“Strategic purchasing for nutrition and the approach proposed in these resources provide policymakers and implementers with tools to focus resources and health provider attention on nutrition actions while taking a holistic view of primary health care financing and payment,” said Cheryl Cashin, a managing director at R4D. “It is a practical way to prioritize nutrition and make it visible in health financing arrangements to increase accountability for coverage and quality of nutrition services.” 

The overview document, developed by the WHO, examines strategic purchasing of nutrition services within PHC. It introduces key terms and payment methods for countries to use in preparing to transform their health financial systems to scale up nutrition services. It does so by introducing nutritional perspectives to strategic health purchasing core areas: what to buy, from whom to buy and how to buy.   

What to buy covers how nutrition services should be prioritized and provides further understanding of nutrition service characteristics with examples and tools to assist decision-makers in deciding what to buy. From whom to buy describes providers and how decision-makers should select providers relevant to their nutrition services through contractual means and accreditation. How to buy introduces the various payment methods and describes recent research on nutrition services and payment schemes.

The document on the diagnostic assessment approach, developed by R4D, aims to strengthen the understanding of how nutrition services can be incentivized within purchasing arrangements for PHC to improve the quality, coverage and efficiency. It proposes a diagnostic approach for the systematic assessment of how nutrition services are purchased within existing health purchasing arrangements. The approach can be used by country teams to document and assess the place of nutrition in broader PHC purchasing arrangements, within a tested, established PHC purchasing framework. It provides four steps and 28 guiding questions to help governments and other stakeholders become more strategic in purchasing nutrition services within PHC.  

“Integrating essential nutrition actions within routine PHC services is important for comprehensive care, and this can only be achieved through sustainable financing,” said Mary D’Alimonte, a program director at R4D. “This tool is a huge step forward in identifying practical solutions countries can take to make financing for essential nutrition actions within PHC more strategic and sustainable. By following these steps, countries can dive deeper into understanding pathways toward more strategic use of funds in ways that avoid fragmentation and siloed programming.”

These publications were developed to ensure that nutrition services are not left behind — by increasing knowledge and building further understanding of strategic purchasing for nutrition services.

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About Results for Development
Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents — government officials, civil society leaders and social innovators — supporting them as they navigate complex change processes to achieve large-scale, equitable outcomes in health, education and nutrition. We work with country leaders to diagnose challenges, co-create, innovate and implement solutions built on evidence and diverse stakeholder input, and engage in learning to adapt, iterate and improve. We also strengthen global, regional and country ecosystems to support country leaders with expertise, evidence, and innovations. R4D helps country leaders solve their immediate challenges today, while also strengthening systems and institutions to address tomorrow’s challenges. And we share what we learn so others around the world can achieve results for development too. www.R4D.org   

Photo © USAID/Morgana Wingard

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The primary goal of the workshop was to discuss nutrition financing situations in Malawi and to agree on what a sustainable financing framework for nutrition should include. This work also complements the ongoing USAID Advancing Nutrition support to the Scaling Up Nutrition Movement to galvanize more and higher quality financing for nutrition in Malawi.

The workshop comprised four sessions including sessions on The National Multi-Sector Nutrition Strategic Plan and a review of its cost by Priority Areas and Nutrition Financing Trends in Malawi. The workshop also probed into district level annual and budget planning processes and ways to secure budget lines for multisectoral nutrition activities across various sectors including health, agriculture and education and discussed ways to advocate for increased nutrition funding within the district council development budgets.

We had participants from four districts in Malawi and from key nutrition stakeholders including the academia, development partners and civil society organizations.

The post Sustainable Financing for Nutrition in Malawi: Post Workshop Report appeared first on Results for Development.

Ms. Dogbe is a program officer on the nutrition practice at R4D where she supports nutrition projects across multiple sub-practices, with a focus on nutrition financing including the USAID Advancing Nutrition Project. 

Before joining R4D, Ms. Dogbe was a senior program associate at ACTION Secretariat where she provided program support to the ACTION partnership advocacy, policy research and policy analysis. Relevant issues under her portfolio included health financing, health systems, World Bank, multilateral banks, maternal, newborn child health and primary health. Nadine also contributed to the development of partnership advocacy strategies, partner and donor management, public-facing documents and programmatic and research design efforts. 

