Public resources are needed to finance nutrition interventions. Therefore, how well these resources are managed matters to how effective governments can be in addressing malnutrition. However, public financial management (PFM) systems are often not set up to serve the multi-sectoral needs that are required for an effective nutrition response. This guide identifies what makes a PFM system responsive to nutrition needs, and what actions can be taken to develop a reform program in a capacity constrained context. Following this guide will allow stakeholders to map priority interventions from strategic plans into the government budget, identify what interventions were approved in the budget, map out when budgets were released for these interventions and monitor spending and implementation. Together this creates the necessary foundation for matching spending data with outcome information to allow for evidence-based course correction. A nutrition responsive PFM reform leverages existing country systems at the margins to foster stewardship, oversight, and coordination, to strengthen the allocation and use of limited resources. At the same time this guide is designed to minimize disruptions to other ongoing reform efforts and avoid duplicating processes, or onerous data collection and reporting requirements.