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QUESTIONNAIRE ON BUDGET TRANSPARENCY & CHILD MALNUTRITION

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Budget Transparency for Children’s Rights (BT4CR)

QUESTIONNAIRE ON BUDGET TRANSPARENCY AND CHILD MALNUTRITION

FINAL VERSION

(version 8)

This final version was informed by consultations with the BT4CR researchers and

Save the Children staff present at a BT4CR workshop in Pretoria 28-29 May 2012,

and with Elena Mondo at the International Budget Partnership.

At the pen: Anna Schnell, Erica Coetzee and Judith Streak

Accountability & Transparency for Human Rights Foundation

COUNTRY: ZAMBIA


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Name of researcher: Frank Chansa

Organisation: Department of Economics, University of Zambia

Address: P.O. Box 32379, Lusaka

Tel: +260976558925/+260211290475

Email: [email protected]

Website: www.unza.zm

Reference group: Child Budget Network

Name Title Organisation

Mrs. Aongola Nutritionist Ministry of Health

Mr. Vincent Chowa Senior Nutritionist National Food and Nutrition Commission

Ms. Priscilla Funduluka Nutritionist Lusaka District Health Management Team

Mrs. Petronella Mayeya Deputy Country Director Save the Children Zambia Office

Mr. Kafupi James Banda Project Officer Zambia Civic Education Association

Mr. Geoffrey Chongo Program Manager-Equity and Economic Governance

Jesuit Centre for Theological Reflection

Mr. Joachim Cuthbert Mumba National Coordinator-Citizens Participation

World Vision Zambia


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CONTENTS

GLOSSARY OF TERMS USED IN THE QUESTIONNAIRE

SECTION 1: INTRODUCTION

SECTION 2: PRELIMINARY RESEARCH ON INTERVENTIONS & SUB-NATIONAL UNITS

SECTION 3: RUNNING REFERENCE LIST OF SOURCES

GENERAL COMMENTS FROM THE PEER REVIEWERS & RESEARCHER’S RESPONSE TO THESE

SECTION 4: QUESTIONS ABOUT POLICY & PLANNING FOR CHILD NUTRITION INTERVENTIONS

A. POLICY AND STRATEGIC COORDINATION IN CHILD NUTRITION INTERVENTIONS

B. PLANNED (BUDGETED) EXPENDITURES FOR CHILD NUTRITION INTERVENTIONS

SECTION 5: QUESTIONS ABOUT THE IMPLENTATION OF CHILD NUTRITION INTERVENTIONS

C. ACTUAL EXPENDITURES ON CHILD NUTRITION INTERVENTIONS

D. BUDGET PERFORMANCE IN RELATION TO CHILD NUTRITION INTERVENTIONS

SECTION 6: QUESTIONS ABOUT PARTICIPATION IN BUDGETING FOR CHILD NUTRITION

E. PUBLIC AND CHILDREN’S PARTICIPATION IN BUDGETING DECISIONS


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GLOSSARY OF TERMS USED IN THE QUESTIONNAIRE

To answer the questions in this questionnaire it is important to know the definitions of the terms used. This is why the glossary below is the first to

be presented in this questionnaire.

Actual expenditures: These are the amounts actually spent by a government department or by the government as a whole on a specific

programme over a given period, usually over a budget year.

Approved expenditure: These are the amounts reflected in the budget enacted by the legislature in a given country, including any revised

estimates and other amendments approved by the legislature during the budget year.

Budget allocations: See ‘Planned expenditures’.

Budget documents: In the questionnaire the term ‘budget documents’ refers to all the formal planning, communication and reporting mechanisms

used by a government to present and disseminate information about its budgets and budgeting. It may include print publications,

unpublished documents as well as online sources. Typically the most common types of budget documents produced by a government to

this end would include a pre-budget statement, the executive’s budget proposal, a popular version of the budget or citizens’ budget, the

enacted budget, in-year budget reports, a mid-term budget review, year-end reports and audit reports. Sector specific planning and

reporting documents may also present budget information, such as strategic plans and annual reports.

Budget information: All information produced, published and disseminated by a government regarding its budgets and budgeting, including the

budget implementation process. This means that information from different sectors and departments regarding the roll-out of programmes

and services should also be seen as part of budget information.

Budget planning: The first phase of the budget process in most countries, usually led by the Ministry of Finance. Budget planning generally

includes macro-economic modelling and analysis, revenue projections and the formulation of detailed spending proposals.


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Budget proposals: Plans drawn up, for example, by a government or by the government as a whole, outlining which programmes and activities it

plans to undertake in the upcoming budget year (or over the medium-term) and the costs associated with those programmes and activities.

Budget transparency: For the purposes of this questionnaire, ‘budget transparency’ is defined as a situation in which a member of the public or

civil society is able to access information about a given government intervention or programme either via the internet, at a public library or

resource centre, or by requesting such information from a government office, in person, by phone or via email. In the latter instance,

transparency is seen to be adequate if the information is provided within two weeks of the request being made. See also ‘publically

available’.

Budget year: A budget year (sometimes called a fiscal year) is the period for which budget planning is done. When the questionnaire refers to ‘the

budget year’ without further qualification, this is the year for which the executive’s most recent budget proposal is being drafted.

Caregivers: All those involved in the care and supervision of children, including parents, grandparents, siblings, other children and family or

household members, as well as child-minders, babysitters, crèche staff, early childhood development practitioners, teachers, teachers’ aides,

nurses and those working in shelters, orphanages and places of safety. See also ‘Primary caregivers’.

Cash transfer: A government intervention that takes the form of providing money to individuals or households, usually targeted to those most in

need or to those with limited or no income-earning capacity. Cash transfer programmes are typically directed to people with disabilities,

veterans, the aged, vulnerable children, the unemployed and impoverished. In different contexts, such programmes may also be referred to

as income support, social grants, social security, social benefits or in the case of the aged, state pensions.

Child: A child is defined as a person between the ages of birth and seventeen years, up to the day before the eighteenth birthday. This is the same

definition as in the United Nation’s Convention on the Rights of the Child and the African Union’s African Charter on the Rights and Welfare of

the Child.


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Children: For the purpose of this questionnaire the word ‘children’ is used to encompass different children and different groups of children. We do

recognise, however, that children are not a homogenous group.

Child malnutrition: Child malnutrition includes three distinct conditions known as stunting, wasting and micronutrient deficiency. Stunting is also

referred to as chronic malnutrition and can come about in two ways. Firstly stunting can result from a poor diet extending over a number of

years, so that the child takes in too few calories or too little nutritious food or both. Secondly, an infection can prevent the absorption of

nutrients in the child’s body. When a child is stunted, he/she is too short for his/her age. Wasting results from a severe and often sudden

lack of food or disease. When a child is wasting, his weight is too low for his height. Micronutrient deficiency exists when a child lacks vital

vitamins and minerals in his/her diet. This is linked to long-term lack of nutritious food, or having an infection such as worms. Nearly all child

deaths linked to micronutrient deficiency are due to a lack of vitamin A, zinc or iron.

Child nutrition: The term ‘child nutrition’ is used to refer broadly to the nutritional status of children. It represents a range of conditions which

differ in the extent to which children are receiving and absorbing the nutrients they need to grow and develop.

Child nutrition interventions: This is used in the questionnaire as a short-hand term to refer to all the various kinds of government programmes,

projects or other undertakings aimed at reducing child malnutrition or otherwise improving the nutritional status of children in a country.

Child rights obligations: The legal obligations on the state to use available resources in order to protect, fulfil and deliver the rights of children

living in that country. Such obligations may derive from international or regional human rights treaties and laws, such as declarations and

conventions of the African Union and United Nations, recommendations from UN and AU committees overseeing the implementation of

specific international or regional human rights treaties, recommendations from the Universal Peer Review of states by the UN Human Rights

Council, the Abuja Declaration, and so forth. These examples are referred to as international and regional documents or sources of child

rights obligations. However, a government’s obligations to children also derive from national laws and policies that give content and


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substance to the delivery of child rights. The in-country documents and sources may include laws and constitutions, policies, strategies,

codes of conduct, norms and standards, regulations, formal guidelines and plans of action.

Consult with the public: As accepted methods of government consultation tend to vary from country to country, the exact form the consultations

take will have to be assessed by the researcher. In most instances, it would be assumed that a government has consulted with citizens if it

has undertaken such activities as hosting public meetings, engaging with different stakeholders, inviting submissions from the public, or

public feedback on its own proposals, holding focus group discussions with affected groups, conducting public opinion polls, and so forth.

Coordinated planning, budgeting and service delivery: Concrete actions taken by government departments to work together to improve child

nutrition through joint planning, budgeting and service delivery concerning an intervention that relates to more than one sector or

department.

Cost an intervention: In short to ‘cost an intervention’ entails mapping the content of a programme or law for example. Then analysing the

content and building a costing model that takes different scenarios into account. The scenarios are based on the current situation and

different roll-out scenarios. The roll-out scenario’s costs are estimated and outlined. The information is used in planning and budgeting for

the intervention.

Current budget documents: In this questionnaire, this refers to all the budget documents and strategic plans produced and disseminated by the

government pertaining to the budget year for which the government’s most recent budget proposal is being drafted. This includes older

documents that were produced before the budget year, but are still being used with reference to the budget year. Researchers are

encouraged to exercise their discretion in identifying publically available government documents that are most apt for answering the

questions.


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Department: For the purposes of this study, ‘department’ is used to refer to an administrative unit of government responsible for the execution of

programmes or services in a given sector. In some countries, such units may be referred to as ministries or agencies. At different levels of

government, departments may also be known as (or divided into) agencies, branches, district offices, and so forth.

Development aid: ‘Development aid’ is used as an umbrella term in this questionnaire to refer to all foreign funds, including grants and loans,

received by a developing country from another country’s government, a donor organisation or international financial institution for the

purposes of welfare and socio-economic development. It may take the form of official development assistance or technical assistance and

includes both bilateral and multi-lateral aid.

Intervention: For the purposes of this questionnaire, the term ‘intervention’ denotes any project, programme, good or service undertaken by a

government sector, department or agency to meet a given objective, for example to improve child nutrition. Typically the interventions

under the spotlight in this study are not once-off events (for example a conference on child malnutrition) but rather on-going initiatives

running for at least one budget year, if not longer.

Income support: See ‘Cash transfer’.

Indicators: See ‘Performance indicators’.

Law: See ‘Policy’.

Mechanisms to gather the public’s perspectives: The government is accountable to the public and is responsive to public participation when it

provides feedback to the public on issues raised. Mechanisms to gather the public’s perspectives are therefore needed. These mechanisms

can take many shapes and forms. This questionnaire agrees with the following statement found in the Open Budget Survey 2012 of the

International Budget Partnership (slightly modified): The government should systematically collect, maintain, monitor, and evaluate

information gained from public involvement activities. The government should also maintain contact information for individuals and groups

that want to be involved in specific budget issues, and it should use multiple communication mechanisms to ensure that those that want to


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be involved are notified of opportunities to engage in and decisions regarding these issues. The government should explain to those who

participated in its public engagement mechanisms, and to the broader public, how this engagement has informed budget plans and

execution. It should also gather feedback on the public’s perception of how successful these processes and their outcomes have been. This

type of engagement is particularly important for those members of the public who put effort into participating. There may be certain

legitimate situations in which the government may choose to withhold the identity of a person providing inputs on the budget, for

instance, if the safety of the person is of concern (e.g., such situations may arise over corruption complaints).

Non-financial data: The budget should not only present the amount of money being spent on an intervention but also other information needed

to analyse it. In terms of this questionnaire ‘non-financial data’ could be the number of vulnerable children, number of beneficiaries, number

of meals, number of social security grants, number of health workers, etc.

Outputs: Goods or services delivered as the result of a government intervention being implemented. For example, the outputs of an education

programme could be teachers trained, schools built or students educated.

Performance indicators: Measures defined and used in government programmes to plan and monitor the implementation of services and

programmes. Indicators may be used to measure progress towards meeting certain targets (see ‘outputs’ and ‘service delivery targets’ in this

glossary). For example, if a performance indicator for a child nutrition programme is to measure the number of children reached through a

school-feeding scheme, the associated service delivery target might be to reach 10,000 children.

Planned expenditures: These are the projected spending figures that make up a department’s (or the entire government’s) budget for the

upcoming fiscal year, and for two to three subsequent years if that country uses a medium-term economic framework. In this questionnaire,

the term ‘planned expenditures’ is seen to be synonymous with ‘budgeted expenditures’, “allocated expenditures” and “allocations”.


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Policy: Guiding national, regional and international documents, including laws, which set out the principles, goals, rules and parameters of a

government’s approach to a certain sector, function, problem or issue. Policies are generally expected to have a longer lifespan than

strategic plans and budgets, and may include norms and standards that have to be met through such strategic plans and budgets.

Primary caregiver: The person or persons responsible for the largest share of the care and supervision given to a child, frequently the mother,

grandmother and/or other female family member(s).

Publically available: For the purposes of this study, information is regarded as publically available if a member of the public or civil society is able

to access it via the internet, at a public library or resource centre, or by requesting such information from a government office, in person,

by phone or via email. In the latter instance, information is seen as publically available if it is provided within two weeks of the request

being made. Only documents that are publically available should be used as source material for this study. See also ‘budget transparency’.

Public participation: For the purpose of this questionnaire the term ‘public participation’ is used to describe what takes place when people engage

with the government in relation to public budget planning and spending. The public’s engagement could for example be intended to lead to

better service delivery of an intervention in a community.

Scale: For the purpose of this study the term scale refers to the number of children.

Sector: A term used to differentiate between broad areas of societal activity and government intervention. Traditionally the social sectors are seen

to include education, health, welfare, housing and so on. The economic sectors are seen to include agriculture, trade and industry, forestry

and so forth.

