MODULE 4 - PATH
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESPATH/Doune PorterMODULE 4:Costing and Financing forNutritionThis module is structured around six key steps and considerations, detailed below, and isaccompanied by featured tools and additional resources:4.1 Assessing Readiness for Costing4.2 Estimating Costs for Nutrition Actions4.3 Conducting a Financial Gap Analysis4.4 Performing a Nutrition Budget Analysis4.5 Tracking Nutrition Financial Investments4.6 Advocating for the Nutrition Budget4-1Costing and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESOverviewOnce a multisectoral nutrition plan, or MSNP (Module 2) and common results framework, or CRF(Module 3) have been developed, the information that they outline—such as strategic objectives,actions and targets across a specified timeline and for various implementing partners—will providethe details needed for a nutrition costing exercise. The CRF and MSNP will also provide the detailsfor identifying what will be tracked and monitored financially on an ongoing basis.Costing, financial tracking and budget analysis provide valuableinsights into government allocations, expenditures and financialneeds for nutrition-specific and nutrition-sensitive interventions.There is growing understanding of the importance of estimatingthe financial costs of MSNPs/CRFs and tracking the financingfor nutrition interventions at the country level. It is also criticalto understand the composition of this financing, particularly thebudgets allocated by governments and nongovernmentpartners to nutrition actions across relevant sectors (health;water, sanitation and hygiene (WASH); education; agriculture;social protection).Costing of nutrition investments at the country level is anessential step in the process of mobilising resources, whilsttracking these investments informs ongoing advocacy andhelps ensure that funds are used to best effect. This moduleoutlines some key methods for: assessing for readiness andcosting an MSNP/CRF (which are crucial initial steps);assessing the financial gap for the costed plan (which can takeplace either during planning or inception); analysing thegovernment’s budget for nutrition, tracking financialinvestments and advocating for the resources needed to fundthe plan (all which take place during implementation). This doesnot represent a static phase, but rather, it should be revisitedPATH/Minzayar Ooand reassessed throughout and alongside the initial phases fordesigning the MSNP and CRF, as well as the later phases for monitoring and evaluation,implementation and advocacy. It is, therefore, recommended to review this module in conjunctionwith Modules 2 and 3, as there are overlapping considerations and processes to keep in mind.Module 1:Setting the Stagefor MultisectoralNutritionPlanning4-2Module 2:Developing aMultisectoralNutrition PlanModule 3:Developing aCommon ResultsFrameworkModule 4:Costing andFinancing forNutritionModule 5:Monitoring,Evaluation andLearning forNutritionModule 6:Preparing forInception andImplementationCosting and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESThe processes of nutrition cost estimation and financial tracking rely on the extent to which actionsfrom the previous modules have been considered and completed. Here are a set of questions toconsider before proceeding with costing and planning for tracking finances for nutrition: Is there adraft or completed and validated CRF with details of the activities and nutrition actions to be costed?Is there a draft or completed MSNP with the details of objectives and actions to be trackedfinancially through both government and nongovernment stakeholders? Is there access to currentand past national, ministry, subnational and donor budgets?If the documentation outlined in these questions is not available, consider revisiting the CRFoperationalisation and MSNP development processes from earlier modules to ensure sufficientinformation is available to proceed. Budget analysis and financial tracking for nutrition can beconducted without an MSNP/CRF; however, having these plans available significantly aids in theexercise because it helps to quickly identify what will be tracked. Several costing and financialtracking methods and tools are presented in this module and through associated resources,highlighting budget analysis in particular because it has been shown to be a simple but effective toolfor countries to begin looking at their nutrition finances.MQSUN ’s Approaches for Nutrition Costing and Financial Tracking inSUN [Scaling Up Nutrition] Countries guidance note provides a summary ofapproaches and tools that can be used by countries at the national orsubnational level to cost MSNPs and track financial resources and budgets fornutrition.In the process of costing and financing for nutrition, it is critically important to take account of fourkey cross-cutting