Multidimensional Poverty Index - Choquecancha Report by Nexos Comunitarios

This study was conducted and written by Yusra Uzair of Nexos Comunitarios Nexos Comunitarios 2016 Urubamba – Cusco. Electronic Version. Peru.

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Contents Acknowledgements................................................................................................................................................ 4 List of Abbreviations............................................................................................................................................. 5 Nexos Comunitarios............................................................................................................................................... 6 Figure 1: NC's development model........................................................................................................ 6 Introduction.............................................................................................................................................................. 8 Methodology.......................................................................................................................................................... 10 Choquecancha....................................................................................................................................................... 12 Figure 2: Map of the District of Lares................................................................................................. 13 Multidimensional Poverty Index (MPI)....................................................................................................... 15 How to measure and analyse the data?.................................................................................................. 15 Figure 3: Ten Indicators of MPI............................................................................................................. 15 Figure 4: The dimensions, indicators, deprivation thresholds and weights of the Global MPI................................................................................................................................................................... 16 Formulating questions for the survey..................................................................................................... 17 Health................................................................................................................................................................... 17 Figure 5: Ten Indicators for MPI for Choquecancha.....................................................................18 Education............................................................................................................................................................ 18 Standard of Living........................................................................................................................................... 19 Figure 6: The dimensions, indicators, deprivation thresholds and weights of the Choquecancha MPI..................................................................................................................................... 20 Analysis of the Results....................................................................................................................................... 22 Health................................................................................................................................................................... 22 Nutrition......................................................................................................................................................... 22 Nexos Comunitarios ÂŠ 2016

Access to Health Services........................................................................................................................ 23 Education............................................................................................................................................................ 23 Years of Schooling...................................................................................................................................... 23 Spanish Literacy.......................................................................................................................................... 23 Standard of Living........................................................................................................................................... 24 Cooking Fuel................................................................................................................................................. 24 Floor................................................................................................................................................................. 24 Water............................................................................................................................................................... 24 Electricity....................................................................................................................................................... 25 Sanitation....................................................................................................................................................... 25 Assets.............................................................................................................................................................. 25 Conclusions............................................................................................................................................................. 26 Annex........................................................................................................................................................................ 28 The Survey Questions............................................................................................................................... 28 MPI Choquecancha Calculations........................................................................................................... 29 Bibliography........................................................................................................................................................... 30

Acknowledgements This empirical analysis could not have been possible without the active participation and generosity of the community of Choquecancha. We thank them for their time and willingness to partake in the research; their survey responses enable us to gain a deeper understanding of the complexities of multidimensional poverty faced by microcosms in the Andes. It is our hope that through collaborative efforts, we will be able to improve the quality of life in the rural communities of Peru. The immeasurable support and assistance of the health centre in Choquecancha is much appreciated, especially the hard work of Javier Espetia-Charaja, chief nurse, who opened up the doors and allowed us a space to work from, and staff who acted as translators and coordinators for organizing the participants for blood tests and surveys. Thank you for all your help in building stronger communities with brighter futures. The contribution of Nexos Comunitarios interns and staff played a vital role from the beginning of the Healthy Meals Program project and in the process of field research. Nexos Comunitarios extends our sincerest thanks for your effort and energetic commitment.

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List of Abbreviations HMP

Healthy Meals Program

INEI

Instituto Nacional de Estadíística e Informaí tica

MDGs

Millennium Development Goals

MIDIS

Ministerio de Desarrollo e Inclusioí n Social

MPI

Multidimensional Poverty Index

OPHI

Oxford Poverty and Human Development Initiative

SDGs

Sustainable Development Goals

UNDP

United Nations Development Programme

Nexos Comunitarios Nexos Comunitarios (NC) is a Peruvian non-profit organization. Founded in 2014, NC continues the work started by Nexos Voluntarios. NC works closely with rural communities in the Microcosms of the Andes, with the goal of facilitating Responsible Human Development. Nexos Comunitarios works alongside communities and helps them in building Human (health and education) and Social Capital (institutions, relations, and more) in search of long-term sustainable solutions. NC’s development model is the basis of all its programs. The model establishes a linear prioritization of factors: the necessity for sound health strengthening human capital, resulting in expanded educational capacity and ability, which increases economic opportunities of a community. These three facets of development are intrinsic to NC’s mission of supporting Responsible Human Development. Figure 1: NC's development model

As illustrated in Figure 1, interculturality and human rights are integral to NC’s vision for sustainable development; however, these factors are only advantageous to a community after the acquisition of the basic necessities for life. At each phase of development, appropriate intellectual exchanges occur with communities, building trust and partnership. In order to initiate dialogue concerning interculturality and human rights, respect and compassion1 need to encompass the discussion. These are the principles that motivate NC’s approach. Cultural awareness of the different customs and norms practised and valued by the Andean microcosms realizes NC’s efforts of promoting sustainable development.

1 NC understands compassion as: " Within languages that do not form the word ‘compassion’ from the root of the affliction, but the substantive sense, these words are used approximately in the same way, however it is impossible to confirm what is a secondary bad feeling. The secret power of its etymology illuminates the word with another light and gives a broader meaning: to have compassion means knowing not only to be able to live with other's misfortune but also to feel with him any emotion: joy, anxiety, happiness, pain" explained by Milan Kundera.