Service delivery targets: The planned outputs to be achieved by a given government intervention over a defined period. For example, the service

delivery targets of a child nutrition programme could be to increase uptake of Vitamin A supplementations by 20 per cent over three years,

or to ensure that 50,000 children are provided with meals through a school-feeding scheme. For the purposes of this questionnaire, service

delivery targets are understood as the immediate (annual) or medium-term aims of an intervention. Service delivery targets may have


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different names in different documents or countries; they may for example be referred to as planned outputs, performance targets, service

delivery milestones and the like. Progress in meeting service delivery targets are often measured with the help of performance indicators

(see ‘Performance indicators’ in this glossary).

Sources of revenue: All the means through which a country, or sub-national section of a country, collects income for public spending, investment

and debt repayment. Sources of revenue could include direct and indirect taxes, levies, interest on investments, income from extractive

industries, loans, grants and other forms of development aid,

Spending plans: See ‘Planned expenditures’.

Sub-national level: A level or sphere of government other than the national level. In many countries, certain powers and duties of government are

devolved to lower levels, for example provinces, states, regions, districts or municipalities.

Sub-national units: A sub-national unit is a single province, district, municipality or similar entity that is under the executive authority of a given

sub-national government.

Vulnerable children and most vulnerable children: The term ‘vulnerable children’ refers to children who due to difficult circumstances in which

they live are at high risk of suffering, or suffer, from malnutrition. The target audience of child nutrition interventions are most often

selected from among these vulnerable children (who form a subgroup to the whole child population). From a child rights perspective, all

children have a right to adequate nutrition, and hence governments should identify and target all vulnerable children in their child

malnutrition interventions. However, in reality, resources are limited. It is acknowledged in the Convention on the Rights of the Child that a

sub-set of vulnerable children may therefore be targeted, with progressive upward adjustment in eligibility over time as more resources

become available. In this questionnaire the term used for this sub-set of vulnerable children is ‘most vulnerable children’. For the purpose of

this study ‘most vulnerable children’ refers to the subset of children among the vulnerable children that suffers most from malnutrition.


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These children are important to identify as they need to be given special priority by government when designing, budgeting for and

implementing interventions to promote child nutrition.

Year-end reports: Budget reports, including actual expenditure figures, submitted at the end of the budget year, reporting on the implementation

of approved programmes.


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SECTION 1: INTRODUCTION

1.1 Broad aims of the Budget Transparency for Child Rights initiative

Budget Transparency for Child Rights (BT4CR) was established to work towards more effective monitoring of children’s rights. The core idea is that

we need greater access to more and better budget information about what governments around the world are doing to realise the rights of

children. Over the next few years, the BT4CR aims to:

Investigate and report on the extent and nature of transparency in public spending on interventions and services aimed at children;

Develop tools to track budget transparency for children through budget planning to service delivery, at national and sub-national levels;

Provide opportunities for child rights advocates in various countries to build a budget transparency angle into their campaigns; and to

Encourage dialogue on possible norms for transparency in public budgeting in relation to children, so that we are better able to meaningfully

monitor the implementation of children’s rights.

1.2 Specific objectives of this questionnaire

The questionnaire contained in this document is a pilot research instrument. It intends to shed light on how transparent government budgeting is

when it comes to one critical responsibility we have towards children: ensuring that they have enough nutrition to survive into adulthood. The

specific objectives of the questionnaire are to:

Take a detailed look into transparency around public spending on child malnutrition in five African countries, namely Kenya, South Africa,

Uganda, Zambia and Zimbabwe.

In these five countries, assess and record how much and what kind of budget information is publically available pertaining to government

interventions aimed at combating child malnutrition.

Collate and compare the findings to formulate recommendations and inform further advocacy and research.


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1.3 Definition of budget transparency

Transparency can be and has been defined in many different ways by civil society actors, academics and governments themselves. It is generally

agreed that transparency is a key element in democratic practice, and helps to ensure and enhance participation and accountability. In an ideal

case, transparency requires more than the mere existence of information, and includes considerations about the quality and usefulness of that

information. However, it would be a huge undertaking to assess not only whether budget information exists in relation to a government’s child

nutrition interventions, but furthermore to evaluate how comprehensive and useful that information is. Given the constraints of this pilot study,

this questionnaire applies a narrow definition of budget transparency. Budget information is regarded as transparent if it is “publically available” in

the sense that:

The information can be accessed online, or

The information can be found in a hard copy budget document in a public library or similar public resource centre, or

The information can be requested (and is duly provided) from a government office, or

The information is provided freely (or at a very low cost) within 2 weeks of a request for such information having been made via letter,

email or telephone.

1.4 The focus on child malnutrition

It is not possible within the bounds of this pilot study to investigate all government budgeting affecting children’s rights. To mark out a

manageable research terrain, this questionnaire has a specific focus on the child’s right to health, and within that, on efforts to prevent and reduce

child malnutrition. (For more information on the definition of child malnutrition, see the Glossary of Terms at the beginning of the document).

The selection of this focus is informed by strategic and practical considerations. The nutritional status of children plays a critical role in their well-

being and survival. Malnourished children are more vulnerable to disease: it is one of the key factors affecting the life expectancy of children,

especially young children. The Millennium Development Goal number 4 (MDG4) is to reduce the mortality rate of children under 5 by a third by


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2015. Addressing child malnutrition has been identified by Save the Children and others as a critical strategy for achieving MDG4. We would expect

to see government interventions aimed at advancing child nutrition and combating child malnutrition in the budgets of any country committed to

reducing child mortality.

In addition, government budgeting to advance child nutrition is likely to display some other features which should assist this study:

It is anticipated that interventions for child nutrition can relatively easily be identified within budgets as distinct programs or projects –

thereby enhancing the scope for meaningful research and comparisons across countries.

Interventions for child nutrition may well involve more than one government department or sector. This could help to shed light on intra-

governmental co-ordination – an important factor affecting government delivery for children more broadly.

Interventions to improve child nutrition stand a good chance of involving more than one level of government. This should allow the study

to gain more nuanced insights into variations in budget transparency at different levels.

1.5 Identification of relevant government sectors

In many countries, government interventions to combat child malnutrition involve more than one government sector. Therefore this questionnaire

cannot be customised for or limited to a single sector. In each of the pilot countries, researchers will have a preliminary task of scanning the

various sectors in their context and identifying interventions that have as a direct or indirect aim to enhance the nutritional status of children. It is

anticipated that in the majority of countries, relevant interventions are most likely to be found in the sectors of health, social development or

welfare, agriculture and education. However, interventions affecting child nutrition may also be uncovered in other sectors such as trade and

industry, community development, water and sanitation, public works – and in some instances, located within dedicated ministries or

departments of child affairs or child welfare. SECTION 2 of this document provides background information and guidelines for conducting this

preliminary exercise.


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1.6 Levels and units of government

This questionnaire asks of researchers to look into budget transparency at both the national level and at relevant sub-national levels in their

countries. The dual emphasis is important because:

The implementation of interventions aimed at children often happens at sub-national levels and it should be possible to track public funds to

where they are spent.

The extent and nature of budget information about interventions at sub-national levels may vary considerably from that which is available at

national level.

There may be noteworthy variations in budget transparency between different sub-national units, for example different provinces or districts,

in the same country.

It is, however, beyond the scope of this study to investigate the budget transparency of government’s child nutrition interventions at all sub-

national levels and within every sub-national unit in a country. It will be necessary for researchers to identify three sub-national units (for example,

three provinces, districts or municipalities) to consider more closely as part of their enquiry. These units should be selected with a view to

including areas that are likely to have better and worse capacity for budget reporting and varying track-records in government transparency.

SECTION 2 of this document provides guidance for researchers to identify the most relevant sub-national units to focus on in their study.

1.7 Spotlight on government budgets

The questionnaire on budget transparency and child malnutrition focuses exclusively on public resources in the five pilot countries; therefore the

spotlight falls on all funds that flow through government budgets, whether at the national or sub-national levels. Development aid (including

donor funds and loans from international financial institutions) may play a significant role in financing government interventions aimed at

combating child malnutrition. Such funds will only form part of the study to the extent that they form part of the country’s public budget. Off-

budget funding of child nutrition interventions are explicitly excluded from this research.


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1.8 The structure of the questionnaire

The questionnaire is divided into six parts:

SECTION 1 is the introduction to the document.

SECTION 2 provides a framework for preliminary research into government budgeting for child nutrition. It guides the selection of five

interventions to focus on in the rest of the questionnaire, as well as the three sub-national units that will be investigated.

SECTION 3 is a running bibliography of sources pertaining to the research. It includes tables for recording documents and other sources

consulted in the process of completing the questionnaire, as well as the details of interviews and other investigative communications.

SECTION 4 consists of questions relating to the government’s policy and planning for child nutrition interventions, including budget planning.

SECTION 5 presents questions about the implementation of child nutrition interventions, including actual expenditures and service delivery.

SECTION 6 sets out questions pertaining to public participation in budget decision-making about interventions to advance child nutrition.

1.9 Research deadlines and submission dates

The overall deadline for the completion of this questionnaire is 17 August 2012. A number of interim deadlines have been set to ensure steady

progress and opportunities for feedback during the research process:

SECTION 2 is to be completed and submitted by 2 July 2012.

SECTIONS 4 and 5 are to be completed and submitted by 27 July 2012.

SECTIONS 6 and 3 are to be completed and submitted by 17 August 2012.

All sections should be submitted to Anna Schnell by email at the following address: [email protected]). Following the

submission of the completed questionnaires, researchers will be asked to respond to questions of clarification and comments from peer reviewers.

Questions related to this questionnaire should also be communicated with Anna.

mailto:[email protected]


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1.10 The findings from this research

The findings from this questionnaire on budget transparency and child malnutrition will be used to inform budget advocacy and child rights

campaigns in each of the five pilot countries. In addition, the collective findings across the five pilot countries will be analysed and summarised to

produce a cross-country research report. Relevant findings and insights will be highlighted and if appropriate, included as a special focus theme in

or alongside the forthcoming Open Budget Index (OBI) 2012 report, which is due to be published and disseminated by the IBP in 2013.

1.11 Organisations involved in the study

This pilot questionnaire on budget transparency and child malnutrition was developed by the Accountability and Transparency for Human

Rights (ATHR) Foundation, in consultation with domain experts. The ATHR is a new organisation created to undertake this pilot study. It seeks

to advance children’s rights by promoting transparency, accountability and participation.

The pilot study is supported by the International Budget Partnership (IBP) and aims to complement the IBP’s work on budget transparency in

countries around the world, particularly through its Open Budget Initiative (see www.internationalbudget.org). IBP staff played a key role in

informing the conceptualisation and design of the project and research methodology.

This pilot study is being carried out in collaboration with the Child Rights Governance Initiative (CRGI) of Save the Children. The pilot study aims

to inform the CRGI breakthrough on “Investment in Children” and complement Save the Children’s EveryOne campaign, which is active in 50

countries and focuses particularly on countries with high child death rates (see www.everyone.org). Save the Children supported the BT4CR

workshop held in Pretoria in May 2012 and is part of the reference group that contributes to the methodology development of BT4CR. Save

the Children intends to use results of the BT4CR to among other target the African Union.

The following organisations are research partners in this pilot study:

In Kenya, the Children’s Legal Action Network (CLAN).

In South Africa, the Public Service Accountability Monitor (PSAM).

http://www.internationalbudget.org/

http://www.everyone.org/


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In Uganda, the Uganda Debt Network (UDN).

In Zambia, the University of Zambia in collaboration with Zambia Civic Education Association (ZCEA).

In Zimbabwe, the National Association of Non-Governmental Organisations (NANGO).


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SECTION 2: PRELIMINARY RESEARCH ON INTERVENTIONS & SUB-NATIONAL UNITS

The aim of this section is to provide a framework for selecting the interventions you will focus on in the rest of the questionnaire, as well as the

sub-national units most relevant for your research. The section is structured as follows:

Sub-section 2.1 offers background information and examples of the typical kinds of interventions you might expect to find in a developing

country to advance child nutrition. Read only.

Sub-section 2.2 gives criteria to inform the selection of interventions for the research you undertake in your country. Read only.

Sub-section 2.3 contains 8 tables to be completed by the researcher. These tables guide you through the process of listing, scoring and

selecting the five most relevant interventions in your context. Researcher to complete TABLES 1A to 1E, as well as TABLES 2, 3 and 4 by ticking

boxes and entering text as instructed.

Sub-section 2.4 gives criteria to inform the selection of the sub-national units you will focus on in your research. Read only.

Sub-section 2.5 contains 2 tables to be completed by the researcher. These tables guide you through the process of analysing and selecting

three appropriate sub-national units for your research. Researcher to complete TABLES 5 and 6 by ticking boxes and entering text as instructed.

Please note: If you are in doubt regarding a definition of a term in this questionnaire, consult the glossary at the beginning of this document or

contact Anna Schnell at ATHR (see section 1.9).

2.1 Government interventions to combat malnutrition

Child malnutrition is caused, in direct terms, by inadequate diet and by infection. These primary causes of malnutrition are influenced by food

access and availability, health care, water and sanitation, the nutritional and hygiene knowledge of caregivers, as well as other determinants of

health and hygiene in the child’s environment.


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Every country will have a different collection of strategies for combating child malnutrition. In addition, various government functions, for example

the provision of sanitation services, can have a significant indirect impact on children’s nutritional status, without having the overt purpose of

combating child malnutrition. For the purposes of this study, the term ‘interventions’ is used as a blanket term to refer to all government

programmes, projects and/or other initiatives that aim to improve, either directly or indirectly, the nutritional status of children. One of the first

tasks you, as the country researcher, will have to undertake is to identify relevant government interventions in your own context that you will

focus on when completing the questionnaire. The interventions you select will depend on what is actually being done by your country’s

government in relation to child nutrition. However, it is important to think broadly when considering which interventions to focus on in. To this

end, some examples are given below of a range of different interventions that governments may be using to reduce child malnutrition and

promote child nutrition. Please note that these are simply examples to inform your own research and thinking, and that the interventions in your

own country may be different from, or not appear on, the list.

Examples of interventions that could advance child nutrition

Income support/cash transfers (including conditional and unconditional grants and transfers) targeted at children and/or vulnerable adults,

for example the elderly.