considerations: advocacy, gender, capacity building and the humanitarian responsesituation. Details on the relevance of these considerations for this step in the process are detailedbelow.ADVOCACYCosting nutrition activities and tracking ofnutrition financial allocations and expendituresare key steps in the process of advocacy andresource mobilisation. Having detailed andaccurate nutrition-financing information is apowerful tool for advocating for increasedfunding from government and donors and is alsokey to holding implementers accountable fornutrition spending. The financial gap analysis ofan MSNP, particularly, is important forunderstanding where funding is lacking,prioritising funding for high-impact activities andadvocating for financial commitments toimplement them. Additional information isavailable in Section 4.6.4-3GENDERFinancial tracking and budget analysis fornutrition are strong opportunities for gendersensitive budgeting. Specifically, tracking theallocations and expenditures for high-impactnutrition activities that target women—and usingadvocacy efforts to increase funding for activitiesthat target women and are gender sensitive—willstrengthen gender equity and genderinclusiveness and further improve the health andnutritional status of women and children. Makinggender-sensitive financial information availablepublicly enhances transparency of the impacts ofgovernment decisions in terms of gender anddiversity and further enhances accountability.Costing and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESCAPACITY BUILDINGHUMANITARIAN RESPONSEGiven that nutrition activities are multisectoraland do not have a public sector budget of theirown but cut across many sectoral budgets, it isimportant to build capacity amongst both centraland sectoral staff for costing, developing andunderstanding budgets for nutrition activities. Inaddition, it is important to build capacity andsystems for financial tracking of nutritionactivities. Countries can engage in learning andgradual improvements of financial planning andmanagement systems for nutrition throughexternal support or opportunities for crosscountry sharing of challenges and successes.The costing and financial-tracking process fornutrition is an opportunity to examine the levelof funding for nutrition-related emergencypreparedness and response actions, such asfood security for migrant and displacedpopulations. Having costing and financialinformation can aid in advocating for a level offunding that is in line with the country’shumanitarian context. Financial contingencyplanning for humanitarian emergencies andother adverse events, such as pandemics, canoffer an additional safety net when thenutritional status of vulnerable populations is atrisk of worsening. More details are available inMQSUN ’s Linking Humanitarian andDevelopment Actions brief.4.1 Assessing Readiness for CostingCosting an MSNP or CRF can be complex and time-consuming given that nutrition activities happenacross various sectors and are implemented by many different stakeholders. As such, a costingreadiness assessment can assist countries—specifically policymakers, programme managers andtechnical assistance providers—to assess whether the MSNP or CRF is ready for a detailed andaccurate costing exercise.Assessing readiness for a costing activity determines whether the MSNP and/or CRF has sufficientdetail regarding intervention activities, targets, coverage, frequency and costing ingredients(elements/inputs for identifying the price needed per intervention) to be able to establish accuratecost estimates. Conducting this costing readiness assessment prior to initiating the full costingexercise can lead to a more efficient, timely and accurate costing process by identifying andaddressing any gaps or issues upfront. Identified gaps or needed clarifications can be addressed tofurther prepare the MSNP/CRF for a full cost estimation.MQSUN ’s Assessing Readiness for Costing guidance note assistscountries in assessing whether their MSNPs/CRFs are ready for a detailed andaccurate costing to be undertaken. (The guidance note can also be used duringthe planning process to guide the initial CRF development.) The Excel templateprovides a simple framework to assist in this assessment, which can save timein collecting the required costing data. The framework considers three aspects:logical flow of the activities, detailed description of the activities and coveragerates for both the current and future periods.4-4Costing and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESThe steps of the costing readiness assessment include (a) documenting the policy plan details (goaland strategic objectives), (b) elaborating the MSNP into a logical framework (or logframe) format (if aCRF logframe is not available) and (c) rating activities for the level of detail using the included ratingscale. An automated score is