary Allocation- Nutrition Specific intervention with FGN's Budget Allocations

0.534

0.122

0.107

1.521

1.406

0.011%

0.002%

0.002%

0.020%

0.015%

0.16%

0.04 %

0.03%

0.40%

0.27%

Allocation for Nutrition Specific intervention as

a percentage of total health sector budget

When compared with the size of the Federal government's budget, the allocation to the key nutrition sector was only 0.011 percent, a small amount because over 3.5 million of children in Nigeria suffered from malnutrition. Budgetary allocation to Nutrition-specific interventions comes to N153 per malnourished child. Hence, the provision in the budget cannot cater for the approximately 3.5 million children under the age of five who are suffering some form of malnutrition.


SOME SELECTED NUTRITION SPECIFIC INTERVENTIONS


Infant and Young Child Feeding (IYCF) encompasses the set of feeding practices needed to prevent malnutrition in infants and young chi ldren. Breastfeeding and complementary feeding are critical factors in child survival,

5growth and development.

Trend Analysis - Infant and young child feeding

Figure 6: FGN's Budgetary allocation: Infant and Young Child Feeding Interventions and Budgetary allocation (Amount in N' million)

FGN's Budgetary allocation: Management of Severe Acute Malnutrition in Children Under Five (Amount in N'billion)

BUDGETARY ALLOCATION

2014 2015 2016 2017

73.64

0

121

228.29211.34


Budgetary Allocations under the IYCF interventions were N228.29 million in 2018 up from the N121 million allocated for the intervention in 2017. Allocation in 2014 and 2016 was N73.64 million and N21.13 million respectively.

*Note: Budgetary allocation Specifically for IYCF in 2014 was approximately N30 million out of N73.64 million

Severe Acute Malnutrition (SAM) remains a major cause of mortality among children under 5 years of age, and much of this mortality can be prevented. In some settings, a large proportion of children with SAM are also suffering from infections (e.g. HIV or diarrhoea), and it is important to screen children with SAM for infectious diseases, as well as monitoring growth and nutrition status as part of preventing SAM.

Trend Analysis - Treatment of Severe Acute Malnutrition

5 http://www.health.gov.ng/doc/IYCFPolicy.pdf


2014 2015 2016 2017

0 00

1.200

0.400


Budgetary Allocations under the IYCF interventions were N228.29 million in 2018 up from the N121 million allocated for the intervention in 2017. Allocation in 2014 and 2016 was N73.64 million and N21.13 million respectively.

2018 2018


TREND ANALYSIS - MICRONUTRIENT FORTIFICATION AND SUPPLEMENTATION

Trend Analysis - Micronutrient Fortification And Supplementation

Many women and chi ldren have at ed through s u p p l e m e n t a t i o n , f o r t i fi c a t i o n , a n d i m p rove d complementary food products (including micronutrient powders and lipid-based nutrient supplements) to improve dietary quality.


2014 2015 2016 2017

7.257.68

20.05

2018

55.00


1.10

FGN's Budgetary allocation: Micronutrient fortification and supplementation (Amount in N'million)

NUTRITION -SENSITIVE INTERVENTION

2014 2015 2016 2017

1.26

0.76

4.22

2018

3.07


1.66

Figure 9: FGN's Allocations to Nutrition- Nutrition sensitive interventions (Amount in N'billion)

Budgetary allocation in 2014 and 2015 was N7.5 million and N7.68 million 6respectively. Allocation tops N55 million in 2018 up from 2017 level of

N20.1million.

Nutrition-Sensitive Interventions

Interventions that address the underlying causal factors of malnutrition and foetal/child mal-development – food security, relevant care resources, in terms of the mother and also the household and community, access to healthcare services and a healthy and hygienic environment – and including nutrition-sensitive actions and objectives. ( See Annex 5).

Out of the 32 nutrition-related line items identified in the 2014 Federal government Budget, 16 were categorised as being nutrition-sensitive. When compared with budgetary allocation to the health sector, budgetary allocation to Nutrition-sensitive interventions was approximately 1.11 percent and 0.58 percent in the fiscal year 2017 and 2018 respectively.