Food transfers (targeted at poor families, households or/and communities).

Providing support to small scale farmers, which may include subsidies for key inputs and/or raising productivity by improving knowledge.

Food fortification.

Providing meals to children at schools (often referred to as school-feeding).

Enhancing the nutritional intake of children attending early childhood development (ECD) facilities, for example by providing subsidies to

centres that provide ECD programmes.

The promotion of exclusive breast-feeding up to 6 months.


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The promotion of breast-feeding plus complementary feeding post 6 months.

Vitamin A and Zinc supplementation for children (from 6 months of age).

Improving the nutrient intake of breastfeeding mothers.

Special care for children exposed to and infected with HIV.

Growth monitoring of very young children.

Food supplements for new mothers at high risk of malnutrition and their children.

Programmes providing social support for pregnant and lactating mothers.

Providing insecticide-treated bed-nets in areas of high risk for malaria (as infection has a detrimental effect on children’s nutritional intake).

Strategies to prevent infectious diseases amongst children.

De-worming of children aged 6 to 69 months.

Interventions that improve access to clean water for children at risk of malnutrition and their families.

Interventions that improve access to adequate sanitation facilities.

Educating caregivers of children on basic hygiene practices to prevent infection.

Interventions to address child malnutrition have been found to work differently in different contexts (World Bank 2010). Therefore it is vital that

the design and combination of interventions in a country is soundly informed by the particular nature of the child malnutrition problem in that

country. The institutional capacity to deliver interventions is also an important consideration. There is no ‘one size fits all’ approach that a

government can adopt wholesale from another country. As a general trend, an appropriate ‘package’ of government interventions to reduce child

malnutrition and promote child nutrition (should) usually displays the following characteristics:


23

Interventions involving different parts of government: Given the broad range of factors affecting child nutrition, action is typically

required across multiple sectors, including health, welfare/social development, education, agriculture, trade and industry, water and

sanitation, community development and public works.

Focus on prevention and cure: More than one strategy is required to deal with the causes and effects of child malnutrition. Governments

typically need to implement both preventive and curative interventions.

Interventions targeting poverty relief or vulnerable households more broadly: At least some interventions that could have substantial

impact on child nutrition may not be defined in nutritional terms or targeted directly to children. For example, in some countries, social

transfers (in cash or in kind) are distributed to poor households, families or communities. The exact extent to which such interventions

specifically benefit children’s nutritional status is not easy to determine. However, research suggests that they do have an impact and that

resources transferred to women are more likely to be spent on child nutrition than those transferred to men.

Prioritisation of very young children: Very young children (those under 2 years of age) are the most vulnerable to malnutrition. The

negative effects of malnutrition are also amplified when it occurs at a young age and more likely to lead to permanent damage.

Interventions to support mothers (ante and post natal): The health of very young children is intertwined with the health of their mothers.

Thus a key element in promoting child nutrition is providing basic health care and social support to pregnant women and new mothers

who, due to poverty and other factors, are at risk of having malnourished children.

To learn more about existing research on government interventions that aim to combat malnutrition (including assessments of what seems to

work and what doesn’t), please see the reference list at the end of this section and consult with health experts in your country. However, keep in

mind that you are not expected to be an expert on child nutrition in order to undertake this research. Nor does this questionnaire ask you to

evaluate the adequacy or effectiveness of your government’s interventions in relation to child malnutrition. The core question is rather whether

resource decision-making and public spending on these interventions (however adequate they may be) are transparent or not.


24

2.2 Criteria for selecting interventions to focus on in this questionnaire

In order to complete the rest of this questionnaire, it is necessary to select a maximum of five government interventions that combat malnutrition

or otherwise advance child nutrition in your country. If there are exactly five or less than five interventions of this nature in your country, there is

no need to make a selection and you should focus on all the interventions that do exist.

However, if there are more than five government interventions for child nutrition to take into consideration in your country, you will have to select

those that are most relevant and appropriate for this study. It is impossible to prescribe a checklist for the selection of these interventions in your

context. The criteria listed below are included here as a set of guidelines to steer your research and thinking. They contain normative phrases like

‘most critical’, ‘best geared’ and so forth. It will be necessary for you to consult with a reference group of health experts and child health experts in

your country to interpret these criteria, and on that basis, apply your own judgment in choosing the interventions to focus on.

The following criteria should be considered in making your decision.

Importance: Select those government interventions that appear, in the light of the current child malnutrition, policy and institutional

context the most critical or central to combating child malnutrition in your country. As is explained below, to identify the most important

interventions you will need to speak to experts in the area of child health, poverty and rights.

Targeting: Select those government interventions that are best geared to reach children who are the most vulnerable to malnutrition in

your country (henceforth called vulnerable children).

Child rights obligations: Select those government interventions that can most clearly be linked back to the government’s legal obligations

to realise children’s rights in your country.

Traceability: Select those government interventions that can most readily be identified as distinct programs or lines of expenditure in your

country’s budget documents.

Decentralisation: Select those government interventions that are implemented (and even better, budgeted for) at levels of government

lower than the national level in your country.


25

2.3 Selecting interventions relevant to child nutrition in your country

This sub-section contains eight tables to be completed by the researcher:

TABLES 1A to 1E provide space for you to capture your consideration of the child nutrition interventions in your country in relation to each of

the five criteria presented in Section 2.2. There is a separate table for each of the criteria.

TABLE 2 is a summary table of your findings from TABLES 1A to 1E. It should allow you to compare the overall ‘scores’ you have allocated to the

various interventions across all five criteria.

TABLE 3 provides space to list your selected interventions and capture some basic information about each one.

TABLE 4 invites the researcher to record the child rights and legal/policy framework relating to each selected intervention.

Instructions for completing TABLES 1A to 1E:

Apply the same process to each of the five tables:

1. Use the left-hand column to list all the government interventions that exist in your country that could be seen to combat child malnutrition or

advance child nutrition in some way. This may require some preliminary research and consultations in your country.

2. Be sure to consider at least the following four sectors: health, social development/welfare, agriculture and education.

3. Once you have listed the interventions in the left-hand column, score each intervention in terms of the criterium given in the heading row,

using a scale of 1 to 5.

4. Please use the comments box that follows each table to record any concerns you had or important points you want to highlight concerning the

scoring of the interventions.

You are encouraged to consult with child health experts in your context, as required, in order to score the interventions.


26

TABLE 1A: SCORING OF INTERVENTIONS IN TERMS OF IMPORTANCE IN COMBATING CHILD MALNUTRITION

Interventions under consideration

IMPORTANCE: How critical is this intervention for advancing child nutrition?

1

(Not critical at

all)

2

(Not very

important)

3

(Fairly

important)

4

(Very critical)

5

(Extremely

critical)

For each intervention, write down a score of 1 to 5 in the corresponding cell

1. Promotion of breastfeeding (0-6 months) 5

2. Complementary feeding 5

3. HIV and Infant feeding 5

4. Marketing of breast milk substitutes (BMS) legislation

5

5. Feeding in exceptionally difficult circumstances 5

6. Promote dietary diversification 5

7. Management of moderate malnutrition 5

8. Management of severe malnutrition 5

9. Ensure micronutrient nutrition supplies for children are available( supplementation of vitamin A and Iron for pregnant mothers)

5

10. Growth Monitoring and promotion (GMP)-Facility based i.e. under five clinics

5

11. Community based growth monitoring and promotion (CBGMP)

5


27

Comments on Table 1A: Scoring for importance

Please use the space below to record any concerns or important issues relating to the scoring of interventions. These comments are not

compulsory, and are to be completed at the discretion of the researcher. There is no need to comment if you are satisfied that, in consultation

with health experts in your country, you have been able to score an intervention with relative ease and accuracy.

Intervention # Comments concerning the scoring of interventions

1

2

3

4

5

6

7

8

9

10

Insert more rows as required


28

TABLE 1B: SCORING OF INTERVENTIONS IN TERMS OF HOW TARGETED THEY ARE TO VULNERABLE CHILDREN


TARGETING: How well-targeted is this intervention to reach vulnerable children?

1

(Not targeted to vulnerable

children at all)

2

(Not very well-targeted to

reach vulnerable children)

3

(Fairly well-targeted to vulnerable children)

4

(Well-targeted to reach

vulnerable children )

5

(Extremely well-targeted to

reach vulnerable children)




3. HIV and Infant feeding


5






5


5


3


29

Comments on Table 1B: Scoring in terms of targeting





1

2

3 Was unable to score this intervention. Its pending further consultation with the experts

4

5

6

7 The experts view in scoring this intervention was that management of moderate malnutrition is done at the community level where sometimes there are no health workers who are properly trained to handle malnutrition cases and equipment maybe lacking. This is unlike management of severe malnutrition where the cases are all handled at the hospitals.

8

9

10

11 The view here was that GMP at community level is done by volunteers who may not be properly trained


30

TABLE 1C: SCORING OF INTERVENTIONS IN TERMS OF HOW CLEARLY THEY CAN BE LINKED TO CHILD RIGHTS OBLIGATIONS

Please note: The aim of including this criterium is to encourage the selection of interventions for which there is a strong basis for advocacy. The

more clearly an intervention can be seen to rest, and give expression to, specific legal obligations that your government has in relation to children

and their rights, the better the chances of using your findings effectively for advocacy. In order to investigate the possible legal obligations in

relation to the interventions:

First look to your country’s constitution (if it has one) and to national legislation pertaining to health, nutrition, child health, children’s

rights and other relevant issues. Also consider whether policies, regulations, codes of conduct, norms and/or standards exist, some of

which may have been formally adopted as legal obligations.

If no legal obligations can be uncovered at the national level, consider any relevant regional and international human rights treaties or

conventions that place legal obligations on the state to advance and deliver children’s rights.


CHILD RIGHTS OBLIGATIONS: How clearly can this intervention be linked to the legal child rights obligations of the government?

1

(Would be hard to link at all to

child rights obligations)

2

(Very vague links to child

rights obligations)

3

Some links to child rights

obligations, but not very clear)

4

(Clear links to child rights obligations)

5

(Extremely clear links to child

rights obligations)






4


31


CHILD RIGHTS OBLIGATIONS: How clearly can this intervention be linked to the legal child rights obligations of the government?

1

(Would be hard to link at all to

child rights obligations)

2

(Very vague links to child

rights obligations)

3

Some links to child rights

obligations, but not very clear)

4

(Clear links to child rights obligations)

5

(Extremely clear links to child

rights obligations)







4


4


4


32

Comments on Table 1C: Scoring in terms of child rights obligations





1

2

3

4

5

6

7

8

9

10



33

TABLE 1D: SCORING OF INTERVENTIONS IN TERMS OF HOW READILY THEY CAN BE TRACED IN THE BUDGET

Please note: This criterium has been included as some interventions may be difficult to conduct budget research on because they are not

presented as distinct items in budget documents.


TRACEABILITY: How easily can this intervention be identified in budget documents?

1

(Impossible to identify )

2

(Difficult to identify in the

budget)

3

(Challenging but possible to identify

in the budget)

4

(Easy to identify in the

budget )

5

(Extremely easy to identify in the budget)





4. Marketing of breast milk substitutes (BMS) legislation 3






4


4


3


34

Comments on Table 1D: Scoring in terms of traceability





1

2

3

4

5

6

7

8

9

10



35

TABLE 1E: SCORING OF INTERVENTIONS IN TERMS OF HOW DECENTRALISED THEY ARE


DECENTRALISATION: How decentralised is the budgeting and implementation of this intervention?

1

(All budgeting & implementation done at national

level)

2

(Budgeting done at national level

& some implementation at sub-national)

3

(Some budgeting &

implementation done at sub

national level)

4

(Most budgeting & all

implementation done at sub-

national level)

5

(All budgeting & implementation

done at sub-national level)






3






4


4


2


36

Comments on Table 1E: Scoring in terms of decentralisation





1

2

3

4

5

6

7

8

9

10



37

Instructions for completing TABLE 2:

TABLE 2 is a summary table for collating and calculating the overall scores of the interventions for child nutrition you considered in TABLES 1A to

1E. In order to complete the TABLE 2 on the following page:

1. Copy all the interventions for child nutrition into the left-hand column of the table.

2. Each of the five criteria is represented by a separate column in TABLE 2. Look back to TABLES 1A to 1E and for each of the criteria, enter the

score you assigned to each intervention.

3. Calculate the total scores of all the interventions. Circle or mark in red the five top scores.

Summary of the five scoring scales (used in TABLES 1A to 1E) and TABLE 2:

Importance: 5 = Highly critical to combating child malnutrition ↔ 1 = Not very critical to combating child malnutrition.

Targeting: 5 = Very well-targeted to vulnerable children ↔ 1 = Not targeted to vulnerable children at all

Child rights obligations: 5 = Clear link to government’s child rights obligations ↔ 1 = No clear link to government’s child rights obligations

Traceability: 5 = The intervention is easy to identify in the budget ↔ 1 = The intervention cannot be specifically distinguished in the budget

Decentralisation: 5 = Budgeted for and implemented at sub-national level ↔ 1 = Budgeted for and implemented at national level


38

TABLE 2: BROAD SCAN & SCORING OF CHILD NUTRITION INTERVENTIONS

Interventions to combat child malnutrition

How important for child

nutrition?

See TABLE 1A

How well-targeted?

See TABLE 1B

How clear CR connection?

See TABLE 1C

How easy to see in the budget?

See TABLE 1D

How decentralised?

See TABLE 1E

SCORE TOTAL

PER INTERVENTION

Enter the assigned score of between 1 and 5 in each cell

1. Promotion of breastfeeding (0-6 months)

5 5 4 4 4 22

2. Complementary feeding 5 5 4 4 4 22

3. HIV and Infant feeding 5 4 3 3 15


5 5 4 3 4 21

5. Feeding in exceptionally difficult circumstances

5 5 4 3 4 21

6. Promote dietary diversification 5 2 4 3 4 18

7. Management of moderate malnutrition 5 3 4 3 4 19

8. Management of severe malnutrition 5 5 4 4 4 22


5 5 4 4 4 22


5 5 4 4 4 22


5 3 4 3 2 17


39


1. Consider the scores of the interventions listed in TABLE 2.

2. In the light of these scores, select the 5 most appropriate and relevant interventions to focus on in the rest of this questionnaire.

