04 Apr 2018

Address Budgetary Challenges in Social Sector Programmes to expedite State's Progress in Maternal and Child Nutrition

Patna, April4, 2018. Bihar has made noticeable improvements in nutritional outcomes over the last decade, with stunting among children under-five years of age falling from 56% in 2005-06 to 48% in 2015-16. However, the levels of under-nutrition in the state remain high with significant intra-state disparities in nutritional outcomes. Persistent challenges in the domain of public financing of these interventions and associated bottlenecks ​ in their implementation,​  have affected their coverage.

In this context, a round table was organized by Asian Development Research Institute (ADRI), Patna in collaboration with UNICEF, Bihar and Centre for Budget and Governance Accountability (CBGA), New Delhi to share the findings of a research study. The study focused on budget outlays for nutrition interventions in Bihar in the most recent years. It assessed the adequacy of budgetary resources for delivery of select nutrition interventions, analysed the trends in fund allocation and utilization and some of the challenges that constrain their effective implementation.

While releasing the study Dr. Shaibal Gupta, Member Secretary, ADRI, Patna, shared that “addressing issues of under nutrition in the state is possible by scaling up a set of proven nutrition interventions, which are included in the existing policy framework. However, with the changes in the fiscal federal architecture, the state has received lesser share of resources from the divisible pool during the period of 14 FC, compared to what it had received during the period of 13 FC. Despite the fact that the present political regime is very much social sector policy driven and has been prioritizing social sector programmes over the years”

While addressing the gathering, Mr. AsadurRahman, Chief of Field Office, UNICEF, Bihar, shared that “Nutrition on first 1000 days in life is the foundation to the overall wellbeing o the population. Evidences suggest that in order to have nourished children with optimal physical and cognitive development, focus has to be on maternal nutrition as well as on adolescent nutrition, since a significant adolescent girl populationare getting married and is becoming mothers in their adolescence. The state of Bihar is providing several interventions but the interventions need to be in convergence which is critical for improving nutritional status of children, adolescents, and pregnant women. The Nutrition Mission launched recently provides an excellent opportunity to the State. Apart from pooling of resources, what is required is also to make adequate budget for direct nutrition interventions. The UNICEF-CBGA-ADRI study on financing for nutrition can better serve the State to identify resource gaps, utilisation challenges which will result in efficient budgeting for Nutrition in the state”.

While deliberating on the issue, Prof. Prabhat P Ghosh, Director, ADRI, shared that “addressing the root causes of child under-nutrition require a wide range of policy interventions with more inclusive approach. Effective strategies have to be devised for effective implementations at the ground. It is important to address the shortage of human resources, particularly the frontline service providers, for effective delivery of the programmes meant for health and nutrition in the state” The existing institutional set ups need to be utilized fully for better delivery of services and getting desired level of outcomes of the public investment”. 

Mr. Subrat Das, Executive Director of CBGA, New Delhi, shared that, “the process of tracking budgets for nutrition poses unique challenges at the state and district level. Most of these challenges are rooted in the differences in the nutrition and budget framework in the country itself. These challenges are: availability of relevant data to track nutritional status, budgets etc. for different social groups and across districts and sub-district level”.  

While reflecting on the study findings and possible way forward Shri. Sanjay Kumar Singh (IAS), Additional Executive Director, State Health Society, shared that, “Government of Bihar is very much proactive in addressing the issue of under-nutrition for which adequate provisioning of Nutrition Rehabilitation Centres and coordination between the Health and Social Welfare departments for better convergence of programmes have been in place. To address the shortage of human resource, particularly doctors in the remote areas, the proposed salary budget has been revised to incentivise them to serve in the remote and rural areas of the state”. 

The said discussion was attended by academia and policy researchers, media personal, representatives from Government and representatives from development partners in the state.

 

Background Note

Budgeting for Nutrition: Why it matters for Bihar?

Bihar has made noticeable improvements in nutritional outcomes over the last decade, with stunting among children under five years of age falling from 56% in 2005-06 to 48% in 2015-16 (as per NFHS-4). Yet, the levels of undernutrition in the state remain high with significant intra-state disparities in nutritional outcomes.

The high levels of undernutrition in the state can be addressed by scaling-up a set of proven nutrition interventions, which are included in government’s policy framework. The efforts towards improving the nutritional status need to be focused on both the nutrition-specific (direct interventions) as well as nutrition-sensitive interventions (indirect programmes). This calls for adequate and effective public spending in sectors such as maternal and child health, access to safe drinking water, sanitationand hygiene, education, agriculture, poverty alleviation as well as providing social safety nets. Both nutrition-specific and nutrition-sensitive interventions are delivered through a mix of centrally sponsored and state-specific schemes in Bihar, spread over a range of departments.

However, despite concerted efforts by the state to strengthen its investment in critical sectors related to nutrition, a plethora of fiscal challenges continue to restrict its efforts in this domain. These relate to limited fiscal capacity of the state for investing in nutrition-related sectors, persistence of systemic issues constraining fund utilisation, and associated bottlenecks in their implementation. Moreover, the recent changes in the domain of fiscal architecture – changed fund sharing pattern in centrally sponsored schemes and a lower share in divisible pool of central taxes for Bihar (9.6% under 14 Finance Commission against 10.9% under 13 Finance Commission) – have increased the fiscal burden on Bihar.

In context of the changed fiscal scenario and the urgent need to invest in nutrition programmes, we have examined some important aspects of public financing for nutrition in Bihar, both at the state and district level. Based on this research, four working papers were developed. These papers have tracked budgets for nutrition at the state and district (Purnea) level, discuss the challenges pertaining to adequacy of funds, issues in fund utilisation and bottlenecks constrainingimplementation of some of these interventions in the state.

The Round Table

In the above context, Asian Development Research Institute (ADRI), Patna in collaboration with Centre for Budget and Governance Accountability (CBGA), New Delhi and UNICEF, Bihar will be organizing a Round Table Discussion on Public Financing for Nutrition in Bihar at ADRI premises on Wednesday, April 4, 2018 at 10.30 AM.

The Round Table would bring together government functionaries, policy makers, and public finance and nutrition experts to discussthe issues associated with public investment in nutrition in Bihar and suggest a possible way forward. We hope the discussion would help in identifying issues and challenges across a range of sectors that require greater attention in the policy framework of the state. The Round Table is a part of ourefforts to deepen the policy discourse in India, at the national and sub-national levels, on nutrition, specifically from the public investment perspective.

The round table discussion will be chaired by Dr. Shaibal Gupta, Member Secretary, ADRI, following the release of reports in the presence of Mr. Asadur Rahman, Chief of Field Office, Bihar and Mr. Subrat Das, Executive Director, CBGA. In the technical session, study findings will be shared in which representatives from the State Government, representatives from development partners and academia and policy analysts are expected.