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Public Expenditure Review for Nutrition in Jharkhand Is Presented in This Section with Reference to Three of the Four Key Objectives of the Project

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Public Expenditure Review for Nutrition in Jharkhand Is Presented in This Section with Reference to Three of the Four Key Objectives of the Project TIPPUBLICPING THEXPENDITUREE BALANC E REVIEW FOR NUTRITION IN JHARKHAND This document is for private circulation and is not a priced publication. Reproduction of this publication for educational and other noncommercial purposes without prior written permission is authorised, provided the source is fully acknowledged. Copyright @2020 Centre for Budget and Governance Accountability (CBGA) and Save the Children Project Conceptualisation and Editing Asadullah (CBGA), Dr. Antaryami Dash (Save the Children), Pranab Kumar Chanda (Save the Children), Subrat Das (CBGA) Authors: Rahat Tasneem (CBGA), Mampi Bose (CBGA) Research Inputs Ajay Pal Singh, Happy Pant, Nilachala Acharya, Shruti Ambast, Shweta Tiwary (CBGA), Dr. Atefh Ali, Dr. Sharmistha Das, Sonal Rai, Soumi Halder (Save the Children) For more information about the study, please contact: [email protected] Cover Photo Credit David Lofman Designed by Common Sans, 1729, Sector 31, Gurgaon, Haryana Published by Centre for Budget and Governance Accountability (CBGA) B-7 Extn./110A (Ground Floor), Harsukh Marg, Safdarjung Enclave, New Delhi-110029 Phone: +91-11-49200400/ 401/ 402 Email: [email protected] Website: www.cbgaindia.org AND Save the Children Bal Raksha Bharat, 1st & 2nd Floor, Plot No. 91, Sector - 44 Gurgaon (Haryana) - 122003, India Phone: +91 124 4752000, 4752100 Views expressed in this report are those of the author and do not necessarily represent the positions of CBGA and Save the Children. Contents List of Tables 02 List of Figures 03 Abbreviations 04 Executive Summary 08 1 Prevalence and Drivers of Undernutrition 11 1.1 Introduction 12 1.2 Socio-Demographic and Economic Landscape of Jharkhand 13 1.3 Rationale and Objectives of the Study 14 1.4 Conceptual Framework and Methodology 15 1.5 Nutritional Outcomes and Gaps in Jharkhand 17 1.6 Interventions and Trends Therein 23 1.7 Drivers of Undernutrition in Jharkhand 25 2 Mapping of Nutrition Intervention and their Delivery Platforms 30 2.1 Nutrition Strategy and Interventions in Jharkhand 31 2.2 Direct Nutrition Interventions 31 2.3 Nutrition Sensitive Interventions 37 3 Budgets for Nutrition 47 3.1 Budgets for Nodal Departments 48 3.2 Budgets for Important CSSs 48 3.3 Expenditure on Direct Nutrition Intervention (DNI) 49 3.4 Budget for Nutrition Sensitive Interventions (NSI) 56 3.5 Adequacy for Budget Outlays 59 4 Fund Utilisation under Direct Nutrition Interventions 63 4.1 Fund Utilisation of Specific DNI Components in Jharkhand 64 4.2 Expenditure on WCD and Health through Treasury in West Singhbhum, Jharkhand 66 4.3 Utilisation of Select DNI Components in West Singhbhum District, Jharkhand 68 4.4 Factor Constraining Utilisation of Funds in West Singhbhum, Jharkhand 69 5 Conclusion and Way Forward 71 Appendix 76 Reference 77 List of Tables Table 1.1: Prevalence of Indicators of Undernutrition in Jharkhand and India 17 Table 1.2: Gaps Between Projected Prevalence of Undernutrition Indicators 