3. Use the left-hand column to list the 5 interventions you have selected.

4. Next to each intervention:

a) In Column A, name the ministry, department or agency that is ultimately responsible for this intervention. Where relevant, note

interventions that formally involve collaboration between more than one ministry or department.

b) In Column B, indicate how this intervention is referred to in the budget. Which budget programme or sub-programme channels its funding?

TABLE 3: SELECTED CHILD NUTRITION INTERVENTIONS - BASIC INFORMATION

Selected interventions A

Responsible ministry/ies or department(s)

B

Corresponding budget programme(s)

1. Promotion of breastfeeding (0-6 months) Ministry of Health Infant and Young Child Feeding

2. Complementary feeding Ministry of Health Infant and Young Child Feeding

3. Management of severe malnutrition Ministry of Health Management of Malnutrition and the Sick Child


Ministry of Health Micronutrients


Ministry of Health Growth Monitoring and Promotion


40


1. As in TABLE 3, list the five interventions you have selected down the left-hand column.

2. For each intervention:

a) In Column A, clarify which specific children’s right the intervention most clearly seeks to protect or realise. For example, does it advance the

child’s right to social security, to health, to safe drinking water?

b) In Column B, list the main laws and policies that govern and have bearing on the intervention you have selected. Give attention first and

foremost to national laws and policies, as their provisions can usually be linked back more directly to government obligations. Once you have

considered the national frameworks, look to relevant international and regional conventions and treaties.

TABLE 4: SELECTED CHILD NUTRITION INTERVENTIONS – CHILD RIGHTS & POLICY FRAMEWORK

Selected interventions

A

Main child right this intervention aims to advance

B

Main laws and policies governing this intervention

1. Promotion of breastfeeding (0-6 months) Public Health Act, National Child Health Policy, National Food and Nutrition Policy

2. Complementary feeding Public Health Act, National Child Health Policy, National Food and Nutrition Policy

3. Management of severe malnutrition Public Health Act, National Child Health Policy, National Food and Nutrition Policy


Public Health Act, National Child Health Policy, National Food and Nutrition Policy


Public Health Act, National Child Health Policy, National Food and Nutrition Policy


41

2.4 Criteria to inform the selection of sub-national units

The five child nutrition interventions selected in Section 2.3 will form the main focus of your research throughout the questionnaire. As you

proceed with Sections 3 to 6 of the questionnaire, you will be asked to apply the questions to either the national level or sub-national level, or to

both, depending on the degree of decentralisation of each intervention. In preparation, it is necessary to decide in advance which areas (here

referred to as ‘sub-national units’) you will use as the unit of analysis when it comes to the sub-national level. It is important for you to apply all

the sub-national questions to the same three sub-national units – for example the same three provinces, three districts or three municipalities.

TABLE 5 in Section 2.5 provides a framework to consider each of the selected child nutrition interventions in relation to the various levels of

government in your country. This should help you to decide which level of government is the most appropriate for you to focus on besides the

national level. Once you have identified the most appropriate level of government, at least one of the following criteria should be applied to

identify which three specific sub-national units (which three provinces, districts or the like) to concentrate on:

Select three sub-national units that have differing socio-economic profiles;

Select three sub-national units that have varying track-records or likely capacity for budget reporting;

Select three sub-national units that have predominantly urban, peri-urban and rural settlement patterns, respectively.

2.5 Selecting sub-national units in your country


1. Select the version of TABLE 5 that matches your country and delete the other versions of TABLE 5.

2. List the five child nutrition interventions you have selected down the left-hand column of the table.

3. For each intervention, find out and record:

a) Which level(s) of government are responsible for the policy-making and strategy that govern the intervention?

b) Which level(s) of government are responsible for budget planning in relation to this intervention?

c) Which level(s) of government are responsible for the implementation of and actual spending on the intervention?


42

TABLE 5: SELECTED CHILD NUTRITION INTERVENTIONS & LEVELS OF GOVERNMENT (ZAMBIA)

Selected interventions Type of responsibility National level Provincial level District level

Ward level and lower

In each line, mark all the level(s) of government involved in this responsibility

1. Promotion of breastfeeding (0-6 months)

Policy-making & strategy Yes Yes Yes

Budget planning Yes Yes Yes Yes

Implementation/spending* Yes Yes Yes Yes

2. Complementary feeding Policy-making & strategy Yes Yes Yes


Implementation/spending Yes Yes Yes Yes

3. Management of severe malnutrition












*Note: The spending that is done for all these interventions at national level is in monitoring and evaluation


43

Interpreting the findings of TABLE 5:

1. Look across the selected child nutrition interventions as listed in TABLE 5, can you identify a level of government in your country that:

a) Is not the national level; and

b) Is sometimes or always responsible for budget planning in relation to the selected child nutrition interventions?

If your answer is yes to the above, this is the level of government you should select for the sub-national research.

2. If there is more than one sub-national level in your country that meets the requirements set out under point 1 above, select either one to focus

on in this study. For example, if budget planning for a specific intervention occurs at both provincial and district level, you could focus on either

of these. It may be wise to choose the level it will be most easy to access budget documents for.

3. If your answer to question 1 above is no, consider further if you can identify a level of government that:

a) Is not the national level; and

b) Is sometimes or always responsible for the implementation of - and actual spending on - the selected interventions.

If your answer is yes to the above, then this is the level of government you should select for the sub-national research. Again if there is more

than one level that meets these requirements, choose the one that is likely to be most feasible and practical to conduct budget research on.

4. If your answer to all the questions above is no, consult with the Anna Schnell at ATHR (see section 1.9). You may not be able to select sub-

national units and complete TABLE 6.


44


1. Assuming you have been able to identify an appropriate level of government following the steps above, the next task is to identify 3 areas

(units) at this level of government to focus on in your research. This could be, for example, three provinces, three counties, three districts or

three municipalities.

2. Apply the criteria given in Section 2.4 in order to decide on the three most appropriate sub-national units for this study. For ease of reference

these criteria were as follows:

Select three sub-national units that have differing socio-economic profiles;

Select three sub-national units that have varying track-records or likely capacity for budget reporting;

Select three sub-national units that have predominantly urban, peri-urban and rural settlement patterns, respectively.

3. Write the names of your chosen sub-national units down in the left-hand column of TABLE 6 on the following page.

In the column next to each sub-national unit, explain which criteria you applied in making your choice. Give a brief motivation why this sub-

national unit is an appropriate unit to consider when investigating budget transparency for child nutrition at the sub-national level.


45

TABLE 6: SELECTED SUB-NATIONAL UNITS

Selected sub-national units (please name them below)

Which of the five selected child nutrition interventions are

present here? (List the corresponding numbers)

Motivation and criteria used in making the selection

1. Lusaka District

All Most likely to find information reported on these interventions

2. Nakonde District

All Most unlikely to find information reported on these interventions

3. Chingola District

All Likely to find information reported on these interventions


46

FURTHER READING ON INTERVENTIONS TO COMBAT MALNUTRITION

Alderman H & Linnemayr S. (2008) Reducing child malnutrition through community intervention programmes: Evidence from a large scale

randomized trial in rural Senegal. 5 March.

Bhutta Z, Ahmed T, Black R, Cousens S, Dewey K, Giugliani E, Haider B, Kirkwood B, Morris S, Sachdev H, Shekar M. (2008) “Maternal and Child

Undernutrition 3: What works? Interventions for maternal and child undernutrition and survival” in Lancet 2008.

Bhutta Z, Ali S, Cousens S, Ali T, Haider B, Rizvi A, Okong P, Bhutta S, Black R. Alma-ata. (2008). “Rebirth and Revision 6 Interventions to address

maternal, newborn, and child survival: what difference can integrated primary health care strategies make?” in Lancet 2008: 972-89.

Masset E, Haddad L, Cornelius A, Isaza-Castro. (2011) A systematic review of agricultural interventions that aim to improve nutritional status of

children. Published by UKaid, IDS, 3ie; ePPI Centre and IOE.

Save the Children. (2012) A life free from hunger: Tackling child malnutrition. Save the Children: UK.

World Bank Independent Evaluation Group. (2010) What can we learn from nutrition impact evaluations? Lessons from a review of interventions to

reduce child malnutrition in developing countries. World Bank: Washington D.C.


47

SECTION 3: RUNNING REFERENCE LIST OF SOURCES

The purpose of this section is to support the accumulation of a comprehensive list of all sources consulted during the course of the research. This

section is to be submitted together with the final sections of the questionnaire at the end of your research process (see Section 1.9 in the

Introduction). In completing all the following tables:

Please give full citations of all document titles and publication details, including names of author(s), date of publication, the publisher and place

of publication.

Under the heading “Available at”, give the physical location (if a hard copy document was consulted) or the internet address (if an on-line

source was used). ‘Physical location’ refers to the name of the office or facility (no street or postal address is necessary).

Documents accessed on or downloaded from the internet should be recorded in TABLE 7 rather than TABLE 8. There is no need to duplicate.

For periodicals, newspaper and journal articles, give the name of the article as well as the publication in which it appeared, and the relevant

issue, volume and/or page numbers.

When giving the date of publication, include the year - and also record the month, when it is given.

Where publication details are unknown, record them as unknown or undated. For example: Department of Health (Undated), Health for the

Future. Published by the National Communications Ministry: Capital City.

For internet sources, please record on which date a site was visited and/or a document was downloaded. Also be sure to give the full internet

address.

In listing interviewees and correspondents, please provide their official designations/full job titles as far as possible.

Unpublished documents may be used to inform your research for SECTION 2. All unpublished documents used should appear in TABLE 7.

For answering the questions in Sections 4 to 6, remember that only publically available government documents are to be used as sources.

Consult the glossary at the beginning of the questionnaire to see how ‘publically available’ is defined for the purposes of this study.


48

TABLE 7: DOCUMENTS CONSULTED

1 Document title: Estimates of Revenue and Expenditure for the Year 1st January, 2012 to 31st December 2012

Author(s) Date of publication

Ministry of Finance 2012

Publication details (publisher, place of publication) Available at (give physical location or internet address and date accessed)

Government Printers, Lusaka Government Printers

2 Document title: Ministry of Health Action Plan 2012

Author(s): Date of publication

Ministry of Health 2012


Unknown Planning Department, Ministry of Health Headquarters, Lusaka

3 Document title: Lusaka District Health Management Team Action Plan 2012


Lusaka District Health Management Team 2012


Unknown Lusaka District Health Office, Lusaka

4 Document title: Chingola District Health Management Team Action Plan 2012


Chingola District Health Management Team 2012


Unknown Chingola District Health Office, Chingola


49

5 Document title: Nakonde District Health Action Plan 2012 – 2014


Nakonde District Health Management Team 2012


Unknown Nakonde District Health Office, Nakonde

6 Document title: National Food and Nutrition Strategic Plan 2011-2015


National Food and Nutrition Commission November, 2011


National Food and Nutrition Commission National Food and Nutrition Commission, Lusaka


50

TABLE 8: WEBSITES CONSULTED

1 Name or website or organisation hosting the website: Ministry of Health

Internet address: Date of visiting site

www.moh.gov.zm 19th June 2012

2 Name or website or organisation hosting the website: Central Statistics Office


www.zamstats.gov.zm 19th June 2012

3 Name or website or organisation hosting the website: Ministry of Finance


www.mofnp.gov.zm 20th June 2012

4 Name or website or organisation hosting the website: National Food and Nutrition Commission


www.nfnc.org.zm 23rd June 2012

5 Name or website or organisation hosting the website: National Assembly of Zambia


www.parliament.gov.zm Fill in date here



51

TABLE 9: NEWSPAPERS, MAGAZINES & JOURNALS CONSULTED

This table is largely relevant only for sources consulted to complete SECTION 2. With reference to SECTIONS 4 to 6, if government budget

information is made publically available in the commercial media, or quoted in magazines or journals, try as far as possible to find the original

government source of the information (for example the budget proposal or annual report the information was originally published in).

1 Name of article or chapter: Fill in name here

Author(s) of article or chapter: Fill in authors’ names here

Name of publication (e.g name of newspaper or journal) Date of publication (year, month, day for newspapers)

Fill in the name of the publication here Fill in publication date here

Volume and Issue number, if relevant: Publication details (publisher, place of publication)

Fill in volume and issue number here, if relevant Fill in publication details here

Available at (give physical location or internet address and date accessed)

Fill in location and the date you accessed the source at this location here

2 Name of article or chapter: Fill in name here

Author(s) of article or chapter: Fill in authors’ names here

Name of publication (e.g name of newspaper or journal) Date of publication (year, month, day for newspapers)

Fill in the name of the publication here Fill in publication date here

Volume and Issue number, if relevant: Publication details (publisher, place of publication)

Fill in volume and issue number here, if relevant Fill in publication details here

Available at (give physical location or internet address and date accessed)

Fill in location and the date you accessed the source at this location here


52

TABLE 10: INTERVIEWS & CORRESPONDENCE AS RESEARCH SOURCES

Name of person interviewed or correspondent

Title/position/organisation Means of communication

(email, telephone, meeting in person)

Date of interview or correspondence

Mr. Vincent Chowa Senior Nutritionist, National Food and Nutrition Commission

Meeting in person 27th June 2012

Ms. Pricilla Funduluka Nutritionist, Ministry of Health Telephone 28th June 2012

Ms. Agnes Aongola Nutritionist, Ministry of Health Meeting in person 21st June 2012


53

GENERAL COMMENTS FROM THE PEER REVIEWERS & RESEARCHER’S RESPONSES TO GENERAL COMMENTS

PEER REVIEWER 1 - GENERAL COMMENT:

No general comment was given.