Introduction In 2000 at the Millennium Summit of the United Nations, eight Millennium Development Goals (MDGs) were established through a collective commitment from member states and international organizations to improve the living conditions for the global poor. The MDGs outline specific targets pertaining to health, education, and human rights that were to be achieved by 2015.While countries have experienced varied success in accomplishing these goals, the MDGs have been a milestone for development; widespread support from the global community in implementing measureable goals for improving the standard of living of all humans. In continued efforts of development post-2015, the Sustainable Development Goals (SDGs) were adopted by the United Nations to continue the work and vision of the MDGs. On September 26, 2015, seventeen goals were formalized at the United Nations General Assembly, which included the issues prioritized by the MDGs such as water and sanitation, primary education and ending poverty but also addressed climate change, industrialization, biodiversity, and peace and security.2 The updated goals demonstrate the developmental advances made in the last fifteen years and more importantly exemplify the broadened perspective on development. As expressed in Resolution A/70, the goals outlined go beyond ending poverty and hunger, but tackle the fabric of unequal societies and address the challenges of building peaceful, inclusive communities. Moreover, the SDGs recognize the interconnectedness of the goals and how efforts towards each goal will have rippled impact on greater development. In order to measure the progress for each goal, quantitative indicators are used to demonstrate the success of each goal. There are various development indicators and methodologies used dependent on institutional capacity for gathering data and the purpose of research and analysis. Subsequently, poverty can be measured and calculated in absolute 2 United Nations General Assembly 70/1. (25 September 2015). Transforming Our World: The 2030 Agenda for Sustainable Development A/RES/70/1. Retrieved January 1, 2016, from http://www.un.org/ga/search/view_doc.asp?symbol=A/RES/70/1&Lang=E

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and relative terms. The absolute and relative methodologies illustrate two different realities of poverty. For instance, the World Bank defines poverty in absolute terms, where a population is considered living in extreme poverty if they are surviving on less than US$1.25 per day.3 Poverty in absolute terms allows for comparisons across countries and is a set-standard of the minimum amount one needs to survive. 4 Comparatively, poverty in relative terms considers the region of the population and the living cost of the environment.5 Both are monetary-based measures that are useful for indicating widespread poverty trends and gathering data for cross tabulation analysis over long time periods. However, monetary assessments alone fail to capture the full reality of the poor. The World Bank classifies Peru as an upper middle income country with a Gross National Income (GNI) per capita of US$6, 360 with 22.7% of the population living below the National Poverty Line.6 The percentage of population considered to be impoverished only reflects an income deprivation, but does not illustrate the context of poverty, the access and availability of services, and people’s well-being. Thus, it is essential to incorporate poverty indicators that are reflective of the intricate nature of poverty that extends beyond measuring income flow in order to achieve MDGs and SDGs for sustainable development. Nexos Comunitarios’ (NC) work in the Andes region is aimed at supporting rural communities living in poverty and social inclusion. It has become apparent through NC’s work in the microcosms of the Andes that poverty is experienced by the communities in complex terms. In order for NC to continue to implement informed projects in the Andes, it is crucial to accompany such efforts with monitoring and evaluation methodologies that accurately reflect the disparity of the communities that are often misrepresented in national and even sub-regional statistics and data. Unfortunately, NC has learned over the 3 The World Bank. (2010, June 6). Extreme Poverty Rates Continue To Fall. Retrieved January 1, 2016, from

http://data.worldbank.org/news/extreme-poverty-rates-continue-to-fall 4 The Poverty Site. (n.d.). Relative Poverty, Absolute Poverty and Social Exclusion. Retrieved January 1, 2016, from http://www.poverty.org.uk/summary/social exclusion.shtml 5 Ibid. 6 The World Bank. (n.d.). Peru Data. Retrieved January 1, 2016, from http://data.worldbank.org/country/peru

past three years working in the Lares Valley in the communities of Cuncani and Choquecancha, that available data and research is rare and district-level statistics are not indicative of the living circumstances and conditions of the microcosms. In order for NC to design and implement effective programs in the Andes region, it is imperative that accurate information be available about the communities that illustrate that poverty goes beyond income deprivation, but standard of living, health, and education are impacted by additional factors which will be discussed in this report. NCâ&#x20AC;&#x2122;s goals for development are complementary to the MDGs and the SDGs; building inclusive, safe, and prospering communities. The aim of this report is to introduce the implementation of the Multidimensional Poverty Index (MPI) as a monitoring and evaluation tool for the organization to explore and obtain firsthand data on the reality of Andean microcosms. The MPI complements existing income-based poverty measures as it aims to capture the intensity and prevalence of deprivations experienced by a population. It considers deprivations across health, education, and standard of living, which corresponds well with NCâ&#x20AC;&#x2122;s developmental model. The report begins with a brief explanation of the research methodology used for this study. This is followed by a community overview of Choquecancha that provides insight into the social context characteristics of the community in the Andes. Next, the report presents the Multidimensional Poverty Index and its functions and application. Furthermore, the document analyzes the findings from the surveys administered in Choquecancha, focusing on deprivations experienced in health, education, and standard of living that are examined through the MPI lens. The report concludes by reviewing the insight gained from MPI in Choquecancha, further addressing the complexities and challenges of development in the Andes of Peru and the complexity of poverty.

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Methodology As the MPI is adaptable to community-specific contextualization, Nexos Comunitarios implements it as a useful tool in monitoring and evaluating the impact of the organizationâ&#x20AC;&#x2122;s efforts in the Andean communities and for further understanding and informed decision-making processes in creating initiatives to promote Responsible Human Development. As NC is a growing organization, current resources are limited for conducting extensive and in-depth research; however the use of the MPI enables NC to introduce the analytical tool as an Exploration Initiative 7. This report is a second product of the Exploration Initiative launched by NC with aims to build research capacity of the organization, to evaluate all its efforts and demonstrate accountability of its work. NC acknowledges the importance of this process for successful, sustainable change. This study follows the methodology as further explained. The data for the purpose of this study was predominately collected through surveys conducted exclusively with participants of the Healthy Meals Program (HMP) ran by NC in the community of Choquecancha. The Healthy Meals Program promotes early childhood development, working alongside pregnant women and children under the age of two to raise awareness of nutrition and healthy cognitive development. NC chose to use only the participants on the HMP in Choquecancha as the sample population due to limited resources and as an initial application of MPI for the organization to familiarize itself with the functionality of the poverty measurement tool. The survey consisted of short questions pertaining to health, education, and standard of living in order to gain quantitative data of the community. The surveys required 5-15 minutes per participant to gather information about their households ranging from schooling, literacy, access to health services, safe drinking water, sanitation facilities, and 7 Uzair, Y. (2016, February 2). The Future of Cuncani: The Importance of Human Rights and Interculturality. Retrieved February 2, 2016, from Nexos Comunitarios website: https://issuu.com/nexoscomunitarios/docs/_published_the_future_of_cuncani_-_/1