6 ** some unknown component of allocation will be spent on other interventions other than micronutrient fortification and supplementation.


SOME SELECTED NUTRITION SENSITIVE INTERVENTIONS

WASH encompasses efforts to maintain adequate water supply, both in terms of quality and quantity, sufficient means of sanitation (encouraging community-based approaches for 'total sanitation' that seek to eliminate the practice of open defecation), and improved hygienic practic es (hand washing with soap).

Trend Analysis - Water, Sanitation and Hygiene (WASH) programme

Poor sanitation and hygiene practices are essential determinants in the causal pathway and cycle of infectious disease burden and undernutrition.

WASH

2014 2015 2016 2017

451

114

2,694

2018

12,971


545

Figure 10 : FGN's Allocations to Nutrition- WASH programme (Amount in N'million)

Budgetary allocation under WASH programme was N1.3 billion in 2018 down from 2017 level of N2.69 billion. Allocation for water, sanitation and hygiene (WASH) in 2014, 2015 and 2016 was N451.34 million, N113.74 million and N545.33 million respectively.

Trend Analysis - Early childhood development

In 2018, N522 million was allocated directly by the federal government for early childhood development down from 2017 level of N641.07 million.

WASH

2014 2015 2016 2017

41.6782.00

644.07

2018

522.98


291.12

FGN's Allocations to Nutrition- Early childhood development (Amount in N'million)

Budgetary allocation to ensure children get adequate nutrients early in life was N41.67 million in 2014. Spending on early childhood development is critical in promoting growth, and stimulating cognitive and socioemotional development in children. The allocation was inadequate in the last five years.


Trend Analysis- Improved food security

Direct budgetary allocation to improve food security in 2018 stands at N266.75m up from 2017 level of N88.5m. Allocations dedicated mainly to mothers and young children health – through changes in income, and increased availability and accessibility of diverse nutrient-dense foods in 2014 and 2015 was N90m and N64.6m respectively.

2015


2016 2017

88.50

2018

266.75


25.09

FGN's Allocations to Nutrition- Improved food security (Amount in million)

2014 2015

90.0064.60

TREND ANALYSIS IN FOCUS STATES



NASARAWA STATESNutrition Related Intervention

Nasarawa - Nutrition Specific Allocation Nasarawa State Budgetary Allocation Nutrition specific ( Amount in Naira)

YEAR BUDGETARY ALLOCATION ACTUAL SPENDING BUDGET PERFORMANCE

2014 54,000,000

2015

2016

2017

2018

64,999,498

64,200,000

193,200,000

229,250,170

5,568,000

131,000

63,015,000

63,368,000

N/A

10.31%

0.20%

98.15%

32.80%

N/A

Source: Nasarawa state government

Nasarawa - Nutrition Specific Allocation Inflation Adjusted : Nasarawa State Budgetary Allocation Nutrition specific ( Amount in Naira)


2014

2015

2016

2017

2018

10.31%

0.20%

98.15%

32.80%

N/A

Source: Nasarawa state government

74,528,959

87, 217, 231

78,642,851

212,971,522

229,250,170

7,684,764

175,778

77,191,266

69,852,895

N/A

Clearly, between 2014 and 2018, the state government has under-allocated to the Nutrition sector. Budget performance which peaked at 98.15 percent in fiscal year 2016 was 10.31 percent and 0.20 percent in fiscal year 2014 and 2015 respectively.


KADUNA STATE Nutrition Related Intervention

Kaduna - Nutrition Specific Allocation Kaduna State Budgetary Allocation Nutrition specific (Amount in Naira)


2014

2015

2016

2017

2018

0

57,000,000

603,480,000

296,190,340

N/A

0.00%

18.34%

182.87%

10.27%

N/A

Source: Kaduna state government

Nasarawa - Nutrition Specific Allocation Inflation Adjusted : Kaduna State Budgetary Allocation Nutrition specific ( Amount in Naira)


2014

2015

2016

2017

2018

0.00%

18.34%

182.87%

22.07%

N/A

Source: Kaduna state government

0

76,483,393

739,242,803

326,501,591

N/A

Clearly, between 2014 and 2018, the state government has under-allocated to the Nutrition sector. Budget performance which peaked at 182.87 percent in fiscal year 2016 was 18.34 percent and 10.27 percent in fiscal year 2015 and 2017 respectively. Additional N16.43 billion was allocated for the Intervention to improve Nutrition in Primary and Secondary Schools. Also, an additional N1.17 billion was allocated for Water and sanitation.