PEER REVIEWER 2 – GENERAL COMMENT:

I have extensively reviewed the answers provided in the questionnaire, as well as the two supporting documents you sent me. I have found the

responses to be largely in line with the documents consulted. However, I found the reference list inadequate for particular questions e.g. questions

D10 and D11. In short, the documents used are more appropriate to questions on planning rather than implementation and M&E.

RESEARCHER - GENERAL RESPONSE TO PEER REVIEWERS:

To Peer Reviewer 1: I appreciate the comments made in the questionnaire. However, my quick impression are that the reviewer did not get a good

handle on the other budget documents that were used to inform the study (i.e the action plans and strategic plans) in addition to the Yellow book

and budget speech. The comments on section E are very helpful.

To Peer Reviewer 2: The comments are accurate.


54

NOTE FROM AT4HR ON PEER REVIEWS AND RESEARCHER’S RESPONSES

For each question in the questionnaire, AT4HR considered the original score given by the researcher, the comments and alternative scores

proposed by the peer reviewers, as well as the researcher’s responses to the peer reviewers. Where differences exist between the assessments of

the peer reviewers and the researcher to any question, the AT4HR has made the final scoring decision. In the tables under each question, the final

score is confirmed by the AT4HR in the bottom row. Where no comment is added by the ATHR, it means that the researcher’s response to the peer

reviewers has been found to be sound. Where the final AT4HR score differs from that of the researcher, a comment of clarification is provided in

the second to last row.


55

SECTION 4: QUESTIONS ABOUT POLICY & PLANNING FOR CHILD NUTRITION INTERVENTIONS

How to complete this section of the questionnaire

General

Save the questionnaire onto your own computer and work directly into the document.

Please respond to all the questions in every section of the questionnaire.

Selecting an answer in response to each question

Every question is followed by five possible answers to choose from, marked a) to e). Select only ONE answer for each of the interventions you

are conducting research on.

The answers contain normative words like ‘extensive’, ‘clearly’, ‘vague’ and ‘limited’. There are no exact definitions of what should count as

‘extensive’ for example, or what characteristics qualify as information that is ‘vague’. When an answer says that ‘important details’ have been

excluded or that a reference is not ‘sufficiently clear’there is no single definition of what those details would be. The definitions will vary

depending on what intervention is in focus. It is necessary for the researcher to apply his or her judgement in interpreting these terms.

The answers represent a range: Keep in mind that the answer marked ‘a’ always represents the ‘best case’ or ideal situation and the answer

marked ‘d’ always represents the worst case scenario. The answers in between – ‘b’ and ’c’ – should be seen to fall on a continuum ranging

between the two poles. If the situation you find in relation to an intervention falls more towards the worst case but is not quite as bad as ‘d’, it

generally makes sense to choose the ‘c’ answer. If your finding is positive but not quite ‘ideal’, it will usually be apt to choose the ‘b’ answer.

Whenever you would like to record concerns or important points regarding the interpretation of the answers, please use the comment boxes

provided to explain or elaborate. Please also highlight any significant anecdotal evidence or other observations about why information being

looked for is not available.


56

When selecting the ‘not applicable’ option

In some instances, it may not be possible or appropriate to apply a certain question to all the interventions. For example, when a question asks

about past expenditure and the intervention is in its first year, the question does not apply to that intervention.

Where it is not relevant or appropriate to provide an answer to a question (for one or more of the interventions), choose ‘not applicable’ as

your response.

When choosing ‘not applicable’, it is always necessary to provide an explanation in the comment box on why the question does not apply to

that intervention.

Deciding which answer box(es) to complete

For each question, there are two answer boxes: one for the national level and one for the sub-national level. The sub-national answer box

provides spaces to enter answers for each intervention across three sub-national units (e.g. three selected provinces, districts, counties or

otherwise-named units).

Which box(es) you complete will depend on the interventions you are researching and at which levels they are planned:

Complete the answer box for the national level in relation to all the interventions that are planned at national level.

Complete the answer box for the sub-national level in relation to all the interventions that are planned at sub-national level.

For interventions where planning takes place at national and sub-national level, complete both boxes.


57

A. POLICY AND STRATEGIC COORDINATION IN CHILD NUTRITION INTERVENTIONS

A1. Do current budget documents explain which laws and/or policies guide the design of interventions for child nutrition?

Consider the question above in relation to each of the child nutrition interventions you selected in SECTION 2. For each intervention, identify one

answer from the list below that most accurately reflects your findings. Write down the corresponding letter (for example “c”) in the boxes below.

You may have different answers for the different interventions. For further guidelines, see the pointers at the beginning of this section.

a) Current budget documents clearly explain which laws and/or policies guide the design of the intervention for child

nutrition.

b) Current budget documents make some reference to laws and/or policies that guide the design of the intervention for

child nutrition.

c) Current budget documents make very limited reference to laws and/or policies that guide the design of the

intervention for child nutrition, although such laws and/or policies exist.

d) Current budget documents make no reference to laws or policies that guide the design of the intervention for child

nutrition.

e) Not applicable (i.e. no such laws or policies exist) / Other (please comment).


58

A1: ANSWER BOX FOR THE NATIONAL LEVEL

Intervention INTERVENTION 1 INTERVENTION 2 INTERVENTION 3 INTERVENTION 4 INTERVENTION 5

Researcher’s initial score c c c c c

Peer reviewer 1: Proposed score

Peer reviewer 1: Comment



Researcher’s response to peer reviewers

AT4HR final score c c c c c


59

A1: ANSWER BOX FOR THE SUB-NATIONAL LEVEL

Sub-national unit

Scores INTERVENTION 1 INTERVENTION 2 INTERVENTION 3 INTERVENTION 4 INTERVENTION 5

Lusaka District


Peer reviewer 1: Proposed score d d d d d

Peer reviewer 1: Comment The budget documents make no reference to interventions at district level e.g Yellow book 2012 (pg. 807 and 809) they use nutrition general.




I disagree with the reviewer. My rating was based on the budget document specific for each district. The reviewer’s rating seems to be based entirely on the national budget document. Thus not accurate.


Nakonde District










60

Sub-national unit


Chingola District



Peer reviewer 1: Comment Chingola is not mentioned in 2011 and 2012 budget documents.






A1: SOURCE REFERENCES

Intervention

number

State the source(s) that informed the selection of your answers. Please provide the relevant internet links, document names

and interview references. Be as specific as possible, by for example giving page or section numbers in documents, quotes from

interviews, as well as the date and full names of interviewees.

1 Ministry of Health (MoH) Action Plan 2012, Lusaka District Health Management Team (LDHMT) Action Plan 2012-2014, Chingola District Health Management Team (CDHMT) Action Plan 2012-2014

2 MoH Action Plan 2012, LDHMT Action Plan 2012, CDHMT Action Plan 2012-2014





61

A1: COMMENTS

Intervention # Comments regarding the interpretation of this question in relation to specific interventions

1

2

3

4

5

Comments regarding the national level answer box

In the Action Plan for Ministry of Health under the logical framework it gives the aim and purpose which according to the nutrition experts is derived from the policy.

Comments regarding the sub-national level answer box

In the Action Plan for Ministry of Health under the logical framework it gives the aim and purpose which according to the nutrition experts is derived from the policy.

Other comments on Question A1:


62

A2. Do current budget documents explain how the interventions for child nutrition are intended to meet the child rights

obligations of the government?




a) Current budget documents explain clearly how the intervention for child nutrition is intended to meet the

government’s child rights obligations.

b) Current budget documents make some links between the intervention for child nutrition and the government’s child

rights obligations.

c) Current budget documents say very little about government’s child rights obligations in relation to the intervention for

child nutrition.

d) Current budget documents make no mention of the government’s child rights obligations in relation to the intervention

for child nutrition.

e) Not applicable (i.e.: No such obligations exist) / Other (please comment).


63



Researcher’s initial score d d d d d






AT4HR final score d d d d d


64


Sub-national unit


Lusaka District








Nakonde District








Chingola District






65

Sub-national unit






Intervention

number




1 MoH Action Plan 2012, LDHMT Action Plan 2012-2014, CDHMT Action Plan 2012-2014






66

A2: COMMENTS


1

2

3

4

5





67

A3. Do current budget documents explain whether the design of child nutrition interventions have been informed by

evidence on the scale of the child nutrition problem in the country?




a) Current budget documents explain clearly how evidence about the scale of the child nutrition problem has informed

the design of this intervention.

b) Current budget documents note that evidence about the scale of the child nutrition problem has informed the design

of this intervention, but the explanation is not sufficiently clear.

c) Current budget documents make very little reference to evidence about the scale of the child nutrition problem.

d) Current budget documents make no reference to evidence about the scale of the child nutrition problem in explaining

the design of this intervention.

e) Not applicable / Other (please comment).


68



Researcher’s initial score b b b b b






AT4HR final score b b b b b


69


Sub-national unit


Lusaka District








Nakonde District








Chingola District





70

Sub-national unit







Intervention

number










71

A3: COMMENTS


1

2

3

4

5


They mention what the current levels are and the sources(i.e. HMIS, ZDHS) of where this information is found but the explanation about the scale is not sufficiently clear in the budget document.


The Action Plans under Bottleneck analysis makes some reference to the evidence on the scale of the problem.



72

A4. Do current budget documents explain whether the design of child nutrition interventions have been informed by

evidence on the geographical distribution of the child nutrition problem in the country?




a) Current budget documents explain clearly how evidence about the geographical distribution of the child nutrition

problem has informed the design of this intervention.

b) Current budget documents note that evidence about the geographical distribution of the child nutrition problem has

informed the design of this intervention, but the explanation is not sufficiently clear.

c) Current budget documents make very little reference to evidence about the geographical distribution of the child

nutrition problem.

d) Current budget documents make no reference to evidence about the geographical distribution of the child nutrition

problem in explaining the design of this intervention.



73











74


Sub-national unit


Lusaka District








Nakonde District








Chingola District





75

Sub-national unit







Intervention

number




1 MoH Action Plan 2012, LDHMT Action Plan 2012-2014, CDHMT Action Plan 2012-2014.

2 MoH Action Plan 2012, LDHMT Action Plan 2012, CDHMT Action Plan 2012-2014.





76

A4: COMMENTS


1

2

3

4

5





77

A5. Do current budget documents, in presenting the selected child nutrition interventions, provide information on

obstacles children may face in accessing these interventions?




a) Current budget documents show clearly how consideration was given, in the design of this intervention, to the

obstacles children may face in accessing the intervention.

b) Current budget documents show that, in the design of this intervention, some consideration was given to obstacles

children may face in accessing the intervention, but the explanation is not sufficiently clear.

c) In discussing the design of the child nutrition intervention, current budget documents make very little reference to

considerations about obstacles children may face in accessing the intervention.

d) Current budget documents make no reference to considerations about obstacles children may face in accessing this

child nutrition intervention.



78











79


Sub-national unit


Lusaka District








Nakonde District








Chingola District






80

Sub-national unit






Intervention

number




1 MoH Action Plan 2012, LDHMT Action Plan 2012-2014, CDHMT Action Plan 2012-2014 (page 63).

2 MoH Action Plan 2012, LDHMT Action Plan 2012, CDHMT Action Plan 2012-2014 (page 63).





81

A5: COMMENTS


1

2

3

4

5



For Chingola district under bottleneck analysis in the action plan, they try to take into account some of the constraints in accessing the

intervention.



82

A6. Do current budget documents, in their description of interventions for addressing child malnutrition, make statements

about reaching the most vulnerable children?




a) Current budget documents, in their description of the intervention, make clear statements about reaching the most

vulnerable children.

b) Current budget documents, in their description of the intervention, make some reference to reaching the most


c) Current budget documents, in their description of the intervention, make very little reference to reaching the most


d) Current budget documents make no reference to reaching the most vulnerable children in their description of the

intervention.



83











84


Sub-national unit


Lusaka District

Researcher’s initial score c c d d d






AT4HR final score c c d d d

Nakonde District








Chingola District






85

Sub-national unit






Intervention

number




1 National Food and Nutrition Strategic Plan 2011-2015 (page 4), MoH Action Plan 2012, LDHMT Action Plan 2012-2014, CDHMT Action Plan 2012-2014.






86

A6: COMMENTS


1 Though the budget document do not make specific statements about reaching the vulnerable, this intervention is aimed at addressing malnutrition in the vulnerable.

2 Though the budget document do not make specific statements about reaching the vulnerable, this intervention is aimed at addressing malnutrition in the vulnerable.

3

4

5





87

A7. Do current budget documents explain how the government intends to promote coordinated planning, budgeting and

service delivery to advance child nutrition?




a) In describing the child nutrition intervention, current budget documents explain clearly how the government intends to

promote coordinated planning, budgeting and service delivery.

b) In describing the child nutrition intervention, current budget documents explain how the government intends to

promote coordinated planning, budgeting and service delivery, but the explanation is not sufficiently clear.

c) In describing the child nutrition intervention, current budget documents make very little reference to the promotion of

coordinated planning, budgeting and service delivery.

d) In describing the child nutrition intervention, current budget documents make no reference to the promotion of

coordinated planning, budgeting and service delivery.



88





d d d d d


The budget documents make general statement e.g on vaccinated, child safety, with no direct interpretation of advancing children nutrition – reference to 2011 budget speech para 4, 76, 128 and 185.




I disagree with the reviewer 1. At the national level the National Food and Nutrition Commission (NFNC) is charged with the responsibility of achieving optimum nutrition status for the Zambian population. As such they have been responsible for coordinating a multi sector strategic response on nutrition issues in Zambia. Therefore my rating was based on the NFNC Strategic Plan for Zambia 2011-2015 which has a specific focus on a multi sector strategic direction on first 1000 most critical days to prevent child stunting. See annex (page 63-142) for matrix on multi sector coordination.



89


Sub-national unit


Lusaka District



Peer reviewer 1: Comment The interventions mentioned are not explicit to district level – they are general statement on budget coordination’s and intervention – reference to 2009, 2010 and 2011 national budget and MTEF 2010.




