Improving nutrition budgeting in health sector plans: Evidence from India's anaemia control strategy

Abstract

In India, 15 nutrition interventions are delivered and financed through the National Health Mission (NHM). Programmatic know-how, however, on tracking nutrition budgets in health sector plans is limited. Following the four phases of the budget cycle-planning, allocations, disbursements and expenditure, this paper presents a new method developed by the authors to track nutrition budgets within health sector plans. Using the example of the Anemia Mukt Bharat (AMB) or Anemia Free India strategy, it reports preliminary findings on the application of the first two phases of the method, that is, to track and act for improved planning and allocations, covering 12 states. The paper lists out the budget heads, cost norms and developed tools to plan adequately. Supportive action was undertaken through sharing trends and trainings for AMB's budgeting to create opportunities for improvements. It was observed that the AMB budget increased over 3 years despite the COVID situation. It increased from INR 6184 million in FY 2019-2020 to INR 6293 million, a 2% increase in FY 2020, and to INR 7433 million, an 18% increase in FY 2021-2022. The difference in allocations and planned budgets were low (16%, 4% and 11%, respectively) while the difference in required budgets and planned budgets were significant but reduced consistently (41%, 31% and 22%, respectively). The paper concludes that the methods adopted for tracking and acting for improved nutrition budgets helped in informing national and state governments regarding yearly trends. Such methods can be effective and be developed for other nutrition interventions.

Identifying risk factors in explaining women’s anaemia in limited resource areas: evidence from West Bengal of India and Bangladesh

“…Anaemia Mukt Bharat (anaemia free India) was launched recently by the Government of India to reduce the prevalence of anaemia by 3% points yearly among children, adolescents, and women in the reproductive age (15–49 years) from 2018 to 2022 [ 36 ]. However, over the past decade, a drop of mere 0.7 percentage points was experienced by women (from 62.5% in 2006 to 61.8% in 2016) in West Bengal, indicating the failure of these targets [ 4 ].…”

Integrating an algorithmic and health systems thinking approach to improve the uptake of government antenatal nutrition services in Vidisha, Madhya Pradesh (India), 2018 to 2021

“…In addition, based on a literature review we identified seven key correlates of utilization of antenatal services, i.e. place of residence, education and age of women, wealth, number of children, social group and religion ( Singh et al , 2012 ; Saad–Haddad et al , 2016 ; Okedo-Alex et al , 2019 ). Apart from unadjusted estimates, difference-in-difference estimates were calculated after adjusting for all these socio-economic correlates using the ‘diff’ command in Stata 15.…”

Diagnostic Validation and Feasibility of a Non-invasive Haemoglobin Screening Device (EzeCheck) for 'Anaemia Mukt Bharat' in India

“…The Indian government has launched several anti-anaemia initiatives over the years, including the National Iron Plus Initiative (NIPI) [3], which provides iron and folic acid supplements to pregnant and lactating women and children. The 'Anaemia Mukt Bharat' (AMB) strategy or 'Anaemia-Free India' was launched in 2018 to reduce anaemia in vulnerable age groups especially women, children, and adolescents through a life cycle approach that includes preventive and curative mechanisms [3].…”

“…The Indian government has launched several anti-anaemia initiatives over the years, including the National Iron Plus Initiative (NIPI) [3], which provides iron and folic acid supplements to pregnant and lactating women and children. The 'Anaemia Mukt Bharat' (AMB) strategy or 'Anaemia-Free India' was launched in 2018 to reduce anaemia in vulnerable age groups especially women, children, and adolescents through a life cycle approach that includes preventive and curative mechanisms [3]. The significance of community anaemia screening lies in its ability to detect and address anaemia at an early stage, particularly in vulnerable populations, improving overall health outcomes and reducing the burden of this widespread condition.…”