Nadine holds a master of science in public health with a concentration in health economics from the London School of Hygiene and Tropical Medicine. She is fluent in French and Ewe. 

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At Results for Development (R4D), Ms. Nnachetta is a senior program associate for the market shaping practice. In this role, she analyzes barriers in health product markets and helps in developing strategic solutions to them. She currently supports projects focusing on sexual and reproductive health products, as well as wasting in children and mothers.

Before joining R4D, Ms. Nnachetta worked at FHI 360 supporting the management of large HIV programs for general and key populations across Nigeria. She also supported programming for the COVID-19 emergency response and vaccination efforts in Nigeria, Haiti, Mongolia, Sri Lanka, Maldives, and the Pacific Islands. Prior to that, she was a program assistant in the Office of the Assistant Administrator at USAID’s Global Health Bureau.

Ms. Nnachetta holds a B.S. in biological sciences with a concentration in human nutrition and a minor in global health from Cornell University.

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Related Resource: Tracking aid for the WHA nutrition targets

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WASHINGTON, D.C. — Results for Development (R4D) today released a report showing that despite the overall increase in global aid for high-impact nutrition interventions, a significant financing gap to meet the World Health Assembly (WHA) targets by 2025 remains. This is especially troubling given the spike in malnutrition caused by global crises, including the COVID pandemic, conflict and the global economic slowdown.

The report, Tracking aid for the WHA nutrition targets: Progress toward the global nutrition goals between 2015-2020, is the first look at trends in nutrition aid since the beginning of the pandemic in 2020. In particular, financing for stunting, exclusive breastfeeding, and anemia have either decreased or plateaued.

The report also includes these key messages for the global nutrition community:

• Donor funding for priority nutrition interventions increased from $1.1 billion in 2015 to $1.6 billion in 2020, but we are still not achieving the scale-up needed to achieve the global nutrition goals.
• Donor funding for stunting and exclusive breastfeeding targets have plateaued, while disbursements to anemia have decreased.
• Donor funding for wasting treatment has increased significantly; however, there is still a large gap and much of this funding (59%) is via humanitarian channels that are less conducive to sustainable change.
• Donor disbursements to above-service delivery investments (such as funding for coordination, governance, advocacy, capacity building, and research and data) also increased significantly, which are important investments in support of programmatic scale-up.
• Major donors have increased or maintained funding for priority interventions since 2015.

“While the child malnutrition crisis is devastating, the recently announced $280 million to child malnutrition — on top of $250M committed in July — gives us hope,” said Albertha Nyaku, R4D’s nutrition practice lead. “With it comes opportunity to help children in immediate need and to strengthen services for the future while governments and donors continue to accelerate these commitments to achieving global nutrition goals.”

In 2017, the World Bank, R4D, and 1000 Days created the Investment Framework for Nutrition as a roadmap toward achieving the World Health Assembly (WHA) nutrition targets by 2025. The framework estimates that the world needs to mobilize an annual additional investment of $7 billion per year to scale-up nutrition-specific interventions at the level needed to achieve the global targets, where, of these costs, $2.3 billion per year is needed for a priority package of ready-to-scale interventions.

Since then, with support from the Bill & Melinda Gates Foundation, R4D has been tracking donor disbursements to priority interventions needed to achieve the WHA nutrition targets to monitor progress toward the financial benchmarks laid out in the Investment Framework.

Click here to view the full report and archive of previous nutrition financing analyses.

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About Results for Development
Results for Development (R4D) is a leading non-profit global development partner. We collaborate with change agents — government officials, civil society leaders and social innovators — supporting them as they navigate complex change processes to achieve large-scale, equitable outcomes in health, education and nutrition. We work with country leaders to diagnose challenges, co-create, innovate and implement solutions built on evidence and diverse stakeholder input, and engage in learning to adapt, iterate and improve. We also strengthen global, regional and country ecosystems to support country leaders with expertise, evidence, and innovations. R4D helps country leaders solve their immediate challenges today, while also strengthening systems and institutions to address tomorrow’s challenges. And we share what we learn so others around the world can achieve results for development too. www.R4D.org

Photo © Mwangi Kirubi/USAID Regional

The post Significant funding gap for nutrition remains despite increase in global aid appeared first on Results for Development.

