REPORT ON ROUND TABLE DIALOGUE ON SUN POST 2015 FINANCING

 

REPORT ON ROUND TABLE DIALOGUE ON SUN POST 2015 FINANCING

COLLEGE OF PHYSICIANS AND SURGEONS

2ND DECEMBER, 2015

 

ACRONYMS

AU                   African Union

DAs                 District Assemblies

DCE                 District Chief Executive

DP                    Development Partner

ECOWAS          Economic Community of West African States

FAO                 Food and Agriculture Organization

FBO                 Farmer Based Organization

GOG                Government of Ghana

GPCAHM         Ghana Parliamentary Caucus against Hunger and Malnutrition

GHACCSUN      Ghana Coalition of Civil Society Organizations on Scaling Up Nutrition

GHS                  Ghana Health Service

GSS                  Ghana Statistical Service

HAG                 Hunger Alliance of Ghana

MOH               Ministry of Health

MOFA              Ministry of Food and Agriculture

MOF                Ministry of Finance

NAAP               National Alliance Partnership Programme

NDPC              National Development Planning Commission

SUN                 Scaling up Nutrition

UNICEF           United Nations Children Fund

WAAAHM        West African Alliance against Hunger and Malnutrition

WIAD              Women in Agriculture Development

WFP                 World Food Programme (UN)

 

1.1 Introduction

Politically, Ghana has demonstrated commitment to addressing her food security and nutrition challenges both locally and internationally. For instance Ghana is a signatory to a number of international declarations endorsing the right of its citizens to adequate food and nutrition. Policies, programmes and strategies to address food insecurity and under nutrition over the years  include the national breast feeding policy (1995), the infant and young child feeding strategy (2008), the vitamin A policy (1998), the food and drugs law amendments on universal salt iodization (1995), the National Nutrition Policy (2014-2017). Ghana also joined the SUN movement as an early riser country in 2011. The 1992 constitution of Ghana also acknowledges the right to good nutrition as a fundamental human right. It is however unknown how these acknowledgements and commitments are translated into investment in nutrition. It has emerged that the implementation of food security and nutrition policies and programmes has been plagued with inadequate financial commitment by government over the years. Analysis of previous national budgets and the 2016 budget of the government of Ghana shows that nutrition has never been given a clear budget line and allocations for nutrition specific and nutrition sensitive sectors have also been fluctuating over the years. It has also emerged that the chunk of the budget allocation for nutrition specific and sensitive sectors has been largely influenced by donor support

 

In pursuit of its objective of making nutrition a development priority given adequate funding in the national budgets, the Ghana Coalition of Civil Society Organizations for Scaling Up Nutrition (GHACCSUN) through the Hunger Alliance of Ghana organized a round table dialogue on nutrition financing Ghana on the 2nd of December 2015 to shed more light on these issues in the 2016 national budget.

 

  • Rational of the dialogue

The rationale of the dialogue was to determine the extent at which the previous and 2016 national budgets are nutrition sensitive. It was also to determine the exact budgetary allocation provided in the budgets for nutrition specific and nutrition sensitive sectors in order to understand the progression of budgetary allocations for nutrition since 2014.

 

  • Objectives of the dialogue
  • To inform participants about the government of Ghana’s financial commitment to scale up nutrition.
  • To call on government of Ghana to recognize nutrition as a development priority issue.
  • To help stakeholders understand and adapt strategies to influence government to increase investment in nutrition

 

1.3 Participants, Resource Person and Methodology

Participants included CSO representatives, UN Agencies, representatives from Development Partners, Academia, the private sector, nutrition champions and advocates. Others included representatives from Ministry of Food and Agriculture, Ministry of Environment, Science and Technology and Innovation, Ministry of Health, National Development Planning Commission and Ghana Health Service. The dialogue was facilitated by Dr. John Nene Azu. The dialogue involved welcome address and statements from key stakeholders followed by a power point presentation. Discussions, deliberations and suggestions followed. The round table dialogue was participatory and interactive and was grounded on solid facilitation process.