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assets in order to better understand the various ways in which deprivations are experienced by the community. To measure the health component of the MPI, blood tests were also administered by Javier Espetia-Charaja, the chief nurse and head of the health centre as well as NCâ&#x20AC;&#x2122;s primary contact in the community. Espetia-Charaja was instrumental in organizing and coordinating the participants for surveys and acted as the liaison between the community and NC in the early stages of the Healthy Meals Program through which a relation formed, making the MPI research possible. In order to ensure our research was done in a sensitive, responsible, and respectable manner, efforts to engage with the community through attendance at community councils, meeting the community president and other citizens was of utmost importance. Majority of the surveys were conducted at the health centre, expect for a few where house visits were necessary; The HMP participants are mothers and pregnant women and if responsibilities or physical inability hindered the women from getting to the health centre, NC staff was accompanied by a health centre staff member in visiting the participants. The surveys and blood tests were conducted in Choquecancha between October 12 and October 26, 2015 where NC visited the community on a weekly basis to complete both elements of the MPI. As Mondays were market days, many citizens were present in the community centre, thus making it the optimal day to complete research. In total all 22 participants of the HMP completed the surveys and blood tests. The surveys were completed with the help of a translator. While an official translator was not hired by NC, a health centre staff member would be present and aid in the survey process as many participants only speak Quechua.8 The responses were reflective at the household level, where participants spoke on the behalf of their children and other family members. While appropriate measures were observed in the administration of the surveys, there were certain limitations within the methodology that necessitate further 8 Quechua is an indigenous language spoken primarily in the Andes region in South America, with strong association to the Inca Empire, although the language predates the civilization.

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consideration. To fully comprehend the results of the field research, it is crucial to account the setting and circumstances under which surveys were administered. Choquecancha is a rural agrarian community of indigenous population. The customs and cultural perceptions of the community are reflective of the societal makeup and the norms of its citizens. While efforts were made in forming relationship with the participants, it must be noted that that a strong level of trust between the participants and NC is a long-term goal as high Andean communities remain suspicious of outsiders due to a history of unfulfilled promises by organizations and governments. In order to make substantial, impactful progress towards Responsible Human Development, forming a trustful bond with the community is of high importance for NC. This is the reality of working in the microcosm of the Andes. Additionally, using Healthy Meals Program participants exclusively as the sample population for this report poses the most decisive limitation. The twenty three HMP participants are women, particularly of child-bearing age and the mothers of children under the age of two. This is a niche population in Choquecancha, therefore the responses and data gathered on level of education, health and standard of living of the participants is biased by their gender, role in the community, and lived experiences. While data of twenty three households is not substantive population sample to reflect the complete realities and deprivations of the whole Choquecancha community, NC believes that as an initial implementation of the MPI with our limited resources, it is beneficial to explore and expand our understanding of the multidimensional poverty in Andean communities to offset and contextualize regional and national statistics which fail to capture the true depiction of rural poor in Peru. The results expressed in this report must be considered with reservation; the analytical basis of this report is based on the participation of the community which from cultural awareness and NCâ&#x20AC;&#x2122;s experience working with the community of Cuncani dictates that all responses by participants may not have been wholesomely accurate. This may be a result of miscommunication, lack of trust, or simply personal bias and cultural norms where particular issues are not discussed in the public sphere. However, NC was proactive

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in addressing these limitations by facilitating a safe and open environment for the participants to respond to the survey questions and have translators who were familiar with the community. The circumstances and the complexity of data collection should be accounted for in reflection of the quality, accuracy, and depth of responses for the participants.

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Choquecancha Choquecancha is located in the District of Lares, which ranks 794 th most poor district out of 1,943 districts of Peru.9 Peru’s National Institute of Statistics and Information (INEI) released its latest poverty map (2013) based on data collected using a Basic Necessity Satisfaction (NBI) methodology accounting for living conditions, sanitation, education, and economic capacity. INEI also determines the monetary value required monthly per capita to meet basic consumption that varies by geographical region and urban or rural setting.10 The poverty line measures the percentage of population living below the required monthly monetary value per capita to meet basic needs. The Peruvian national poverty line for 2014 is 303 PEN, which is approximately 86 USD per month whereas the poverty line for rural, Andean communities is 225 PEN or 64 USD per month. 11 Lares’ projected population is 7 210 with an average of 49% poverty in the district indicating that half of the population is living off of less than 225 PEN per month. 12 This is 7.5 PEN per day, equivalent to 2.2 USD.13 These monetary figures introduce a disparity in the national and regional information, prompting a closer look at how poverty is experienced in small communities. As official statistics are not available on Choquecancha through governmental and authorized sources, the following information collected about the community of Choquecancha is based on NC’s multiple community visits on different occasions in 2015 to meet with health centre personnel, members of the community, and participation in three community assemblies. The following information about the community of Choquecancha is a result of the meetings between the community and NC. 9Instituto Nacional de Estadíística e Informaí tica. (n.d.). Mapa de Pobreza Provincial y Distrital 2013. Retrieved January 1, 2016, from https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1261/Libro.pdf 10Instituto Nacional de Estadíística e Informaí tica. (n.d.). EVOLUCIÓN DE LA POBREZA MONETARIA 2009-2014 Informe Technico (Rep.). Retrieved January 1, 2016, from https://www.inei.gob.pe/media/cifras_de_pobreza/informetecnico_pobreza2014.pdf