19 Against National and Global Targets Table 1.3: Annual Rate of Reduction and Required Rate of Reduction as per 20 as National and Global Targets for Jharkhand and India Table 1.4: Five Districts With High and Low Prevalence of Undernutrition Indicators 22 Table 1.5: Coverage by Direct Interventions in Jharkhand and India (in %) 24 Table 1.6: Children's Anthropometrics as per as Mother's BMI (in %) 26 Table 1.7: Women's BMI as per as Social Category (in %) 26 Table 1.8: Prevalence of Underlying Indicators in Jharkhand and India 27 Table 1.9: Children's Anthropometric as per as Mothers' Schooling (in %) 28 Table 2.1: Mapping of DNIs and Their Delivery Platforms Under CSSs 32 Table 2.2: Mapping of NSIs Under Their Respective Sectors and Departments 38 Table 3.1: Total DNI Budget for Jharkhand (in Rs. Crore) 53 Table 3.2: Rank of DNI Categories on the Basis of Average Expenditure 55 During 14th FC (2015-16 to 2019-20) (in Rs. Crore) Table 3.3: NSI Budget for Jharkhand (in Rs. Crore) 58 Table 4.1: Shortfall in ICDS Workers Across Blocks in West Singhbhum in 2018-19 70 Table A.1: District Wise Variation in Nutrition Interventions 76 02 List of Figures Figure 1.1: Prevalence of Micronutrient Deficiency in Children aged 1-4 years (in %) 25 Figure 1.2: Women's Weekly Intake of Iron and Folate Rich Food (in %) 26 Figure 3.1: Budget of WCD and Health as Compared to Total State Budget 48 During 14th FC and First Year of 15th FC (in Rs. Crore) Figure 3.2: ICDS and NHM Budget During 14th FC and First Year of 15th FC (in Rs. Crore) 49 Figure 3.3: Growth Over the Previous Year: Outlays for DNIs and Total State Budget (in %) 50 Figure 3.4: Extent of Growth in WCD and Health Budget Across States 51 During 14th FC Period (in %) Figure 3.5: Priority for Nutrition in 2017-18 (A) Across States (Share in %, Budget in Rs. Crore) 51 Figure 3.6: Share of NHM and ICDS Components in Total DNI Budget (in %) 55 Figure 3.7: Expenditure on Different NSIs Across Sectors (in Rs. Crore) 56 Figure 3.8: Resource Gap in the Budget Allocation for SNP-ICDS (in Rs. Crore) 60 Figure 3.9: Resource Requirement for Universalisation of SNP-ICDS in Jharkhand 61 During 2017-18 and 2018-19 (in Rs. Crore) Figure 3.10: Resource Requirement for Some of the DNIs Delivered Through NHM 62 in 2018-19, Jharkhand Figure 4.1: Utilisation of Funds Under SNP-ICDS in Jharkhand From 64 2015-16 to 2018-19 (in Rs. Crore) Figure 4.2: Utilisation of Funds Under SAG (Nutrition) in Jharkhand From 64 2015-16 to 2018-19 (in Rs. Crore) Figure 4.3: Utilisation of Funds Under PMMVY in Jharkhand From 65 2015-16 to 2018-19 (in Rs. Crore) Figure 4.4: Utilisation of Funds Under JSY and IFA for Children in Jharkhand 65 in 2016-17 (in Rs. Crore) Figure 4.5: Expenditure on WCD and Health Through Treasury, West Singhbhum 66 District, Jharkhand (in Rs. Crore) Figure 4.6: Uneven Distribution of Expenditure on WCD Across Quarters in 67 West Singhbhum, Jharkhand Figure 4.7: Uneven Distribution of Expenditure on Health Across Quarters 67 in West Singhbhum, Jharkhand Figure 4.8: Utilisation of Funds Under ICDS in West Singhbhum, Jharkhand 68 From 2016-17 to 2018-19 (in %) Figure 4.9: Utilisation of Funds for SNP-ICDS in West Singhbhum, Jharkhand 68 From 2016-17 to 2018-19 (in %) Figure 4.10: Utilisation of Funds for SAG & PMMVY in West Singhbhum, Jharkhand 69 During 2017-18 and 