2.0 Chairpersons opening remarks (Dr. Edith Tetteh)

The event started with a prayer by Amen Amen Reynolds Amen followed by an introduction of the Chairperson by the facilitator in the person of Dr. Edith Tetteh, a Commissioner of the National Development Planning Commission. Dr. Tetteh was happy about the timing of the round table dialogue since it was just after the country had presented its national budget to parliament. She reiterated how important nutrition was and needed adequate funding in the country’s budget to scale it up as a priority area. She hoped that participants would bring out better strategies to advocate for increased investment in the national budgets for nutrition moving forward. She wished participants fruitful deliberations and encouraged everyone to partake in the discussions.

 

3.0 Welcome Address- (Dr. Frank Mcavor)

Dr. Frank Mcavor, Chairman of the Ghana Coalition of Civil Society Organizations for Scaling Up nutrition (GHACCSUN) in his welcome address explained that nutrition was a multi-sectorial issue and emphasized how pressing nutrition issues were to the overall development of the country. He said as Civil Society Organizations under the umbrella of GHACCSUN, more was expected to put pressure on government for increased financial commitments in nutrition sensitive and specific sectors in the nation’s budget. According to Dr. Mcavor policies have been adopted, advocacies have been embarked upon since the government joined the Scaling Up Nutrition movement in 2011, however there was no clear budget line for nutrition in the national budget to date. He saw the dialogue to be a good opportunity to come out with practicable strategies to advocate for financial commitment to nutrition and urged participants to contribute their ideas to solving this challenge.

 

 

4.0 Statement on behalf of the Ghana Parliamentarians Against Hunger and Malnutrition Caucus) (Honorable Kwabena- Appiah Pinkrah

Honorable Kwabena Appiah-Pinkrah, Member of Parliament for Akrofuom constituency and also the Co-Chairman of the Ghana Parliamentarians Caucus against Hunger and Malnutrition made a Statement on behalf of the Caucus on the role of Parliament in influencing the allocation of adequate funds for nutrition sensitive sectors in national budgets. He emphasized that nutrition was a very sensitive area that needed adequate attention. He supported the call for a nutrition agency to be placed under the Presidency, advising the civil society organizations to start early lobbying to ensure that nutrition issues got a high budgetary allocation. He also explained that before the budget comes to parliament for approval, it goes through a number of processes. Civil Society should not wait till it has come to parliament for approval before making a case out of what has been allocated to nutrition specific and sensitive sectors that would be too late. He commended the alliance for organizing the round table dialogue and pledged his support and that of the caucus in parliament for the continued lobbying to making nutrition a national priority issue supported with adequate funding.

Honorable Kwabena Appiah Pinkrah giving his statement at the dialogue

 

5.0 Presentation on the analysis of budgetary allocation for nutrition

Mr. Fidelis Avogo, a Resource Person made a presentation on the  analysis of budgetary allocation for nutrition specific and nutrition sensitive sectors in national budgets from 2014 to 2016. He also presented the country’s nutritional situation to stakeholders and pointed out that seven out of 10 children in Ghana suffer from vitamin A deficiency, seven out of 10 children under age five were anaemic and two out of five women were anaemic. Investing in nutrition could save 3,000 lives by preventing underweight and 2,500 children by decreasing vitamin A deficiency. It could also help prevent permanent brain damage in 50,000 children by decreasing iodine deficiency while saving the lives of more than 4,500 mothers by decreasing maternal anaemia. Mr. Avogo said even though Ghana had demonstrated political commitment to scale up nutrition, there seem to be no clear effort at enhancing food security and nutrition interventions through the provision of budgetary support. He called on government to show a lot more commitment towards improving nutrition in the national budgets moving forward. Some details of his presentation are below:

 

THE COMPLEX MIX OF NUTRITION

 

WHY MUST WE INVEST IN NUTRITION

  1. We are all human beings and eat food
  1. We all can be affected by either-under nutrition or over-nutrition
  1. Consequences of nutrition challenges:
  2. Increased Infections
  3. Impaired Physical Growth
  4. Impaired Mental Development
  1. Investing in nutrition will achieve the following targets in one year:
  • Save 3,000 lives by preventing underweight
  • Save the lives of more than 2,500 children by decreasing vitamin A deficiency
  • Prevent permanent brain damage in 50,000 children by decreasing iodine deficiency