Since then, R4D has been tracking donor disbursements to priority interventions needed to achieve the WHA nutrition targets to monitor progress toward the financial benchmarks laid out in the Investment Framework. In our latest update, we report donor disbursements from 2015 to 2020 and the financing gap that remains. This is the first look at trends in nutrition aid since the beginning of the pandemic in 2020. Disbursements have increased overall but a significant financing gap to meet the WHA nutrition targets remains. While financing for wasting and above-service delivery increased over this period, financing for stunting, exclusive breastfeeding, and anemia have either decreased or plateaued as need grows.

Please contact Caroline Andridge or Mary D’Alimonte for any questions or comments on these materials.

We wish to thank the many partners who participated in the development of the method and review of the findings, including members of the Scaling Up Nutrition (SUN) Donor Network who contributed their time and input to this analysis across the years. The authors would like to thank the Bill and Melinda Gates Foundation for supporting this study.

Additional Resources

• Methods (September 2022)
• Supplementary Material for 2020 Analysis (September 2022)

We are grateful for the support provided by the 2022 research team, including Abbe McCarter, Luka Pauwelyn, Lauryn Cravens, Henrike Schmalfuss, and Rana Iscazai. R4D is also grateful to the core team that helped spearhead this initiative in 2016, including Mary D’Alimonte, Jack Clift, Emily Thatcher, Stephanie Heung, and Augustin Flory, and to integral team members who joined as the analysis evolved into what it is today, including Caroline Andridge, Kyle Borces, Ryan LeMier, Felicity Nelson, Abbe McCarter, and David Christensen.

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At Results for Development (R4D), Mrs. Ajeigbe work closely with the Innovation practice team to devise and execute strategies and systems that support operational excellence, improve strategic budgeting and resource management, program management and quality control, business development, team-building, and human resources strategy. Some of the projects she works on include the International Development Innovation Alliance (IDIA), FCDO- Frontier Tech Hub, among others.

Some of Mrs. Ajeigbe’s major career achievements include restructuring an organization’s financial processes and procedures that had a major impact on delivery of their objectives. She also formulated and developed financial models and tools for government-funded startup projects.

Before joining R4D, Mrs. Ajeigbe worked with national not-for-profit organizations in the UK managing operational and strategic financial operations. This includes compliance to the UK Charity Commission, Companies House and Her Majesty’s Revenue and Customs (HMRC). She also worked on the Equality Justice and Alliance (EJA) Programme, funded by UK Foreign Commonwealth and Development Office (FCDO), where she managed budgets, grants and contracts.

Mrs. Ajeigbe holds a masters degree in development economics and BSc in accounting. She is a member of the Chartered Institute of Management Accountant (CIMA). She speaks English and Yoruba.

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Ms. Harp is a program officer on the nutrition practice at R4D where she supports nutrition projects across multiple sub-practices, with a focus on nutrition financing.

Before joining R4D, Ms. Harp supported the International Zinc Nutrition Consultative Group (IZiNCG) to update analysis estimating the prevalence of global zinc deficiency. This work produced several country-level briefs on fortification efforts and a report released globally to increase support for mandatory zinc fortification programs.

Ms. Harp also worked at Chemonics International on a famine early warning project which monitored agroclimatology, markets, and livelihood change across sub-Saharan Africa, Central Asia, and Central America. In this position, she led the team responsible for project operations and supported the senior management team in program implementation. Throughout her career, Ms. Harp has focused on facilitating inclusive collaboration with colleagues and partners. She has coordinated several large workshops on food security and nutrition with international attendees.

As of May 2022, Ms. Harp will hold a master’s degree in food and nutrition policy and programs from the Friedman School of Nutrition at Tufts University. She has a bachelor’s degree in agricultural economics from the University of Wisconsin-Madison.

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