11 Ibid. 12 Instituto Nacional de Estadíística e Informaí tica. (n.d.). Mapa de Pobreza Provincial y Distrital 2013. 13 Canadian Forex. (2015). Yearly Average Exchange Rate for Currencies. Retrieved January 1, 2016, from http://www.canadianforex.ca/forex-tools/historical-rate-tools/yearly-average-rates

Choquecancha, as a microcosm within the District of Lares has a population of approximately 1,400 people living between 3,250m and 3,800m above sea level. There is a total of 9 annexes that make up the whole community, but the central regions for the reportâ&#x20AC;&#x2122;s analysis include: San Blas, Qosqo, Huaynaparta, and Collotayoc. The annexes of Choquecancha are widely dispersed where individuals living in the periphery annexes such as Matinga have to walk two hours to reach central Choquecancha and do not have access by car or truck. Lack of roads is also a symptom of microcosms in the Andes that remain largely isolated and socially excluded from the larger Peruvian society. It takes approximately three hours for NC staff to journey from Urubamba, NCâ&#x20AC;&#x2122;s main operations office, to Choquecancha using three different methods of transportation including two public buses, a moto-bicycle, and a taxi. Often there is no vehicle available between Choquecancha and Lares, and staff must hike for three and half hours uphill to Lares in order to get a bus back to Urubamba. This is just an example of the isolation experienced by residents of these Andean communities. Considering the difficulty in reaching Choquecancha, through poorly constructed roads, unreliability of transportation, and the distance, the social services available to the community are limited and lack accessibility. The community has an initial, primary, and secondary school and a health centre located around a plaza, the community core. As Choquecancha is a rural agrarian society, majority of the community members journey to the plaza on Mondays to sell and buy goods from other community members. Many citizens also attend the market in Lares which is bigger and attracts people from all neighbouring communities, including Cuncani14. While market days draws the larger community together, the distances travelled on foot by is inconvenient for frequent access to services such as schools and health centres.

14 Cuncani is an Andean microcosm located a 30 minute drive from Lares, but administratively part of the Urubamba Province in Cusco. NC has been working in Cuncani at the multi-grade school for the past three years running a Lunch Program and other health and education projects with the small community.

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Figure 2: Map of the District of Lares15

Choquecanchaâ&#x20AC;&#x2122;s daily life is defined by its cultural identity of an Andean microcosm. Women are responsible for running the household as well as being the primary caregiver of the children and animals while men work in agricultural or tourism-based positions. Economic opportunities are gravely limited for Choquecancha residents; they would have to migrate to bigger towns such as Calca for more work opportunities in different sectors. 16 Familial and gender roles are traditional; there are separate, social opinions of gender roles in private versus public life which set the expectations of women and men. This impacts the dialogue of development. Discussion regarding educational capacity or sensitive issues such as child mortality are evaded and avoided. Therefore, building trust and forming supportive relationships with the community of Choquecancha is vital for the successful implementation of development initiatives. Even to engage in a conversation about poverty requires trust and respect where the community feels comfortable to share their opinions 15The Andean Alliance for Sustainable Development. (2015). Garden in the Clouds: Families and Vegetable Cultivation in the Andes. Retrieved January 1, 2016, from http://aasd.maps.arcgis.com/apps/MapSeries/index.html?appid=68c4908549964e64a4c753e6ed22be41 16 Calca is approximately 3 hours away by bus from Lares.

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and concerns. The MPI will further support NC’s efforts in Andean communities by initiating dialogue with the community to better understand their reality by assessing the social patterns and norms of the population. The complexity of building relationships is further contextualized through consultation with Javier Espetia-Charaja who expressed the challenges faced by the health centre. The staff at the health centre, much like the municipal government offices located in Lares are employees posted from Cusco, the largest urban centre in the Peruvian Andes. Cultural misunderstanding has resulted in strained trust relations between the community and the employees and language barriers as most staff speaks only Spanish or with little working knowledge of Quechua. Furthermore, employees posted to small microcosms from Cusco do not stay in the position long term resulting in high turn-over in health centre staff. While Choquecancha is isolated and largely socially excluded from development, the government has made efforts to improve access to health and welfare services to the community. There is active presence of national social programs including Q’ali Warma, Cuna Mas, JUNTOS, and Vaso de Leche in the community. According to National Institute of Statistics and Information (INEI), Lares has a projected population of 7,210 for 2015 which helps to contextualize the presence of national social programs in the district. 17 Social programs active in the district of Lares currently benefit approximately the following amount of recipients ranging from early childhood development and nutrition, to pension for seniors and economic opportunities for rural household: 1,129 through Q’ali Warma, 457 through Pensioí n 65, 1,603 through Foncodes, 1,223 through JUNTOS, and 269 through Cuna Mas. 18 As figures for Choquecancha are not available, the reach of governmental efforts to districts is important to note in understanding the services available to the communities in rural areas. However, national programs dissemination across rural communities is still bogged with logistical errors and ineffectiveness.

17 Ministerio de Desarrollo e Inclusioí n Social. (2015). INFOMIDIS. Retrieved January 1, 2016, from

http://www.midis.gob.pe/mapas/infomidis/ 18 Instituto Nacional de Estadíística e Informaí tica. (n.d.). Mapa de Pobreza Provincial y Distrital 2013.

For example, Q’ali Warma’s implementation faces the same structural problems as in other microcosms where regional management is unreflective of the actual needs of the community which are not captured in district level statistics undermining the severity of poverty. The other programs have limited reach to all children and mothers in Choquecancha and also suffer from management and distribution inefficiencies due to a national program being supervised at the regional level, as oppose to at a community level. In spite of these efforts, poverty is still widespread in Choquecancha. NC’s efforts to bridge the social service gap resulted in the HMP which aims to encourage healthy early childhood development by promoting the importance of nutritious and balanced meals for physical and cognitive development of children. HMP incorporates health and education development goals with long term goal of increasing economic opportunity of the women in the community. It is NC’s hope that in the future the organization will have the resources to do a more thorough and extensive MPI application in communities with NC presence where development efforts can be evaluated to show the importance of a multidimensional approach to poverty, similar to the aims of the SDGs.

