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Nutrition investments affect human capital formation, which in turn affects economic growth. Malnutrition is intrinsically connected to human capital—undernutrition contributes to nearly half of child mortality, and stunting reduces productivity and earnings in adulthood. Improving nutrition requires a multisectoral effort, but it is difficult to identify and quantify the basic financing parameters as used in traditional sectors. What is being spent and by whom and on what? To address these questions, nutrition public expenditure reviews (NPERs) determine the level of a country’s overall nutrition public spending and assess whether its expenditure profile will enable the country to realize its nutrition goals and objectives. When done well, NPERs go beyond simply quantifying how much is spent on nutrition; they measure how well money is being spent to achieve nutrition outcomes and identify specific recommendations for improvement. A Guiding Framework for Nutrition Public Expenditure Reviews presents the key elements of an NPER and offers guidance, practical steps, and examples for carrying out an NPER. The book draws upon good practices from past NPERs as well as common practices and expertise from public expenditure reviews in other sectors. This handbook is intended for practitioners who are tasked with carrying out NPERs. Other target audiences include country nutrition policy makers, development partner officials, government technical staff, and nutrition advocates. The book presents data and analytical challenges faced by previous NPER teams and lays out the kinds of analyses that past NPERs have been able to carry out and those that they were unable to perform because of data or capacity constraints. It concludes with further work needed at the global and country levels to create the conditions necessary to conduct more comprehensive NPERs.
Public expenditures (PE), their sizes, and allocations across sectors, are some of the important instruments for the public sector to contribute toward sustainable development goals (SDGs). However, knowledge gaps remain as to how PEs have actually contributed to key SDG outcomes in the past, including the eradication of poverty and hunger, and the improvement in food and nutrition security in sustainable manners (SDGs 1 and 2). This study aims to partly fill this knowledge gap using the Statistics on Public Expenditures for Economic Development (SPEED data) and various country-level panel data. We find that PEs in different sectors have been significantly associated with key indicators under SDGs 1 and 2. Specifically, greater PEs for agriculture and health sectors have had relatively positive effects on total factor productivity growth in agriculture, reduced consumer food price indices, reduced poverty, reduced stunting, underweight or overweight among children under 5. A greater PE for agriculture has also been weakly associated with enhanced biodiversity. These relationships are observed for a broad class of countries, but somewhat stronger for countries that had been classified as low- or lower-middle-income in 2000. Greater PEs for education and social protection, which have been generally higher than PEs for agriculture and health, have had more mixed effects on these outcomes. While continued analyses are required to better understand the complex linkages between PE and these outcomes, the current study offers useful preliminary insights.
World Bank Discussion Paper No. 318. Analyzes the condition needed for achieving sustainable private sector growth in the Visegrad countries--the Czech Republic, Hungary, Poland, and the Slovak Republic. The analysis focuses on the legal and regulatory framework and institutional capacity, the privatization of state enterprises, and private sector development.
This paper presents a methodology for public expenditure review and analysis for climate change adaptation and mitigation in the agricultural sector. It outlines the basic methodological concepts, including the classification of public expenditures in the context of their links to climate change adaptation and mitigation. It also illustrates how such analysis can usefully contribute to policy decision making to better achieve the climate change adaptation and mitigation goals using the case study of Uganda. The proposed classification allows for analysing the level and the composition of public expenditures that influence adaptation capacity of the sector to climate change, and actions that increase or decrease greenhouse gas emissions (GHG) in agriculture. This, in turn, allows for assessing whether the sector is stimulated in a way that allows achieving a country’s climate change adaptation and mitigation objectives and form a basis for further evaluation of the effectiveness of individual measures in reaching these objectives.
This Public Expenditure Review (PER) for health in Zimbabwe is an analytical report developed by the World Bank Health, Nutrition and Population Task Team working with the World Bank's Macroeconomics and Fiscal Management Global Practice team, Zimbabwe's Ministry of Finance and Economic Development (MOFED) and Ministry of Health and Child Care (MOHCC), with input from development partners. The aims of the PER are to provide objective evidence to inform the allocation of resources to enable equitable, efficient, and sustainable health care provision and to highlight questions about health sector performance for policy makers and key stakeholders. The findings also aim to present Zimbabwe's health sector spending in an international and regional perspective, highlighting key issues for improving health outcomes. The PER is based on analysis of primary and secondary data as well as an extensive review of existing literature. The research was complemented by interviews with key stakeholders, and data collection from major development partners and domestic health funders, including private companies. Micro-level data from household and health facility surveys in May-August 2014 (primarily for the impact evaluation of the Results-Based Financing (RBF) program supported by the World Bank) complemented these scarce data.
Many development programs that aim to alleviate poverty and improve investments in human capital consider women’s empowerment a key pathway by which to achieve impact and often target women as their main beneficiaries. Despite this, women’s empowerment dimensions are often not rigorously measured and are at times merely assumed. This paper starts by reflecting on the concept and measurement of women’s empowerment and then reviews some of the structural interventions that aim to influence underlying gender norms in society and eradicate gender discrimination. It then proceeds to review the evidence of the impact of three types of interventions—cash transfer programs, agricultural interventions, and microfinance programs—on women’s empowerment, nutrition, or both. Qualitative evidence on conditional cash transfer (CCT) programs generally points to positive impacts on women’s empowerment, although quantitative research findings are more heterogenous. CCT programs produce mixed results on long-term nutritional status, and very limited evidence exists of their impacts on micronutrient status. The little evidence available on unconditional cash transters (UCT) indicates mixed impacts on women’s empowerment and positive impacts on nutrition; however, recent reviews comparing CCT and UCT programs have found little difference in terms of their effects on stunting and they have found that conditionality is less important than other factors, such as access to healthcare and child age and sex. Evidence of cash transfer program impacts depending on the gender of the transfer recipient or on the conditionality is also mixed, although CCTs with non-health conditionalities seem to have negative impacts on nutritional status. The impacts of programs based on the gender of the transfer recipient show mixed results, but almost no experimental evidence exists of testing gender-differentiated impacts of a single program. Agricultural interventions—specifically home gardening and dairy projects—show mixed impacts on women’s empowerment measures such as time, workload, and control over income; but they demonstrate very little impact on nutrition. Implementation modalities are shown to determine differential impacts in terms of empowerment and nutrition outcomes. With regard to the impact of microfinance on women’s empowerment, evidence is also mixed, although more recent reviews do not find any impact on women’s empowerment. The impact of microfinance on nutritional status is mixed, with no evidence of impact on micronutrient status. Across all three types of programs (cash transfer programs, agricultural interventions, and microfinance programs), very little evidence exists on pathways of impact, and evidence is often biased toward a particular region. The paper ends with a discussion of the findings and remaining evidence gaps and an outline of recommendations for research.