I disagree. My rating was based on information contained in budget documents specific for the district (The district action plan). The action plans contain a stakeholders list which mentions other government departments, donors, NGO etc which are involved in the activities of the district health team. See LDHMT action plan page 13.


Nakonde District







I disagree with the peer reviewer 1 for the same reasons stated above.



90

Sub-national unit


Chingola District







I disagree with the peer reviewer 1 for the same reasons stated above.



Intervention

number




1

National Food and Nutrition Strategic Plan 2011-2015, LDHMT Action Plan 2012-2014(page 3), CDHMT Action Plan 2012-2014

2

3

4

5


91

A7: COMMENTS


1

2

3

4

5


The National Food and Nutrition Strategic plan provides information on how the government intends to coordinate nutrition interventions.


The Action Plan at district level makes mention of the other government departments, donors, NGOs that are generally involved in the activities done by the district health team. This is under what is called a Stakeholders list but the list is for nutrition in general.



92

A8. Do current budget documents provide details on the sources of revenue for child nutrition interventions?




a) Current budget documents provide extensive information on sources of revenue for the child nutrition intervention.

b) Current budget documents provide information on sources of revenue for the child nutrition intervention, but some

details are excluded.

c) Current budget documents provide little information on sources of revenue for the child nutrition intervention, and

important details are excluded.

d) Current budget documents provide no information on sources of revenue for the child nutrition intervention.

e) Not applicable/ Other (please comment).


93











94


Sub-national unit


Lusaka District








Nakonde District








Chingola District






95

Sub-national unit






Intervention

number










96

A8: COMMENTS


1

2

3

4

5


The MoH Action plan shows the sources of revenue for nutrition in general but does not show for the specific intervention.




97

A9. Do current budget documents provide information about the role of development aid in financing child nutrition

interventions?




a) Current budget documents provide extensive information on the role of development aid in financing the child

nutrition intervention, including details about sources of aid, aid modalities and conditionalities.

b) Current budget documents provide information on the role of development aid in financing the child nutrition

intervention, but some details are excluded.

c) Current budget documents provide little information on the role of development aid in financing the child nutrition

intervention, and important details are excluded.

d) Current budget documents provide no information on the role of development aid in financing the child nutrition

intervention.

e) Not applicable (i.e.no development aid plays a role in this sector) / Other (please comment).


98





c c c c c


There is very little information provided by the government if at all its provided.




I disagree with Peer Reviewer 1. The Ministry of Health national action plan does mention if any funding on a particular intervention is coming from a donor. See page 45 for example.



99


Sub-national unit


Lusaka District


Peer reviewer 1: Proposed score c c c c c

Peer reviewer 1: Comment There is very little information provided by the government if at all its provided.





Nakonde District








Chingola District



Peer reviewer 1: Comment There is very little information provided by the government if at all its provided.



100

Sub-national unit




I disagree with Peer Reviewer 1. My rating was based on the fact that I did not find any mention of development aid in the Chingola district action plan and the explanation was that the guideline that the district has is not to reveal if the funding is coming from a donor or other source but to just show that its general government funding.



Intervention

number




1 MoH Action Plan 2012(page 87), GRZ Estimates of Revenue and Expenditure 2012, LDHMT Action Plan 2012, CDHMT Action Plan 2012-2014.

2 MoH Action Plan 2012(page 87), GRZ Estimates of Revenue and Expenditure 2012, LDHMT Action Plan 2012, CDHMT Action Plan 2012.





101

A9: COMMENTS


1

2

3

4

5



For Lusaka district, the Action Plan just shows the gross amount of how much is expected from donors. It does not show the breakdown for each intervention.



102

A10. Do current budget documents provide information on steps taken to enhance delivery capacity in the child nutrition

interventions?




a) Current budget documents provide extensive information on steps taken to enhance delivery capacity in the child

nutrition intervention.

b) Current budget documents provide information on steps taken to enhance delivery capacity in the child nutrition

intervention, but some details are excluded.

c) Current budget documents provide little information on steps taken to enhance delivery capacity in the child nutrition

intervention, and important details are excluded.

d) Current budget documents provide no information on steps taken to enhance delivery capacity in the child nutrition

intervention.

e) Not applicable/ other (please comment).


103











104


Sub-national unit


Lusaka District



Peer reviewer 1: Comment The budget documents provide no information on delivery capacity on these interventions.




I disagree with Peer Reviewer 1. Please refer to SWOT analysis, Bottleneck analysis and Log frame analysis in the district action plan.


Nakonde District








Chingola District



Peer reviewer 1: Comment The budget documents provide no information on delivery capacity on these interventions.



105

Sub-national unit




I disagree with Peer Reviewer 1. Please refer to SWOT analysis, Bottleneck analysis and Log frame analysis in the district action plan.



Intervention

number




1 MoH Action Plan, LDHMT Action Plan, CDHMT Action Plan.






106

A10: COMMENTS


1

2

3

4

5



Generally by looking at the SWOT Analysis, Bottleneck analysis and the Log frame analysis that are contained in the district Action plans you get some indication of the steps taken to enhance delivery capacity.



107

A11. Do current budget documents provide information on steps taken to expand vulnerable child coverage in the child

nutrition interventions?




a) Current budget documents provide extensive information on steps taken to expand vulnerable child coverage in the


b) Current budget documents provide information on steps taken to expand vulnerable child coverage in the child

nutrition intervention, but some details are excluded.

c) Current budget documents provide little information on steps taken to expand vulnerable child coverage in the child

nutrition intervention, and important details are excluded.

d) Current budget documents provide no information on steps taken to expand vulnerable child coverage in the child


e) Not applicable/ other (please comment).


108





c c c c c


Para 61 of the 2012 National budget for instance gives ways on how they will expand interventions.




I agree with the Peer Reviewer 1. I would like to change my rating to “c”. I had missed information in paragraph 61 of the budget speech.



109


Sub-national unit


Lusaka District








Nakonde District








Chingola District






110

Sub-national unit






Intervention

number




1 MoH Action Plan, LDHMT Action Plan, CDHMT Action Plan






111

A11: COMMENTS


1

2

3

4

5





112

A12. Do current budget documents provide information on attempts to cost the child nutrition interventions?




a) Current budget documents provide extensive information on attempts to cost the child nutrition intervention, including

details about how the costing informed the design of the intervention.

b) Current budget documents provide extensive information on attempts to cost the child nutrition intervention, but

some details are excluded.

c) Current budget documents provide extensive information on attempts to cost the child nutrition intervention, and


d) Current budget documents provide no information on attempts to cost the child nutrition intervention.

e) Not applicable (i.e.no development aid plays a role in this sector) / Other (please comment).


113











114


Sub-national unit


Lusaka District








Nakonde District








Chingola District






115

Sub-national unit






Intervention

number










116

A12: COMMENTS


1

2

3

4

5


Its aggregated at national level. The break down will be at the community and centre level.


The item by item costing is done at much lower level i.e. community and health centre. At the district its aggregated.



117

B. PLANNED (BUDGETED) EXPENDITURES FOR CHILD NUTRITION INTERVENTIONS

B1. Do current budget documents provide information on planned expenditures in relation to the selected child nutrition

interventions?




a) Current budget documents provide extensive information on planned expenditures for the child nutrition intervention,

including narrative discussion and quantitative estimates.

b) Current budget documents provide information on planned expenditures for the child nutrition intervention, but some


c) Current budget documents provide little information on planned expenditures for the child nutrition intervention, and


d) Current budget documents provide no information on planned expenditures for the child nutrition intervention.



118

B1: ANSWER BOX FOR THE NATIONAL LEVEL










119

B1: ANSWER BOX FOR THE SUB-NATIONAL LEVEL

Sub-national unit


Lusaka District








Nakonde District








Chingola District






120

Sub-national unit





B1: SOURCE REFERENCES

Intervention

number










121

B1: COMMENTS


1

2

3

4

5



Other comments on Question B1:


122

B2. Do current budget documents provide information about planned expenditures for the child nutrition interventions for

at least one year beyond the budget year?




a) Current budget documents provide extensive information about planned expenditures for the child nutrition

intervention for at least one year beyond the budget year, including narrative discussion and quantitative estimates.

b) Current budget documents provide information about planned expenditures for the child nutrition intervention for at

least one year beyond the budget year, but important details are excluded.

c) Current budget documents provide little information about planned expenditures for the child nutrition intervention

one year beyond the budget year.

d) Current budget documents provide no information about planned expenditures for the child nutrition intervention

beyond the budget year.



123











124


Sub-national unit


Lusaka District








Nakonde District








Chingola District






125

Sub-national unit






Intervention

number




1 MoH MTEF, LDHMT Action Plan 2012-2014, CDHMT Action Plan 2012-2014






126

B2: COMMENTS


1

2

3

4

5





127

B3. Do current budget documents provide non-financial data in relation to the planned expenditures on the child nutrition

interventions?




a) Current budget documents provide extensive non-financial data in relation to the planned expenditures on the

intervention.

b) Current budget documents provide non-financial data in relation to the planned expenditures on the intervention, but


c) Current budget documents provide little non-financial data in relation to the planned expenditures on the intervention,

and important details are excluded.

d) Current budget documents provide no non-financial data in relation to the planned expenditures on the intervention.



128











129


Sub-national unit


Lusaka District








Nakonde District








Chingola District






130

Sub-national unit






Intervention

number










131

B3: COMMENTS


1

2

3

4

5





132

SECTION 5: QUESTIONS ABOUT THE IMPLEMENTATION OF CHILD NUTRITION INTERVENTIONS


General


















133





your response.


that intervention.





Which box(es) you complete will depend on the interventions you are researching and at which levels they are implemented:

Complete the answer box for the national level in relation to all the interventions that are implemented at national level.

Complete the answer box for the sub-national level in relation to all the interventions that are implemented at sub-national level.

For interventions where implementation takes place at national and sub-national level, complete both boxes.


134

C. ACTUAL EXPENDITURES ON CHILD NUTRITION INTERVENTIONS

C1. Do current budget documents provide information on actual expenditures in relation to the selected child nutrition

interventions?




a) Current budget documents provide extensive information about actual expenditures on the child nutrition

intervention, including narrative discussion and quantitative figures.

b) Current budget documents provide information about actual expenditures on the child nutrition intervention, but some


c) Current budget documents provide little information about actual expenditures on the child nutrition intervention, and


d) Current budget documents provide no information about actual expenditures on the child nutrition intervention.



135

C1: ANSWER BOX FOR THE NATIONAL LEVEL










136

C1: ANSWER BOX FOR THE SUB-NATIONAL LEVEL

Sub-national unit


Lusaka District








Nakonde District








Chingola District






137

Sub-national unit





C1: SOURCE REFERENCES

Intervention

number




1

2

3

4

5


138

C1: COMMENTS


1

2

3

4

5



Other comments on Question C1:


139

C2. Do current budget documents provide comparison between actual and budgeted expenditures in relation to the

selected child nutrition interventions?




a) Current budget documents provide substantial comparison between actual and budgeted expenditures in relation to

the selected child nutrition intervention, including a narrative explanation and quantitative data.

b) Current budget documents provide comparison between actual and budgeted expenditures in relation to the selected

child nutrition intervention, but some important details are excluded.

c) Current budget documents provide little comparison between actual and budgeted expenditures in relation to the

selected child nutrition intervention.

d) Current budget documents provide no comparison between actual and budgeted expenditures in relation to the

selected child nutrition intervention.



140











141


Sub-national unit


Lusaka District








Nakonde District








Chingola District






142

Sub-national unit






Intervention

number




1

2

3

4

5


143

C2: COMMENTS


1

2

3

4

5





144

C3. Do current budget documents provide information about past actual expenditures on the child nutrition interventions

for at least one year prior to the budget year?




a) Current budget documents provide extensive information about past actual expenditures on the child nutrition

intervention for at least one year prior to the budget year, including narrative discussion and quantitative estimates.

b) Current budget documents provide information about past actual expenditures on the child nutrition intervention for

at least one year prior to the budget year, but some details are excluded.

c) Current budget documents provide little information about past actual expenditures on the child nutrition intervention

prior to the budget year, and important details are excluded.

d) Current budget documents provide no information about past actual expenditures on the child nutrition intervention

prior to the budget year.



145











146


Sub-national unit


Lusaka District








Nakonde District








Chingola District




Peer reviewer 2: Proposed score b b b b b


147

Sub-national unit


Peer reviewer 2: Comment This is based on the document reference given by the researcher.


I disagree with Peer Reviewer 1. Please refer to the document Review of Action Plan 1st

Quarter. It only shows actual expenditures for year of review.



Intervention

number




1

2

3

4

5


148

C3: COMMENTS


1

2

3

4

5





149

C4. Do current budget documents provide non-financial data in relation to the actual expenditures on the child nutrition

interventions?




a) Current budget documents provide extensive non-financial data in relation to the actual expenditure on this child


b) Current budget documents provide non-financial data in relation to the actual expenditure on this intervention, but


c) Current budget documents provide little non-financial data in relation to the actual expenditure on this intervention,

and important details are excluded.

d) Current budget documents provide no non-financial data in relation to the actual expenditure on this child nutrition

intervention.



150











151


Sub-national unit


Lusaka District








Nakonde District








Chingola District




Peer reviewer 2: Proposed score b b b b b


152

Sub-national unit


Peer reviewer 2: Comment This is based on the document reference given by the researcher.


I disagree with Peer Reviewer 1. There is no non-financial data in the document.



Intervention

number




1

2

3

4

5


153

C4: COMMENTS


1

2

3

4

5





154

C5. Do current budget documents provide actual expenditure information more often than on a yearly basis in relation to

the child nutrition interventions?




a) Current budget documents provide actual expenditure information on the child nutrition intervention at least monthly,

including narrative discussion and expenditure estimates.

b) Current budget documents provide actual expenditure information at least quarterly on the child nutrition

intervention.

c) Current budget documents provide actual expenditure information at least twice a year on the child nutrition

intervention.

d) Current budget documents s provide no in-year actual expenditure information on the child nutrition intervention.