Save the lives of more than 4,500 mothers by decreasing maternal anaemia

 

 GHANA’S BUDGETARY ALLOCATIONS FOR NUTRITION SPECIFIC AND SENSITIVE SECTORS

Sector 2014 Budget 2015 Budget (Ghs) Variance 2014 – 2015 2016 Budget (Ghs) Variance 2015 – 2016
MoH 3,353,707,814 3,068,244,628 (285,463,186) 3,386,762,864 318,518,236
MoFA 306,891,987 411,821,430 104,929,443 501,501,708 89,680,278
MLGRD 239,851,160 290,983,971 51,132,811 605,039,658 31,405,587
Gender 91,038708 43,631,694 (47,407,014) 49,520,377 5,888,683
MoE 5,816,315,034 6,740,437,383 924,122,349 6,532,352,029 208,085,354
MoWWH 531,389,023 463,103,420 (68,285,603) 1,418,584,338 955,480,918
NDPC 6,548,479 6,173,672 (374,807) 4,993,001 (1,180,671)
MEST 245,955,307 243,399,833 (2,555,474) 274,215,152 30,815,319

 

SOME OBSERVATIONS MADE IN THE NUTRITION SPECIFIC SECTORS

MOH MOFA POLICY
  1. Nutrition is a department under GHS with no specific budgetary allocation
  1. Over concentration on developing cash crops instead of Food Crops

 

  1. Ghana’s constitution guarantee the right to food and nutrition but there seem to be no clear effort at food security and nutrition

 

  1. The whole GHS has no budget line  all come under MoH
  1. No thought given to fruits and vegetables development

 

2.      Development of strategic and national long-term development plans including GSGDA II,  National Medium term Dev’t framework etc

 

  1. No effort at promoting

nutrition awareness as a

national agenda by

resourcing the nutrition

department.

  1. No commitment to developing the poultry industry except to provide vaccines

 

3.      Training selected committees on M & E system

 

 
  1. Lack of attention for

extension and      research

 

4.      No mention of NDPC as National Focal point for Nutrition
 
  1. Women in agriculture empowerment very superficial

 

 
 
  1. Livestock production

dwindling

 

 
 
  1. Not meeting the  CAADP budgetary requirement  and or Maputu agreements

 

 
 
  1. Promotion of agriculture taking away land from subsistence  farmers thereby increasing poverty

 

 

 

 

6.0 Comments from presentation

Participants appreciated the presentation made on the budget analysis from the Resource Person. The Facilitator then gave participants the opportunity to ask questions regarding issues they may have identified from the presentation.