Multidimensional Poverty Index (MPI) The Multidimensional Poverty Index (MPI) was published in the 2010 Human Development Report, a joint initiative by the United Nations Development Programme (UNDP) and the Oxford Poverty and Human Development Initiative (OPHI). The MPI’s objective is to complement existing income-based, one-dimensional poverty measures such as the income gap ratio and the headcount ratio, in order to illustrate the multiple deprivations experienced by the poor. The Index identifies deprivations in health, education, and standard of living, and is comparable to the Millennium Development Goal (MDGs) that further synthesize efforts to combat multidimensional poverty. While the data collected through income-based indicators is significant, the MPI allows for modification and flexibility in application for what is most relevant to a community. The MPI is calculated using data on the intensity and prevalence of deprivations

across health, education, and standard of living indicators. The indicators are reflective of the Millennium Development Goals (MDGs), further tying together global targets and objectives to combat poverty. In designing an MPI that would be most suitable for Choquecancha, measurement trends and academic research of Latin America were considered. For example, in the working paper by OPHI, “A Multidimensional Poverty Index for Latin America”, the authors have chosen specific indicators to best reflect the information that may be gathered as well as the issues pertaining to rural Latin American communities. The following subsections expand on the structure of the MPI and how to constructively use the tool to learn more about how a population experiences poverty.

How to measure and analyse the data? The MPI has three dimensions of poverty which include a total of ten indicators for the purpose of measuring deprivations experienced per household. As shown in Figure 3, each dimension (health, education, and living standard) have an equal weight of 1/3, whereas health and education indicators have a weight of 1/6, and standard of living indicators each have a weight of 1/18 due to the number of indicators corresponding with each dimension. Figure 3: Ten Indicators of MPI

Three Dimensions of Poverty

Education

Nutrition

Nutrition Child Mortality

Nutrition

Years of Schooling School Attendance Cooking Fuel Sanitation

Living Standard

Nutrition

Water Electricity Floor Assets

As the MPI indicators are closely linked to MDGs, Figure 4 illustrates the relationship between each indicator and the associated MDG as outlined by OPHI. While the OPHI indicators were heavily consulted for creating the MPI for Choquecancha, other factors were considered which resulted in a slightly different list of indicators for NC than OPHI’s Global MPI indicators. Figure 4: The dimensions, indicators, deprivation thresholds and weights of the Global MPI Dimension

Education

Indicator

Relative

to…

Weight

No household member has completed five years of schooling.

MDG2

1/6

Any school-aged child is not attending school up to class 8.

MDG2

1/6

Child Mortality

Any child has died in the family.

MDG4

1/6

Nutrition

Any adult or child for whom there is nutritional information is

MDG1

1/6

Years of

Deprived if…

Schooling Child School Attendance Health

malnourished. Living

Electricity

The household has no electricity.

Improved

The household’s sanitation facility is not improved (according to

Sanitation

MDG guidelines), or it is improved but shared with other

1/18

Standard MDG7

1/18

MDG7

1/18

households.20 Safe Drinking

The household does not have access to safe drinking water

Water

(according to MDG guidelines) or safe drinking water is more than a 30-minute walk from home, roundtrip.***21

19 Adults are considered malnourished if their BMI is below 18.5 m/kg2. Children are considered

malnourished if their z-score of weight-for-age is below minus two standard deviations from the median of the reference population. 20 A household is considered to have access to improved sanitation if it has some type of flush toilet or latrine, or ventilated improved pit or composting toilet, provided that they are not shared. 21 A household has access to clean drinking water if the water source is any of the following types: piped water, public tap, borehole or pump, protected well, protected spring or rainwater, and it is within a distance of 30 minutes’ walk (round-trip).

Flooring

The household has a dirt, sand or dung floor.

1/18

Cooking Fuel

The household cooks with dung, wood or charcoal.

MDG7

1/18

Assets

The household does not own more than one radio, TV, telephone,

MDG7

1/18

bike, motorbike or refrigerator and does not own a car or truck.

Formulating questions for the survey The questions selected by NC as part of the MPI survey for Choquecancha are reflective of the three dimensions (health, education, and standard of living) evaluated in the Global MPI and sustain NC’s development model. The questions associated with each indicator vary slightly to complement the situation for Choquecancha. For example, educational questions pertaining to the participant’s Spanish literacy is beneficial information as Quechua is widely spoken but Spanish is the language of educational instruction, demonstrating formal education.. To illustrate the reality and the social context of Choquecancha, it was important to consider indicators that would actually present the scope of underlying gaps in development. In order to contextualize the MPI survey for Choquecancha, the accessibility of social services was important to measure. As shown in Figure 5, the health indicators include nutrition and access to health services. As supported by the OPHI working paper, “A Multidimensional Poverty Index for Latin America”, incorporation of indicators that demonstrate the poor quality of access to basic services that should be guaranteed to all citizens further illustrates the complexity and far reach of poverty. One cannot discuss the quality of services provided to a community if access to services is hindered or challenged. Furthermore, including indicators that go beyond recognized extreme poverty deprivations like access to water, illustrates obstacles faced by Andean communities who continue to be socially excluded, impacting their development.