155











156


Sub-national unit


Lusaka District








Nakonde District








Chingola District






157

Sub-national unit






Intervention

number




1

2

3

4

5


158

C5: COMMENTS


1

2

3

4

5





159

C6. Do current budget documents provide comparison between actual and budgeted expenditures (based on the enacted

budget) more often than on a yearly basis in relation to the child nutrition interventions?




a) Current budget documents provide comparison between actual and budgeted expenditures (based on the enacted

budget) at least monthly in relation to the child nutrition intervention.

b) Current budget documents provide comparison between actual and budgeted expenditures (based on the enacted

budget) at least quarterly in relation to the child nutrition intervention.

c) Current budget documents provide comparison between actual and budgeted expenditures (based on the enacted

budget) at least twice a year in relation to the child nutrition intervention.

d) Current budget documents provide no in-year comparison between actual and budgeted expenditures (based on the

enacted budget) in relation to the child nutrition intervention.



160











161


Sub-national unit


Lusaka District








Nakonde District








Chingola District






162

Sub-national unit


Peer reviewer 2: Comment The documents do not show comparisons of comparison between actual and budgeted expenditures more often than on a yearly basis even that's of Chingola.


I disagree with Peer Reviewer 1. The budget documents provide comparisons on a quarterly basis.



Intervention

number




1

2

3

4

5


163

C6: COMMENTS


1

2

3

4

5





164

C7. Do year-end reports explain differences between the approved expenditures on the child nutrition interventions

(including supplementary budgets) and actual expenditures?




a) The year-end report provides extensive account of differences between approved expenditures and actual

expenditures on the child nutrition intervention.

b) The year-end report provides information on the differences between approved expenditures and actual expenditures

on the child nutrition intervention, but some differences are not addressed.

c) The year-end report provides very little information on the differences between approved expenditures and actual

expenditures on the child nutrition intervention, and important differences are not explained.

d) The year-end report provides no explanation for differences between the approved expenditures and actual

expenditures on the child nutrition intervention.



165











166


Sub-national unit


Lusaka District








Nakonde District








Chingola District






167

Sub-national unit






Intervention

number




1

2

3

4

5


168

C7: COMMENTS


1

2

3

4

5





169

C8. Have the data on the actual expenditures related to the intervention been audited in any of the two years prior to the

budget year?




a) Yes. the data on the actual expenditures related to the intervention have been fully audited in one or both of the years

prior to the budget year.

b) Most (more than half) of the data on the actual expenditures related to the intervention has been audited in one or

both of the years prior to the budget year.

c) The minority (less than half) of the data on the actual expenditures related to the intervention has been audited in one

or both of the years prior to the budget year.

d) None of the data of the data on the actual expenditures related to the intervention has been audited any of the two

years prior to the budget year.

e) Not applicable / other (please comment).


170











171


Sub-national unit


Lusaka District








Nakonde District








Chingola District






172

Sub-national unit






Intervention

number




1

2

3

4

5


173

C8: COMMENTS


1

2

3

4

5





174

D. BUDGET PERFORMANCE IN RELATION TO CHILD NUTRITION INTERVENTIONS

D1. Do current budget documents present performance indicators for monitoring the service delivery of the child nutrition

interventions?




a) Current budget documents provide clear performance indicators for monitoring the service delivery of the child


b) Current budget documents provide performance indicators for monitoring the service delivery of the child nutrition

intervention, but they are not sufficiently clear.

c) Current budget documents make limited reference to performance indicators for monitoring the service delivery of the

child nutrition intervention, but do not clarify what these indicators are.

d) Current budget documents make no reference to performance indicators for monitoring service delivery in relation to

the child nutrition intervention.



175

D1: ANSWER BOX FOR THE NATIONAL LEVEL


Researcher’s initial score d d b b b


c c c


The budget document does give limited performance indicators. The budget document make little reference to performance indicators- for instance the NATIONAL HEALTH STRATEGIC PLAN 2011-2015, page 51.

But no reference to performance indicators for monitoring service delivery in relation to the child nutrition intervention is made – e.g the progress report of the SNDP Makes no reference.




I disagree with Peer Reviewer 1. Please refer to MoH national action plan 2012 page 85-90.

AT4HR final score d d b b b


176

D1: ANSWER BOX FOR THE SUB-NATIONAL LEVEL

Sub-national unit


Lusaka District








Nakonde District








Chingola District



Peer reviewer 1: Comment No reference is made in Chingola in the SNDP progress report, the MTEF and the 2009-2012 national budgets.


177

Sub-national unit





I disagree with Peer Reviewer 1. Please refer to Chingola district action plan 2012.


D1: SOURCE REFERENCES

Intervention

number










178

D1: COMMENTS


1

2

3

4

5



For Chingola the indicators that are listed in the action Plan are for malnutrition in general not for the specific intervention.

Other comments on Question D1:


179

D2. Do current budget documents present service delivery targets for the child nutrition interventions for the current

budget year?




a) Current budget documents provide detailed information on service delivery targets for the child nutrition intervention

for the current budget year.

b) Current budget documents provide information on service delivery targets for the child nutrition intervention for the

current budget year, but some details are excluded.

c) Current budget documents provide very little information on service delivery targets for the child nutrition intervention

for the current budget year, and important details are excluded.

d) Current budget documents don’t provide any information on service delivery targets for the child nutrition

intervention.



180



Researcher’s initial score d d b b c


c c


Very little information is provided if at all it is provided, national budget for 2010.




I disagree with Peer Reviewer 1. Please refer to MoH national action plan 2012, page 85-90.

AT4HR final score d d b b c


181


Sub-national unit


Lusaka District








Nakonde District








Chingola District



Peer reviewer 1: Comment Very little information of provided – yellow book 2009-2012, budget speech 2008-2012, FNDP and SNDP.



182

Sub-national unit




I disagree with Peer Reviewer 1. Please refer to Chingola district action plan 2012.



Intervention

number










183

D2: COMMENTS


1

2

3

4

5





184

D3. Do current budget documents present service delivery targets for the child nutrition interventions for at least two

years beyond the current budget year?




a) Current budget documents provide detailed information on service delivery targets for the child nutrition intervention

for at least two years beyond the current budget year.

b) Current budget documents provide information on service delivery targets for the child nutrition intervention for at

least two years beyond the current budget year, but some details are excluded.

c) Current budget documents provide very little information on service delivery targets for the child nutrition intervention

beyond the current budget year, and important details are excluded.

d) Current budget documents do not provide any information on service delivery targets for the child nutrition

intervention beyond the current budget year.



185





d d d


No nutrition intervention is mentioned.







186


Sub-national unit


Lusaka District








Nakonde District








Chingola District






187

Sub-national unit






Intervention

number










188

D3: COMMENTS


1

2

3

4

5





189

D4. Do the service delivery targets attached to the child nutrition interventions make reference to reaching the most

vulnerable children?




a) The service delivery targets for this child nutrition intervention make clear reference to reaching the most vulnerable

children.

b) The service delivery targets for this child nutrition intervention make reference to reaching the most vulnerable

children, but the reference is not sufficiently clear.

c) The service delivery targets for this child nutrition intervention make very little reference to reaching the most


d) The service delivery targets for this child nutrition intervention make no reference to reaching the most vulnerable

children.



190



Researcher’s initial score e e d d d


d d


No reference is made to nutrition intervention.




I disagree. Two things here; while I did not find any service delivery targets attached to these interventions, they are basically designed for the vulnerable children as they fall under infant and young child feeding. Thus in my view rating “e” is more appropriate than “d”.

AT4HR note As no service delivery targets exist that make explicit reference to reaching vulnerable children, the score of “d” is most appropriate.



191


Sub-national unit


Lusaka District








Nakonde District








Chingola District






192

Sub-national unit






Intervention

number










193

D4: COMMENTS


1

2

3

4

5





194

D5. Do the performance targets for monitoring the delivery of the child nutrition interventions make reference to

overcoming obstacles in children’s access to such interventions?




a) The performance targets for monitoring the delivery of this child nutrition intervention make clear reference to

overcoming obstacles in children’s access to the intervention.

b) The performance targets for monitoring the delivery of this child nutrition intervention make reference to overcoming

obstacles in children’s access to the intervention, but the reference is not sufficiently clear.

c) The performance targets for monitoring the delivery of this child nutrition intervention make little reference to

overcoming obstacles in children’s access to the intervention.

d) The performance targets for monitoring the delivery of this intervention make no reference to overcoming obstacles in

children’s access to the intervention.



195











196


Sub-national unit


Lusaka District

Researcher’s initial score d d d d b

Peer reviewer 1: Proposed score d


There are no performance targets that are mentioned in the budget documents, they just highlight expenditures.




I agree with Peer Reviewer 1 and would like to change my score to “d”.


Nakonde District








Chingola Researcher’s initial score d d d d d


197

Sub-national unit


District Peer reviewer 1: Proposed score







Intervention

number




1

MoH Action Plan 2012, LDHMT Action Plan 2012-2014, CDHMT Action Plan 2012-2014.

2

3

4

5

D5: COMMENTS


198


1

2

3

4

5





199

D6. Do the performance targets for monitoring the delivery of these child nutrition interventions make reference to

reaching children in their very early years (from birth to two years)?




a) The performance targets for monitoring the delivery of this intervention make clear reference to reaching children in

their very early years (from birth to two years).

b) The performance targets for monitoring the delivery of this intervention make reference to reaching children in their

very early years (from birth to two years), but the reference is not sufficiently clear.

c) The performance targets for monitoring the delivery of this intervention make very little reference to reaching children

in their very early years (from birth to two years).

d) The performance targets for monitoring the delivery of this intervention make no reference to reaching children in

their very early years (from birth to two years).



200











201


Sub-national unit


Lusaka District








Nakonde District








Chingola District






202

Sub-national unit






Intervention

number










203

D6: COMMENTS


1

2

3

4

5





204

D7. Do the performance targets for monitoring the delivery of these child nutrition interventions make reference to

reaching children in their first five years?




a) The performance targets for monitoring the delivery of this intervention make clear reference to reaching children in

their first five years.

b) The performance targets for monitoring the delivery of this intervention make reference to reaching children in their

first five years, but the reference is not sufficiently clear.

c) The performance targets for monitoring the delivery of this intervention make very little reference to reaching children

in their first five years.

d) The performance targets for monitoring the delivery of this intervention make no reference to reaching children in

their first five years.



205











206


Sub-national unit


Lusaka District








Nakonde District








Chingola District






207

Sub-national unit






Intervention

number










208

D7: COMMENTS


1

2

3

4

5





209

D8. Are the performance indicators for the child nutrition interventions well-designed to enable monitoring of whether

service delivery targets have been met?




a) The performance indicators for the child nutrition intervention are well-designed to enable thorough monitoring of

whether service delivery targets have been met.

b) The performance indicators for the child nutrition intervention are designed in such a way that they enable some

monitoring of whether service delivery targets have been met.

c) The performance indicators for the child nutrition intervention are designed in such a way that they enable very limited

monitoring of whether service delivery targets have been met.

d) The performance indicators for the child nutrition intervention are not adequate to enable any monitoring of whether

service delivery targets have been met.



210





d d d


There are no baseline indicators so it is difficult to enable monitoring and no performance reports are given every year.







211


Sub-national unit


Lusaka District








Nakonde District








Chingola District



Peer reviewer 1: Comment There are no baseline indicators so it is difficult to enable monitoring and no performance reports is given every year.


212

Sub-national unit





I disagree with Peer Reviewer 1. Please refer to Chingola district health management team action plan 2012.



Intervention

number










213

D8: COMMENTS


1

2

3

4

5





214

D9. Are the performance indicators for the child nutrition interventions well-designed to enable monitoring of whether the

most vulnerable children have been reached?




a) The performance indicators for the child nutrition intervention are well-designed to enable thorough monitoring of

whether the most vulnerable children have been reached.

b) The performance indicators for the child nutrition intervention are designed in such a way that they enable some

monitoring of whether the most vulnerable children have been reached.

c) The performance indicators for the child nutrition intervention are designed in such a way that they enable very limited

monitoring of whether the most vulnerable children have been reached.

d) The performance indicators for the child nutrition intervention are inadequate to enable any monitoring of whether

the most vulnerable children have been reached.



215











216


Sub-national unit


Lusaka District








Nakonde District








Chingola District






217

Sub-national unit






Intervention

number










218

D9: COMMENTS


1

2

3

4

5





219

D10. Do current budget documents compare the results achieved through the child nutrition interventions against the

service delivery targets that were set for the corresponding year?




a) Current budget documents give a substantial comparison of the results achieved through the child nutrition

intervention against the service delivery targets that were set for the corresponding year, including a narrative

explanation and quantitative data.

b) Current budget documents make reference to the results achieved through the child nutrition intervention relative to

the service delivery targets that were set for the corresponding year, but some important details are excluded.

c) Current budget documents provide little information on the results achieved through the child nutrition intervention

relative to the service delivery targets that were set for the corresponding year.

d) Current budget documents do not compare the results achieved through the child nutrition intervention against the

service delivery targets that were set for the corresponding year.



220








Documents used to answer the question are not adequate for this question.


I agree with the Peer Reviewer 2. That’s why I initially left this question unanswered when the questionnaire was first submitted. However, if we are to base the response on the previous year's end year report then I would revise my score to ”c”.



221


Sub-national unit


Lusaka District





Peer reviewer 2: Comment Documents used to answer the question are not adequate for this question.




Nakonde District









Chingola District





222

Sub-national unit








Intervention

number





Interview with the Planner for Chingola Health Management Office, December 2012. 2

3

4

5


223

D10: COMMENTS


1

2

3

4

5


The budget document likely to show this information is the end year report but this is not yet available for the current year.


The budget document likely to show this information is the end year report but this is not yet available for the current year.