produced for each strategic objective, identifying which nutritionactions or interventions are ready for costing and which need additional information to ensure anaccurate and reliable costing exercise. See Annex 3 for an example of conducting a costingreadiness assessment in Yemen.CHECKLIST FOR ASSESSING READINESS FOR COSTINGA. Logical flow (goal objective outcomes outputs interventions/activities) Will the outcomes result in the objective being achieved? Do the activities constitute the logical steps/interventions needed to achieve theoutputs and outcomes? Does every objective have adequate and logical interventions and activities indicated?B. Intervention and activity detailFor each intervention and its activities, ask the following: Is there an adequate description of the intervention and activity?Is there a separation of each activity into separate rows in the logframe/CRF?Does it include the ingredients required to carry out the activities (e.g. personnel, drugs,consumables, capital good, overheads) or whether these could be obtained fromimplementing partners?Does it include the quantities of the ingredients (or whether these could be obtainedfrom implementing partners)? Will additional staff (and at what level) be required for thewhole period or only for a specific time/quarter/year?Is there information on the frequency of the activity/intervention per year?Is there information on which government ministries, nongovernmental organisations,private entities or others are already undertaking these activities?Are any existing unit costs of these interventions noted? If so, is the reference/sourceprovided?C. Current and targeted coverage Is the target population clearly indicated? Is the baseline (current or most recently available) coverage provided (where applicable)for each intervention or activity? Are the year and reference/source of the coverage rate provided? Are the units of measure provided (e.g. percentage of school-going children 5-17 yearsold)? Are annual targets provided (where applicable)? If targets are provided as percentages, are the denominators provided (so that theannual quantities can be calculated)?4-5Costing and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXES4.2 Estimating Costs for Nutrition ActionsAccurate estimates of the financial resources required to implement an MSNP or CRF are essentialfor planning, prioritisation, budgeting, reallocation and resource mobilisation. For the purpose of thistoolkit, ‘cost estimation’ is the process of assigning a value to the resources required for nutritionservices and interventions in a given setting, over a given time period, for designated target groupsor populations, and with a given coverage. Cost estimation is critical for adequately allocatingresources to ensure effective implementation of nutrition actions and for the process of mobilisingresources.The level of effort for estimating the costs of activities in an MSNP/CRF is highly variable anddependent on country context, available data, the number of nutrition actions to be costed and thenumber of sectors or stakeholders involved in implementation of nutrition interventions.Interventions with more complex delivery structures—implemented by multiple partners, sectors orstakeholders and across various locales—may take longer to cost given the complexity of detail anddata needed. This level of detail is necessary, however, because ultimately, a costed MSNP/CRF willserve as a tool to initiate nutrition actions.A Maximising the Quality of Scaling Up Nutrition (MQSUN) guidance note on costing finds severalimportant elements to consider for guiding the costing process. These include ensuring that there isan operational plan in place—such as an MSNP or CRF—before costing and including all relevantstakeholders: ministries, implementers and donors. For the cost-estimation stage, the MQSUNguidance note highlights that the following information should be included:1Clear and exhaustive understanding of each action in the plan.2Implementation targets for specific actions in the plan.3Target coverage.4Current implementation and spending.5Recurrent and capital costs.6Shared (indirect) costs.When determining how much it will cost to implement the CRF or MSNP, effective scale up is onlypossible when all costs associated with an intervention are included in the total cost of a plan, suchas fixed and variable costs, capital and recurrent costs, human resources and staffing costs andgovernance and infrastructure costs (such as those for monitoring, evaluation and learning).Assumptions around costs come down to what is included and excluded from cost estimates.Interventions that are not thoroughly and accurately costed may lead to an inaccurate estimation ofresource requirements and, thus, actions that fall short of their intended outcomes.It is also essential that both governance arrangements and nutrition