Health The changes to health indicators were concurrent with many studies that find early nutrition crucial for mental and physical development of children, where under-nutrition leads to stunting, lowered educational achievement, and hindered cognitive skills. 22 These issues are largely spurred by the absence of proper micronutrients in a child’s diet. Although micronutrients are required in small amounts, they are the substances that allow the body to grow and develop properly. According to the World Health Organization, the absence of iodine, vitamin A and iron in the diets of children and pregnant women in lowincome countries present a major threat in terms of global public health. 23 For the purpose of our MPI survey, NC conducted blood tests measuring haemoglobin levels in all participants to indicate iron deficiency. Testing for anemia is a common and widely recognized health indicator in Peru across national and regional monitoring and evaluative processes.24 The global MPI measures nutritional level using the BMI indicator however, NC chose to measure haemoglobin levels to primarily address iron deficiencies among the participants of the Healthy Meals Program national household BMI useful for assessing health of women, but the anemia test provides more telling analysis regarding nutrition levels. Assessing a community’s ability to access health services was also included to gauge effectiveness of health centres to rural Andean communities. As mentioned, citizens living in some of Choquecancha’s annexes have to walk 2-3 hours to reach the main plaza where the health centre and schools are located; in emergencies or check-ups, inquiring about access to health services sheds light on the what type of impact (if any) such social services are having for rural communities. However, due to the challenging distance, these services are not used to their full benefit for the members of the community.

22 UNESCO. (2010). EFA Global Monitoring Report 2010: Reaching the Marginalized. Retrieved January 1,

2016. 23 World Health Organization. Micronutrients. Retrieved January 1, 2016, from http://www.who.int/nutrition/topics/micronutrients/en/ 24 Instituto Nacional de Estadíística e Informaí tica. (2014). Perú: Encuesta Demográfica y de Salud Familiar 2014 (Rep.). Retrieved January 1, 2016, from https://www.inei.gob.pe/media/MenuRecursivo/publicaciones_digitales/Est/Lib1211/index.

The child mortality indicator was excluded in the analysis due to concern over accurate provision of information. Culturally, topics such as child mortality are not discussed in the public sphere and many women are not forthcoming about such sensitive information. While this question was asked during the survey process, ultimately NC decided to omit the results from the MPI analysis. This decision was reached after conferring with women from Choquecancha who voiced that even if women has experience a death of a child in their families, it was highly unlikely for them to confirm this information. Figure 5: Ten Indicators for MPI for Choquecancha

Health

Nutrition

Nutrition Access to Health Services

Three Dimensions of Poverty

Education

Nutrition

Years of Schooling Spanish Literacy Cooking Fuel Sanitation

Living Standard

Nutrition

Water Electricity Floor Assets

Nexos Comunitarios ÂŠ 2016

Education Indicators for education were altered to reflect the reality of the Choquecancha community. Spanish literacy replaced school attendance as NC did not have the means for obtaining this data as participants of the HMP are mothers and children under two years who are below school attending age. On their children’s behalf, the mothers provided answers to reflect the current living conditions of the household. Spanish literacy was measured by asking if the participants could comprehend, read, or write Spanish. Spanish literacy was included as it is the language of schooling instruction as well as the economic and commercial language of Peru. Through NC’s Explorative Initiative conducted in Cuncani, NC learned that the community experienced discrimination for not being able to speak Spanish; Quechua speakers are viewed as inferior by Spanish-speakers from urban centres.25 Moreover, citizens of Andean microcosms feel insecure interacting with Spanish-speaking and urban residents for they experience discrimination obtaining health services, difficulty in finding jobs, and personal insecurity. 26 These experiences and concerns of citizens in the Andes reflect the divide between rural and urban Peru, which is demonstrated through language literacy. The ability to speak Spanish provides increased opportunity and possibility for Andean citizens to adapt and build relations with the rest of Peru; there is a common factor for communication and understanding one another. All the participants who additionally had school-aged children affirmed that those children only went to school and were not partaking in any work activities. Spanish literacy provokes analysis of access to schooling and exposure to spanish speaking enivornments, potentially outside Andean microcosms.

25 Uzair, Y. (2016, February 2). The Future of Cuncani: The Importance of Human Rights and Interculturality (Rep.). Retrieved February 2, 2016, from Nexos Comunitarios website: https://issuu.com/nexoscomunitarios/docs/_published_the_future_of_cuncani_-_/1 26 Ibid.

Standard of Living The living standards indicators remained the same for NC’s MPI as OPHI’s Global MPI, however alterations were made to the thresholds which determined if a participant is deprived in a certain indicator or not. Figure 6 outlines the defining characteristics of deprivation thresholds and weights for the Choquecancha MPI. For the improved sanitation indicator, OPHI asserts that the households sanitation facility must meet MDG guidelines where a flush or pour-flush toilet/latrine to a piped sewer system, a septic tank or a pit latrine, ventilated improved pit latrine, pit latrine with slab, or composting toilet are considered improved sanitation.27 In the case of Choquecancha, the citizens have three available options: a toilet with a sewer system, a “dry bathroom” which is a pit latrine, or open defecation. For Choquecancha’s MPI, a sanitation facility without a sewer system or a “dry bathroom” were given half points and improved sanitation was classified as a bathroom with a sewer system. Additionally, access to safe drinking water is considered to be treated, filtered water, going beyond just access to piped drinking water which is considered improved access to safe drinking water by MDG guidelines.28 Across Peru’s urban and rural areas, water is available in wells, and pipes bit it is not necessarily safe to drink and requires additional filteration processes before consumption.29 Having access to water source, having to boil it or simply consuming it were given half points for the MPI. Lastly, deprivation in assets is calculated by the OPHI MPI where a household does not own more than one radio, TV, telephone, bike, motorbike or refrigerator and does not own a car or truck. For the Choquecancha MPI, this threshold for asset deprivation was modified to a household receving half points for owning more than one radio, TV, telephone, bike, motorbike or refrigerator and does not own a truck or car for many citizens own a radio and a cellular phone but no vehicle. The threshold adjustments to the 27 UNDESA. Access to Sanitation. Retrieved January 1, 2016, from http://www.un.org/waterforlifedecade/sanitation.shtml 28 Ibid. 29 WSP. (2008). Construyendo una Cultura del Agua en el Perú. Retrieved January 1, 2016, from http://www.wsp.org/sites/wsp.org/files/publications/Construyendo_una_cultura.pdf

indicators for the Choquecancha MPI were made to better capture the extent and spread of poverty in the community.