  • Paulina Addy, Deputy Director of Women in Agriculture Development (WIAD) under the Ministry of Food and Agriculture commended the presentation as a good one and suggested that the Agenda 2063 under NEPAD should have been added to the presentation. She further suggested that there was the need to critically look at agencies that are coordinating food security and nutrition interventions and the ones that are actually implementing to find out their clear roles and responsibilities. In conclusion she tasked the Resource Person to add the Ministry of Fisheries to the nutrition frontline sectors outlined in the presentation.
  • Isaac Ampomah from Concerned Health Ghana said it was imperative to know how much of the national budget was being funded by Development Partners and what was being funded by Civil Society Organizations to really assess the role CSOs play in support of nutrition. He gave an example that SEND Ghana contributes financially to government’s budget and this should be factored as a contribution from the CSO front. Mr. Ampomah added that aside the budgets, there was the need to analyze actual releases to show the actual commitment of government.
  • Victor Ngongalah from UNICEF said examining the budget allocations is very important and only the budget statement is not enough. MDA’s should be open to give CSOs information on the exact allocations in their district common funds since implementation takes place at the grass root level. He added that the National Development Planning Commission also required a high level of commitment and expertise to coordinate the Scaling Up Nutrition in Ghana, there was the need to critically look at that before committing resources to NDPC.
  • Edith Tetteh, Commissioner of the NDPC said 2014 was a challenging year for Ghana. This was because most of the allocations in the national budget were not released till the end of the 3rd quarter of the year. This made it very difficult to work since releases were not timely. It was then not enough to talk about allocations and not focus too on the actual releases of those allocations. There was the need to reexamine that aspect too.
  • Ngongalah again said there is no document in Ghana to show the actual commitment of the government of Ghana. There was the need to push for the promulgation of the National Nutrition Policy which was still before cabinet else in his view nutrition can never have a clear budget line in the subsequent national budgets. He added that CSOs are not publicizing their work on nutrition enough to receive the needed attention. CSOs should find ways of documenting their work to show their commitment.
  • Professor Agyemang Badu Akosa, the National Scaling Up Nutrition focal person said having a Nutrition Policy will not cure the malnutrition situation in Ghana. Policies have been passed and are not being used in the country. He said lobbying at the district level in his view was the solution. CSOs should be involved in the district planning process and the things that inform cabinet memo and the legislative instruments. He asked participants to assume that there was no policy on nutrition whereas high proportion of stunting and wasting was affecting the country’s growth, if participants had influences in the district levels, he did not see why channels like that could not be used to solve the problem. He stressed that the policy shall come however there was the need to start with the practicability of it and show the politicians what is actually happening in the communities. There was the need for CSOs to step out of their comfort zones and use radio opportunities to advocate for improved nutrition by enlightening District Chief Executives to know that nutrition is the bedrock of development.
  • Siapha Kamara, CEO of SEND Ghana asked how a nutrition budget could be developed and linked to the district assemblies. He said 2016 is gone there was the need to look at what CSOs can do to make nutrition reflective in the 2017 national budget and beyond. Communication should be intensified. Another critical area to be looked at was research to provide unquestionable data for nutrition planning and budgetary allocations.

 

 

 

                                    Participants at the dialogue

7.0 Proposed strategies

The Facilitator asked participants to come out with strategies and recommendations for joint action to advocate for increased investment in nutrition. Some of the recommendations were;

  1. The budget structure should be well understood by stakeholders’ especially civil society organizations before it goes to the district assemblies.
  2. There is the need to differentiate between actual coordination and implementation to identify what has to be dealt with. There is the need to look at specific challenges in the districts to find specific interventions that suit those challenges in each district.
  3. There is the need for NDPC to have a separate budget for nutrition or for SUN so that planning can help coordination.
  4. The mid-year review of the 2016 budget will present an opportunity for CSOs to still influence nutrition allocations.
  5. CSOs should advocate for the timely release of funds so as to effectively run nutrition programmes.
  6. A statement should be crafted for a Member of Parliament who can read it in parliament and also at the district assemblies. District assemblies should put up plans with resources beside it. They should not focus more on their district common funds. Some can generate enough resources from internally generated funds to fund nutrition interventions. This should be encouraged and be made part of the development planning process.
  7. There should be a sizable number of Members of Parliament advocating for increased budgetary allocation for nutrition.
  8. CSOs should collectively develop tactics to achieve one agenda in nutrition advocacy.
  9. CSOs who are investing in nutrition should document their experiences and impact to show their commitment to nutrition funding to also encourage government to invest more in nutrition.
  10. The one size fits all mentality should be demystified, each district should be profiled to see the nutrition gaps and what intervention to be designed for it.
  11. Budget analysis should be embarked upon at the upstream level.
  12. CSOs under the leadership of the Hunger Alliance of Ghana should plan a national nutrition conference hopefully in April and invite key Ministers and the President of the Republic of Ghana to discuss issues around nutrition.

 

8.0 Closing remarks

Dr. Edith Tetteh, the Chairperson of the round table dialogue was happy about the success of the dialogue and thanked participants for the zeal and enthusiasm in coming out with the numerous strategies outlined. In her closing remarks, she stressed that the ideas gathered from the deliberations should not be shelved but there should be a translation of all that into meaningful actions. Advocacy should not be only at the policy level, the grass roots level should not be left out. There was the need to also come out with innovative approaches to get finances of nutrition scaled up. She wished participants well in their efforts. The dialogue came to a conclusive end at 2:00 pm.