117,750,500

310,744,516

330,000,000

1,342,083,251

1,127,760,034

162,515,226

416,961,316

404,238,956

1,479,428,116

1,127,760,034


KANO STATE Nutrition Specific Allocation

Kano State Budgetary Allocation Nutrition specific (Amount in Naira)


2014

2015

2016

2017

2018

142,699,667

10,000,000

55,383,330

74,530,330

N/A

22.84%

1.70%

6.24%

43.58%

N/A

Source: Kano state government

Inflation Adjusted : Kano State Budgetary Allocation Nutrition specific ( Amount in Naira)


2014

2015

2016

2017

2018

22.84%

1.70%

6.24%

43.58%

N/A

Source: Kano state government

196,949,216

13,418,139

67,842,726

82,157,545

N/A

Clearly, between 2014 and 2018, the state government has under-allocated to the Nutrition sector. Budget performance which peaked at 43.58 percent in fiscal year 2017 was 22.84 percent, 1.7 percent and 6.24 percent in fiscal year 2014, 2015 and 2016 respectively.

624,647,808

587,254,467

887,209,008

171,000,000

1,480,320,620

862,117,612

787,986,216

1,086,801,342

188,499,639

1,480,320,620


NIGER STATE Nutrition Specific Allocation

Niger State Budgetary Allocation Nutrition specific (Amount in Naira)

YEAR BUDGETARY ALLOCATION ACTUAL NUTRITION SPENDING

2015

2016

2017

2018

N/A

10,000,000

N/A

N/A

Source: Niger state government

Inflation Adjusted : Niger State Budgetary Allocation Nutrition specific ( Amount in Naira)

198,200,000

55,000,000

80,000,000

137,746,250

YEAR BUDGETARY ALLOCATION ACTUAL NUTRITION SPENDING

2015

2016

2017

2018

N/A

12,392,905

N/A

N/A

Source: Niger state government

269,057,336

68,160,977

89,218,166

137,746,250


LAGOS STATE

Nutrition Specific Interventions

Lagos State Budgetary Allocation Nutrition specific (Amount in Naira)

Budgetary grew from N17.393 million in 2014 to N73.24 million in 2018, however actual spending has declined. In 2014,

91.84 percent of Nutrition related budgetary allocation was release. Budget performance however declined standing at

47.31 percent in 2017.

YEAR ALLOCATION RELEASES BUDGET PERFORMANCE

2014

2015

2016

2017

2018

15,973,850

4,821,850

9,115,000

12,165,000

N/A

91.84%

48.50%

51.28%

47.31%

N/A

Source: Lagos state government

Trend: Inflation Adjusted Nutrition Related Allocation (Lagos State)

YEAR ALLOCATION RELEASES BUDGET PERFORMANCE

2014

2015

2016

2017

2018source: Lagos State govenrment ( Inflation adjustment done using GDP implicit deflator)

22,304,361

6,545,682

11,296,133

13,566,737

N/A

17,393,850

9,941,850

17,775,000

25,715,000

73,238,400

24,287,114

13,496,103

22,028,389

28,678,064

73,238,400

91.84%

48.50%

51.28%

47.31%

N/A

Budgetary allocation for aimed at reversing trends of malnutrition is rising. Despite dropping to N13.5 million in fiscal

year 2015 from 2014 level of N24.29 million, Allocation has risen to N22.03 million, N28.68 million and N73.24 million

in 2016, 2017 and 2018 respectively.

The population in Lagos State is higher than the budget allocated for nutrition.

The allocation for nutrition activities have been fluctuating over the past five years.

The allocation at the Primary Healthcare Board level is low and not released, also, most activities are still at the

Ministry of health and not at the PHCB level, where implementation of program should take place according to the

Primary Healthcare Under One Roof (PHCUOR)

There is no direct budget line for nutrition, it is buried under health and other ministries/MDAs with nutrition related

activities.