Figure 6: The dimensions, indicators, deprivation thresholds and weights of the Choquecancha MPI Dimension

Education

Indicator

Relative

to…

Weight

Survey respondent has not completed five years of schooling.

MDG2

1/6

Literacy

Knowledge of Spanish (Speaking, reading and writing)30

MDG2

1/6

Access to health

The household that has to walk longer than 30 minutes to access a

MDG4

1/6

services

health center from home, round-trip.

Nutrition

Any adult or child for whom there is nutritional information

MDG1

1/6

Years of

Deprived if…

Schooling

Health

having anemia. Living

Electricity

The household has no electricity.

Improved

The household’s sanitation facility is not improved, or it is

Sanitation

improved but shared with other households.32

Safe Drinking

The household does not have access to safe drinking water or safe

Water

drinking water is more than a 30-minute walk from home, round-

1/18

Standard MDG7

1/18

MDG7

1/18

trip.33 Flooring

The household has a dirt, sand or dung floor.

Cooking Fuel

The household cooks with dung, wood or charcoal.

1/18 MDG7

1/18

30 A household received a score of 0.5 if the participant could speak Spanish but could not read or write. 31 Participants were categorized intro three levels when testing for Anemia: Normal, Low Anemia, and

Moderate Anemia. A 0.5 score was given for low anemia and participant was considered deprived with a level of moderate anemia. 32 A household is considered to have improved sanitation if it has some type of sewage system in association with a bathroom. A house is not considered to have improved sanitation if the participants indicate having a bathroom but no sewage system, a “banñ o seco” (dry bathroom), or no bathroom. 33 Access to “clean” drinking water is contested in the case of Peru, where drinking tap water is commonly considered unsafe, even in urban areas like Cusco and Lima and requires purification. For the MPI, having to boil water, or simply drink from the tap received a score of 0.5, where having no access to a water source, or walking farther than 30 minutes, round-trip to obtain water was considered deprived.

Assets

The household does not own more than one radio, TV, telephone, bike, motorbike or refrigerator and does not own a car or truck.

MDG7

1/18

The MPI survey, attached in the annex, is lengthier than one question per indicator, as listed above. Additional questions were asked to provide context to the living situation and historical circumstances of the participants of the Healthy Meals Program. For example, participants were asked how often they used the health services at the health centre following being asked about their level and ease of access to the health centre. Participants were also asked to describe their level of Spanish proficiency in reading, writing, and oral ability. NCâ&#x20AC;&#x2122;s aim with implementing the MPI is to allow the organization to better understand the reality of the beneficiaries of the projects and in the communities.

34 A household received a score of 0.5 if they owned more than one radio, TV, telephone, bike, motorbike or refrigerator and does not own a truck or car.

Nexos Comunitarios ÂŠ 2016

Analysis of the Results Once the survey and blood tests were conducted with the participants, the MPI score had to be calculated for Choquecancha. This calculation was important as it would allow NC to compare national MPI score results and delve into poverty measurement analysis by different sources. The MPI results provide qualitative and quantitative findings that are important to understanding the multidimensional reality of communities in the Andes region. In order to analyse the results, it is vital to define important terminology as well as components of the calculation. For the purpose of this study, a person or household is considered multi-dimensionally poor if they are deprived in at least one third of the weighted indicators, thus the percentage cut-off is equal or greater than 33.33%. 35 The MPI is calculated by multiplying the incidence of poverty within a population, meaning the proportion of the population that is multi-dimensionally poor (H), by the prevalence, or intensity of poverty among the poor in the population attained by average proportion of indicators in which poor people are deprived (A).36

MPI= H x A Moreover, categorical distinction of MPI scoring can also place populations on a spectrum of the extremity of poverty. If a person or household is deprived in 20-33.3% of the weighted indicators, they are considered Vulnerable to Poor, 50% or more, they are identified as being Severely Poor, and those deprived in at least one third of more extreme indicators are considered Destitute.

35 Oxford Poverty and Human Development Initiative. (2015, December). Peru Country Briefing,

Multidimensional Poverty Index Data Bank (Rep.). Retrieved January 1, 2016, from OPHI, University of Oxford website: http://www.dataforall.org/dashboard/ophi/index.php/mpi/country_briefings 36 Ibid.

Nexos Comunitarios ÂŠ 2016

The MPI calculated for the participants of the HMP at Choquecancha is 49%. 37 Through these calculations, 91% of households surveyed are in the Vulnerable to Poor range and ten households are identified as Severely Poor. The MPI for Peru (calculated by OPHI and UNDP) in June 2015 is 4%, with only 10% of households surveyed identified as poor.38 Peru ranked 47 out of 110 as multi-dimensionally poor amongst developing countries. This figure is strikingly low compared to the MPI for Choquecancha, demonstrating the disparity across the national and regional realities. A closer look to the results of the MPI survey provides a holistic comprehension of what constitutes poverty and the complex relationship across education, health, and standard of living trends in the community. The following analysis of the MPI is categorized by indicator.

Health Nutrition Blood test results indicate that 48% of participants have normal iron levels, whereas 37% have low anemia and 17% have moderate levels of anemia. The participants are pregnant women and children under the age of two and among them only one out of four women has moderate anemia with more than half the children having low to moderate anemia. In total, more than 50% of participants have some level of anemia which is a telling indicator for the nutritional level of populations living in the Andes. While maternal anemia is not adversely linked to newborn anemia, sound early childhood development is a crucial phase for the cognitive and physiological health of the child. 39 Alleviating early childhood deficiencies have long-term benefits including academic achievement; this further builds on the significance of deconstructing poverty and re-imaging the multidimensional nature of poverty.40 Health and education are correlated and the negative aspects of one factor have 37 Complete calculations are available in the Annex. 38 Oxford Poverty and Human Development Initiative. (2015, December). Peru Country Briefing, Multidimensional Poverty Index Data Bank (Rep.). Retrieved January 1, 2016, from OPHI, University of Oxford website: http://www.dataforall.org/dashboard/ophi/index.php/mpi/country_briefings 39 RAMIREZ-CARDICH, M. E., SAITO, M., GILMAN, R. H., ESCATE, L., STROUSE, J. J., KABRHEL, C., . . . BAUTISTA, C. T. (2004). EFFECT OF MATERNAL ANEMIA AT HIGH ALTITUDE ON INFANT HEMATOCRIT AND OXYGENATION. The American Society of Tropical Medicine and Hygiene, 420-424. Retrieved January 1, 2016, from http://www.ajtmh.org/content/70/4/420.full.pdf 40 Scott, K. G., Claussen, A. H., & Hurtado, E. K. (1999). Early childhood anemia and mild or moderate mental retardation. American Society for Clinical Nutrition, 69, 115-119. Retrieved January 1, 2016, from http://ajcn.nutrition.org/content/69/1/115.full