staff salaries are fully costed inMSNPs/CRFs. This should include both the creation and maintenance of nutrition planning bodies4-6Costing and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESand the costs associated with systems to track programme implementation, expenditures andoutcomes. Sometimes referred to as the ‘enabling environment’, the processes, governancearrangements and personnel/salaries for staff supporting nutrition actions ‘above service delivery’are important to include in cost estimates. These may also include such things as informationmanagement, coordination, advocacy and communication, capacity building and policy development.One thing to consider is that there may be difficulty accounting for the costs of increasing nutritionrelated human capital, particularly because in many countries, nutrition-related activities are notimplemented by dedicated staff. If there are dedicated staff for certain nutrition interventions,capacity-building efforts may be easier to cost in those cases. In other cases, human capital may beaccounted for in sectoral budgets.There is additional complexity related to costing nutrition-sensitive actions. The MQSUN guidancenote on costing also lays out some of the issues and offers recommendations for nutrition-sensitivecosting. Nutrition-sensitive interventions are generally more difficult to cost because they are moredistal to the nutrition outcomes, there aremore stakeholders involved in theirimplementation, they are often non-healthsector interventions and there is generallyless experience in or standard procedures forestimating their costs. They can consist ofinterventions that are subcomponents oflarger interventions or parts ofwider/integrated programmes, respectively.A variety of costing methods can be usedwhen costing an MSNP/CRF, depending onthe context, level of detail, time and dataavailability. What is critical, however, is thatthe chosen method is clearly understood anddocumented by all stakeholders involved inthe exercise.PATH/Evelyn HocksteinOne common way to categorise costing methods is by top-down and bottom-up approaches. Topdown approaches are made by disaggregating high-level expenses into cost categories or facilities,whilst bottom-up approaches aggregate individual cost elements. Bottom-up costing approaches aregenerally more time-intensive but have the advantage of providing more detailed, accurate andreliable cost estimates. A common method of data collection for bottom-up costing is the ingredientsbased approach, which estimates the quantity and price of all the resources needed for a givenintervention or programme.A related costing approach that is not usually classified as either top-down or bottom-up is to takethe costs that exist for a current, similar programme and make relevant adjustments. This issometimes called a programme- or experience-based approach.Regardless of the method(s) used, it is important to fully document the approach, decisions andassumptions made so that the costing exercise is transparent and replicable. In many cases, a mixof different costing approaches is used (see country case study from Afghanistan for an example, aswell as a country case study for Togo).4-7Costing and Financing for NutritionMQSUN Toolkit on Multisectoral Planning for Nutrition - 2020
INTRODUCTIONMODULE 1MODULE 2MODULE 3MODULE 4MODULE 5MODULE 6ANNEXESCOUNTRY CASE STUDYEstimating the costs of implementing Afghanistan’s Strategic PlanIntroductionThe Afghanistan Food Security and Nutrition Agenda (AFSeN-A) Strategic Plan (2019-2023) wasdeveloped to translate the AFSeN-A, launched in 2017, into actions that address the foodsecurity and nutrition issues faced in the country. The goal of the AFSeN-A is to ensure that noAfghan suffers from hunger and that every Afghan is well-nourished at all times.A costing exercise was completed in 2018 with the objective of informing programme managersof the resource requirements for improving food security and nutrition over the course of theplan’s five years, as well as to be used for advocacy for resource mobilisation.MethodsTwo methods were used for the costing: the ingredients approach (microcosting) and theexpenditure/budget approach. The ingredients approach was used when the cost per beneficiarywas available. The expenditure/budget approach was used when detailed information on pricesand quantities were not available. In those cases, the team used aggregate estimates of the costof an activity.The study team focused on off-budget activities and not the activities funded through on-budgetfunds. The on-budget funds are for government personne
introduction module 1 module 2 module 3 module 4 module 5 module 6 annexes The steps of the costing readiness assessment include (a) documenting the policy plan details (goal and strategic objectives), (b) elaborating the
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