224

D11. Do year-end reports show the differences between the original estimates of number of beneficiaries for the

interventions and the actual outcome?




a) The year-end report provides an extensive account of differences between the original estimates of beneficiaries

and the actual outcome of the child nutrition intervention.

b) The year-end report comments on the differences between the original estimates of beneficiaries and the actual

outcome of the child nutrition intervention, but the commentary is not sufficiently detailed.

c) The year-end report says very little about the differences between the original estimates of beneficiaries and the

actual outcome of the child nutrition intervention, and important discrepancies are not explained.

d) The year-end report provides no explanation of the differences between the original estimates of beneficiaries and

the actual outcome of the child nutrition intervention.



225








Documents used to answer the question are not adequate for this question.





226


Sub-national unit


Lusaka District









Nakonde District









Chingola District





227

Sub-national unit








Intervention

number





Interview with the Planner for Chingola Health Management Office, December 2012. 2

3

4

5


228

D11: COMMENTS


1

2

3

4

5





229

SECTION 6: QUESTIONS ABOUT PARTICIPATION IN BUDGETING FOR CHILD NUTRITION


General


















230





your response.


that intervention.





Which box(es) you complete will depend on the interventions you are researching and at which levels the scope for participation is located:

Complete the answer box for the national level in relation to all the interventions where scope for participation is located at national level.

Complete the answer box for the sub-national level in relation to all the interventions where scope for participation is more appropriately

located at sub-national level.

For interventions where participation does or could take place at national and sub-national levels, complete both boxes.


231

E. PUBLIC AND CHILDREN’S PARTICIPATION IN BUDGETING DECISIONS AROUND CHILD NUTRITION

E1. In developing its expenditure plans, did the government consult with the public about priorities to focus on in the

design and implementation of interventions for child nutrition?




a) In developing its expenditure plans, the government consulted extensively with the public about which priorities to

focus on in the design and implementation of the intervention for child nutrition.

b) In developing its expenditure plans, the government consulted to a fair extent with the public about which priorities to


c) In developing its expenditure plans, the government consulted to a negligible extent with the public about which

priorities to focus on in the design and implementation of the intervention for child nutrition.

d) In developing its expenditure plans, the government didn’t consult with the public about which priorities to focus on in

the design and implementation of the intervention for child nutrition.



232

E1: ANSWER BOX FOR THE NATIONAL LEVEL




b b b b b


The government consulted the public and CSO to make submission towards the SNDP (Sixth National Plan) and the CSO came up with an alternative national plan which was incorporated in the government documents – see www.cspr.org.zm.




I would like to change my rating to ”b” for all five interventions based on evidence provided by Peer Reviewer 1.


http://www.cspr.org.zm/


233

E1: ANSWER BOX FOR THE SUB-NATIONAL LEVEL

Sub-national unit


Lusaka District








Nakonde District








Chingola District






234

Sub-national unit





E1: SOURCE REFERENCES

Intervention

number




1 Interview with the nutrition expert






235

E1: COMMENTS


1

2

3

4

5



Interview with the nutrition expert at district level revealed that the government hold consultations with child health volunteers and other community partners such as the local councils. It is this select group which helps them decide on the focus areas .

Other comments on Question E1:


236

E2. In developing its expenditure plans, did the government consult with children about priorities to focus on in the design

and implementation of interventions for child nutrition?




a) In developing its expenditure plans, the government consulted extensively with children about which priorities to focus

on in the design and implementation of the intervention for child nutrition.

b) In developing its expenditure plans, the government consulted to a fair extent with children about which priorities to


c) In developing its expenditure plans, the government consulted to a negligible extent with children about which


d) In developing its expenditure plans, the government didn’t consult with children about which priorities to focus on in

the design and implementation of the intervention for child nutrition.



237











238


Sub-national unit


Lusaka District








Nakonde District








Chingola District






239

Sub-national unit






Intervention

number










240

E2: COMMENTS


1

2

3

4

5



The nutrition expert at district level said that they do not directly consult their client (either children or their mothers) but they depend on the advice from the volunteers and other community partners such as the local councils, who live close to these children and are well placed to know the needs of the children.



241

E3. In developing its expenditure plans, did the government consult with vulnerable children about priorities to focus on in

the design and implementation of interventions for child nutrition?




a) In developing its expenditure plans, the government consulted extensively with vulnerable children about which


b) In developing its expenditure plans, the government consulted to a fair extent with vulnerable children about which


c) In developing its expenditure plans, the government consulted to a negligible extent with vulnerable children about

which priorities to focus on in the design and implementation of the intervention for child nutrition.

d) In developing its expenditure plans, the government didn’t consult with vulnerable children about which priorities to




242











243


Sub-national unit


Lusaka District








Nakonde District








Chingola District






244

Sub-national unit






Intervention

number










245

E3: COMMENTS


1

2

3

4

5






246

E4. In developing its expenditure plans, did the government consult with primary caregivers of vulnerable children about

priorities to focus on in the design and implementation of child nutrition interventions?




a) In developing its expenditure plans, the government consulted extensively with care givers of vulnerable children about

which priorities to focus on in the design and implementation of the child nutrition intervention.

b) In developing its expenditure plans, the government consulted to a fair extent with care givers of vulnerable children

about which priorities to focus on in the design and implementation of the child nutrition intervention.

c) In developing its expenditure plans, the government consulted to a negligible extent with care givers of vulnerable

children about which priorities to focus on in the design and implementation of the child nutrition intervention.

d) In developing its expenditure plans, the government didn’t consult with care givers of vulnerable children about which

priorities to focus on in the design and implementation of the child nutrition intervention.



247





c c c c c


The government consulted the public and CSO to make submission towards the SNDP (Sixth National Plan) – they invited people to make submission on priority issues – the outcome is the alternative CSO SNDP which is highly incorporated in the national SNDP.




I would like to change my rating to ”c” for all five interventions based on evidence provided by Peer Reviewer 1.

AT4HR comment The comment from the Peer Reviewer makes no reference to consultations with caregivers of vulnerable children. Therefore the score of “d” is more appropriate.



248


Sub-national unit


Lusaka District







AT4HR comment Based on the comment made by the researcher in the comment box that follows, no consultations were held directly with primary caregivers of vulnerable children. Therefore a score of “d” is more appropriate.


Nakonde District










249

Sub-national unit


Chingola District










Intervention

number










250

E4: COMMENTS


1

2

3

4

5






251

E5. Has the government created accessible mechanisms to gather the public’s perspectives on the implementation of child





a) The government has established mechanisms to gather the public’s perspectives on the implementation of the child

nutrition intervention, and these mechanisms are accessible in practice to the majority of the public.

b) The government has established mechanisms to gather the public’s perspectives on the implementation of the child

nutrition intervention, but these mechanisms are accessible in practice only to some but not the majority of the public.

c) The government has established mechanisms to gather the public’s perspectives on the implementation of the child

nutrition intervention, but these mechanisms are not effective or practical or are not accessible in practice to a majority

of the public.

d) The government has not established any mechanisms to gather the public’s perspectives on the implementation of




252





c c c c c


There are Sector Advisory groups that can be used to information, also there is the provincial development coordinating committees and district development coordinating committees , etc that's can be used.




I would like to change my rating to ”c” for all five interventions based on evidence provided by Peer Reviewer 1.



253


Sub-national unit


Lusaka District








Nakonde District








Chingola District






254

Sub-national unit






Intervention

number










255

E5: COMMENTS


1

2

3

4

5



The nutrition expert at district level said that even when it comes to implementation, they do not directly engage with the public but instead depend on the advice from the volunteers and other community partners such as the local councils, who live close to the children.



256

E6. Does the government provide detailed feedback to the public on how its budget inputs have been used to deliver child


(Please note, such feedback could be through the media, including radio, newspapers, television, bulletin boards, or through public meetings

and other events)




a) The government provides extensive and detailed feedback to the public on how its budget inputs have been used to

deliver the child nutrition intervention.

b) The government provides a fair amount of feedback to the public on how its budget inputs have been used to deliver

the child nutrition intervention, but some details are not communicated.

c) The government provides very little feedback to the public on how its budget inputs have been used to deliver the child

nutrition intervention and important details are not communicated.

d) The government provides no feedback to the public on how its budget inputs have been used to deliver the child


e) Not applicable / Other (please comment)


257











258


Sub-national unit


Lusaka District



Peer reviewer 1: Comment There are no such mechanism to give feedback – even at national level there are no existence.




I disagree with Peer Reviewer 1. There is mechanism to give feedback to certain groups of the community e.g. volunteers and other partners.


Nakonde District









Chingola District






259

Sub-national unit







Intervention

number










260

E6: COMMENTS


1

2

3

4

5



Feedback is given to the volunteers and the community partners but not directly to the public.



261

E7. Between 2007 and 2012, has the government produced any summaries of its budget documents in a format that is

designed for children?

Consider the question above in relation to each level of government selected for this study and identify an answer from the list below that most

accurately reflects your findings for each level. Write down the corresponding letter (for example “c”) in the boxes below. You may have different

answers for the different levels of government. For further guidelines, see the pointers at the beginning of this section.

a) Between 2007 and 2012, the government produced at least one summary of its budget documents in a format

designed for children, which provided a very user-friendly overview of information.

b) Between 2007 and 2012, the government produced at least one summary of its budget documents in a format

designed for children, but it excluded some information.

c) Between 2007 and 2012, the government produced at least one summary of its budget documents in a format

designed for children, but it excluded a great deal of information.

d) Between 2007 and 2012, the government did not produce any summaries of its budget documents in a format

designed for children.



262


Intervention Score/comment

Researcher’s initial score d






AT4HR final score d


263


Sub-national unit

Scores

Lusaka District







AT4HR final score d

Nakonde District







AT4HR final score d

Chingola District






264

Sub-national unit

Scores



AT4HR final score d


State the source(s) that informed the selection of your answers. Please provide the relevant internet links, document names and

interview references. Be as specific as possible, by for example giving page or section numbers in documents, quotes from interviews, as

well as the date and full names of interviewees.

Interview with the nutrition expert

E7: COMMENTS

Intervention # Comments regarding the interpretation of this question in relation to specific child nutrition interventions

1

2

3

4


265

5


The informant said that there has not been any budget document designed for children.




266

E8. Between 2007 and 2012, has the government produced any summaries of its budget documents focusing on

interventions that directly and/or indirectly target children?




a) Between 2007 and 2012, the government produced at least one summary of its budget documents focussing on

interventions that directly and/or indirectly target children, which provided an extensive overview.

b) Between 2007 and 2012, the government produced at least one summary of its budget documents focussing on

interventions that directly and/or indirectly target children, but it excluded some details.

c) Between 2007 and 2012, the government produced at least one summary of its budget documents focussing on

interventions that directly and/or indirectly target children, but it excluded important details.

d) Between 2007 and 2012, the government did not produce any summaries of its budget documents focussing on

interventions that directly and/or indirectly target children.



267









AT4HR final score d


268


Sub-national unit

Scores

Lusaka District







AT4HR final score d

Nakonde District







AT4HR final score d

Chingola District






269

Sub-national unit

Scores



AT4HR final score d





Interview with the nutrition expert

E8: COMMENTS

Intervention # Comments regarding the interpretation of this question in relation to specific child nutrition interventions

1

2

3

4


270

5







271

E9. Do the laws of this country allow children to access budget information?

Consider the question above and identify one answer from the list below that most accurately reflects your findings. Write down the corresponding

letter (for example “c”) in the answer box below. For further guidelines on the interpretation of terms, see the pointers at the beginning of this

section.

a) The laws of this country allow children to access budget information without restriction.

b) The laws of this country allow children to access budget information, but there are some restrictions.

c) The laws of this country allow children to access budget information, but there are extensive restrictions.

d) The laws of this country do not allow children to access budget information.



272



Researcher’s initial score a


b


There is no freedom of information Act in place and the public and children do not have endless rights to access budget documents – for instance the current draft planning and budget Act is still be considered a secret document by document.




I disagree with the reviewer's rating for E9. In the light of discussions at our last workshop in Pretoria and subsequently with the AT4HR, I would like to change my score to “c”. While laws do not restrict access to information, there is currently no Freedom of Information Act or other law in place which explicitly guarantees citizens (including children’s) right of access to government information.

AT4HR final score c


273


State the source(s) that informed the selection of your answer. Please provide the relevant internet links, document names and interview

references. Be as specific as possible, by for example giving page or section numbers in documents, quotes from interviews, as well as the date

and full names of interviewees.

E9: COMMENTS

Any comments on Question E9:


274

E10. Are there mechanisms in place for government to engage with children during the budget process?




a) There are mechanisms in place for government to engage with children during the budget process, and these

mechanisms are accessible in practice to the majority of children.

b) There are mechanisms in place for government to engage with children during the budget process, but these

mechanisms are accessible in practice only to some but not the majority of children..

c) There are mechanisms in place for government to engage with children during the budget process, but these

mechanisms are not effective or practical or are not accessible in practice to a majority of children.

d) There are no mechanisms in place for government to engage with children during the budget process.



275









AT4HR final score d


276


Sub-national unit

Scores

Lusaka District







AT4HR final score d

Nakonde District







AT4HR final score d

Chingola District






277

Sub-national unit

Scores



AT4HR final score d






278

E10: COMMENTS

Any comments on Question E10:


279

E11. Has the government created accessible mechanisms to gather children’s perspectives on the implementation of child




You may have different answers for the different interventions and levels of government. For further guidelines, see the pointers at the beginning of

this section.

a) The government has established mechanisms to gather children’s perspectives on the implementation of the child

nutrition intervention, and these mechanisms are accessible in practice to the majority of children.

b) The government has established mechanisms to gather children’s perspectives on the implementation of the child

nutrition intervention, but these mechanisms are accessible in practice only to some but not the majority of children.

c) The government has established inaccessible mechanisms to gather children’s perspectives on the implementation of

the child nutrition intervention, but these mechanisms are not effective or practical or are not accessible in practice to

a majority of children.

d) The government has not established any mechanisms to gather children’s perspectives on the implementation of the




280











281


Sub-national unit


Lusaka District








Nakonde District








Chingola District






282

Sub-national unit






Intervention number




1

2

3

4

5


283

E11: COMMENTS


1

2

3

4

5





284

END OF THE QUESTIONNAIRE