BOX: Note on Lagos Nutrition Budget


COMPARATIVE ANALYSIS IN FOCUS STATE



STUNTING RATE (2017)

WASTING RATE (2017)


Underweight (2017)

Nasarawa

Kano

Kaduna

Niger

Lagos

N229m

N1.480bn

N1.128bn

N138m

N73m

COMPARATIVE ANALYSIS OF NUTRITION BUDGET ACROSS THE FOCUS STATE

Source: State government


LAGOS N1.05tn

NASARAWAN125.4bn

KANON216.5bn

KADUNAN246.6bn

NIGERN134bn

N

BUDGET SIZE

NUTRITION BUDGET AS A PERCENTAGE OF A TOTAL BUDGET (2018)

0.18%0.68%0.46%

Lagos

0.01%

Kano

Kaduna

Nasarawa

0.10%

Niger

Nutrition Budget per capita of the Focus State

YEAR NUTRITION BUDGET**

UNDER 5 POPULATION

ESTIMATED* POPULATION

Nasarawa

Kano

Kaduna

Niger

LagosSource: State government, NPC, NBS, Unicef, IMF, Worldbank, CBN Statistical Bulletin

531,230

2,614,482

1,630,822

1,142,783

1,637,981

0.229

1.48

1.128

0.138

0.073


WOMEN OF CHILD BEARING AGE

584,449

3,462,704

1,865,709

1,280,170

2,582,671

1,115,766

6,077,186

3,496,532

2,422,954

4,220,652

TOTAL POPULATION (NUTRITION BURDEN

PER CAPITA ALLOCATION

TO NUTRITION (BASED ON

(N’bn) In Persons In Persons In Persons In Persons Naira

2,600,244

13,515,629

8,503,688

5,748,408

12,958,712

88.07

109.50

132.65

24.01

5.63

*Population estimate used is for 2017 (CBN Statistical Buletin)**2018 Budgetary allocation for Nutrition specific and Nutrition Sensitive intervention

Per capita Budgetary allocation by the focus states to

Nutrition specific and Nutrition sensitive interventions

remains low. The Nutrition budget per capita is

inadequate as compared to the burden on health and

nutrition in across almost all the State.

BOX Metrics for estimating Under 5 population and Women of Childbearing Age ( 2017)

20.4

3%

Percentage of population under the age of 5 Percentage of Population Women of Childbearing Age (15 - 44 years)

NASARAWA KANO KADUNA NIGER LAGOS

12.6

4%22

.27%

19.8

8%

21.9

4%

19.1

8%

19.3

4%

25.6

2%

22.4

8%

19.9

3%

Source: Estimated using 2006 censor, fertility rate ( NBS), Nigeria population commission’s Projected 2017 population of States.


Government investments in health and key nutrition interventions have been

and still very poor between 2014 and 2018. Also, the attention of government at

the National level is skewed towards corrective interventions like administering

RUTF.

For instance, at the national level, only 43.40 percent of the amount budgeted

for health was utilised. Nasarawa and Kano state could only spend 32.8 percent

and 8.72 percent of the amount budgeted for Nutrition in 2017 respectively.

Government is doing too little in terms of preventive interventions thus like

micronutrients among others. Even when allocations are made, Government at

National and sub-national level are spending less than half of the budgeted

amount, with spending rates varying significantly.

The Federal Government and state government when faced with reduced

revenue tends to focus more on visible capital investment like the construction

of rail tracks neglecting key nutrition intervention as we saw in 2015 and 2016.

As a result, advocacy messages target at government is needed to address the

lack of budget credibility especially as it relates to the key Nutrition

interventions.

Also, the analysis shows that there was a great variance between what is

budgeted and what was spent. Even where there is a release notwithstanding

the low allocation , what government spend on and why they do at the detriment

of other nutrition relation allocations is not clear suggesting that there is issue of

understanding importance of nutrition by the policy makers and prioritizing

nutrition.

CONCLUSION

trend analysis of health and nutrition budget in...

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