2018-19 (in %) 03 Abbreviations AB-PMJAY Ayushman Bharat-Pradhan Mantri Jan Aarogya Yojana AJJPY Adim Jan Jati Pension Yojana AMRUT Atal Mission for Rejuvenation & Urban Transformation ANC Ante-natal Care ANM Auxiliary Nurse Midwife ARR Annual Rate of Reduction ASHA Accredited Social Health Activist AWC Anganwadi Centre AWW Anganwadi Workers AY Annapurna Yojana AYUSH Ayurvedic, Yoga and Naturopathy, Unani, Siddha and Homeopathy AAY Antyodaya Anna Yojana BCC Behavior Change Communication BMI Body Mass Index CAF&PD Consumer Affairs, Food & Public Distribution CBGA Centre for Budget and Governance Accountability CDPO Child Development Project Officer CFQC&TI Central Fertilizer Quality Control and Training Institute CMAM Community Management of Acute Malnutrition CMTC Community Managed Training Center CNNS Comprehensive National Nutrition Survey CSO Civil Society Organization CSS Centrally Sponsored Scheme DAY Deendayal Antayodaya Yojana DBT Direct Bank Transfer DDG Detail Demands for Grants DNI Direct Nutrition Interventions DPR Detail Project Report DW&S Drinking Water & Sanitation EBB Educationally Backward Block EmOC Emergency Obstetric Care FCI Food Corporation of India FPS Fair Price Shop FMR Fianancial Management Report FY Financial Year 04 GoJ Government of Jharkhand HBNC Home Based Newborn Care HBYC Home Based Young Care HCM Hot Cooked Meal HH Household HSS Health Systems Strengthening HVA High Value Agriculture ICDS Integrated Child Development Services IEC Information Education and Communication IFA Iron Folic Acid IFAD International Fund for Agricultural Development IFPRI International Food Policy Research Institute IGNDPS Indira Gandhi National Disability Pension Scheme IGNOAPS Indira Gandhi National Old Age Pension Scheme IGNWPS Indira Gandhi National Widow Pension Scheme IMNCI Integrated Management of Newborn and Childhood Illness ITN Insecticide Treated Nets IUCD Intrauterine Contraceptive Device IYCF Infant and Young Child Feeding JHIMDI Jharkhand Horticulture Intensification by Micro Drip Irrigation JSNM Jharkhand State Nutrition Mission JOHAR Jharkhand Opportunities for Harnessing Rural Growth JSLPS Jharkhand State Livelihood Promotion Society JSSK Janani Shishu Suraksha Karyakaram JSY Janani Suraksha Yojana JTELP Jharkhand Tribal Empowerment & Livelihoods Project KGBV Kasturba Gandhi Balika Vidyalaya LLIN Long Lasting Impregnated Bednets LPCD Litres per Capita per Day MAA Mother's Absolute Affection MDM Mid-Day Meal MGNREGS Mahatma Gandhi National Rural Employment Guarantee Scheme MIDH Mission for Integrated Development of Horticulture MO Medical Officer MoH&FW Ministry of Health and Family Welfare MoRD Ministry of Rural Development MOVCDNER Mission Organic Value Chain Development in North Eastern Region MoWCD Ministry of Women and Child Development 05 MPI Multidimensional Poverty Index MSF Medecins Sans Frontieres NBA Nirmal Bharat Abhiyan NCD Non-Communicable Disease NCOF National Centre of Organic Farming NFBS National Family Benefit Scheme NFDB National Fisheries Development Board NFHS National Family Health Survey NFSM National Food Security Mission NGCP National Goiter Control Programme NHM National Health Mission NIPI National Iron Plus Initiative NLUM National Urban Livelihood Mission NMOOP National Mission on Oilseeds
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