Nexos Comunitarios ÂŠ 2016

consequences on educational capacity which are additionally linked to economic opportunities impacting standard of living. Access to Health Services As the program includes participants from the closest annexes to the core of Choquecancha, majority of the participants have easy access to the health centre, however only 39% of these residents use the health services provided regularly, regardless of proximity. Other participants have indicated using the health centre if required for their children, or generally not preferring to visit the health centre. Through insight provided by Javier Espetia-Charaja, it has been mentioned that there is a level of mistrust among the community members and the staff at the health centre who tend to be posted in Choquecancha from Cusco. It is important to also consider the willingness of the residents to visit the health centre and receive the health services provided in the community. It is very telling of the mistrust and misunderstanding between staff and patients if less than half of the participants visit the health centre. While access to services can be improved, ultimately use of the facilities and services will contribute to better health practises. This requires efforts to strengthen community-based partnerships and build trust amongst Choquecancha residents and government employees.

Education Years of Schooling Out of the 23 participants surveyed for the Healthy Meals Program, 22 were female respondents, and 1 was male, a father who surveyed on behalf of his daughter who is the participant. 40% of the respondents indicated having completed primary education and 13% of these had some secondary education as well. Surveyed participants were mostly women that may indicate the dramatically low level of secondary education. Gender norms in Choquecancha may dictate a shift in priorities for females to take on more household responsibilities rather than pursue further education.41

41 Uzair, Y. (2016, February 2). The Future of Cuncani: The Importance of Human Rights and Interculturality. Retrieved February 2, 2016, from Nexos Comunitarios website: https://issuu.com/nexoscomunitarios/docs/_published_the_future_of_cuncani_-_/1

Nexos Comunitarios ÂŠ 2016

Spanish Literacy Only 13% of the participants can speak Spanish. Majority of the surveys were conducted with assistance from the health centre staff that performed the role of translator between NC and the participants who spoke Quechua. More than half (57%) of the participants indicated some knowledge of Spanish ranging from comprehension to limited proficiency. Less than half of the participants had completed primary schooling indicating a severe deprivation of access to education. As most of the participants were women, another layer unveiled itself as culturally women care for the children and fulfill household responsibilities whereas men work in the agriculture and tourism to provide for their families; thus a larger need for men to be proficient in Spanish to communicate for increased work opportunities.42

Standard of Living Standard of living indicators illustrate social patterns and the general level of infrastructural development of Choquecancha. Cooking Fuel All of the participants use wood as cooking fuel demonstrating that 100% of the participants ranked MPI poor. The use of biomass for cooking fuel poses serious threats to the environment and contributes to failure of reaching Millennium Development Goals. As women are responsible for cooking in most societies including the microcosms in the Andes, they spend many hours of the day exposed to the fire and smoke, having negative impact on their health, especially contributing to respiratory problems. 43 Pregnant women may also be at a higher risk to the air pollution. Consequently infants who are in close vicinity to their mothers are at higher risk of being harmed by inefficient energy practises leading to many health complications.44 This is coupled with undependable access to health services and time-consuming labour of collecting wood for cooking fuel affects the 42 Ibid. 43 World Health Organization. (n.d.). Household Energy and the Millennium Development Goals (Rep.). Retrieved January 1, 2016, from http://www.who.int/indoorair/publications/fflsection2.pdf 44 Ibid.

Nexos Comunitarios ÂŠ 2016

multidimensionality of poverty experienced by people living in communities like Choquecancha. Floor In the context of Choquecancha, a rural Andean community, all houses having dirt floors illustrate the lack of infrastructural development in the region. Majority of the families in Choquecancha and surrounding Andean microcosms such as Cuncani share their living space with the family’s animals creating unhygienic and disease-prone environments for children and adults further impacting the multidimensional poverty experienced by the citizens through different deprivations. Water Access to safe drinking water is a complicated indicator when applying the MPI to Choquecancha. As 91% of participants have access to water for consumption, yet the quality and cleanliness of the water for safe consumption is very questionable. Approximately 70% of the participants boil the water before use, 22% just drink it and 8% claim water source is too far for access.. NC asserts that access to a water source does not indicate access to safe drinking water. Water contamination is possible through polluted river basin, plant to water contamination, and through antiquated pipe networks. 45 All these including mine tailings, industrial processes as well as physical discharge are concerns for water maintenance in Peru.46 Nationally, filtration systems are necessary before water can be consumed from the tap; tap or free running water is not safe to drink in rural or urban centres however many citizens equate access to running water to safe drinking water.47 Cultural beliefs that nature provides water and there is no need for purifying it may lead inhabitants to avoid water provision systems. 48 Thus, it is important to develop trust among the communities and local partners to ensure transparency, access to information, and accountability of maintaining clean water supply. 45¿Coí mo califican los peruanos la calidad de agua que reciben? (2015, May 22). Retrieved January 1, 2016, from http://rpp.pe/peru/actualidad/como-califican-los-peruanos-la-calidad-de-agua-que-reciben-noticia799855 46 Ibid. 47 Ibid. 48 Gaí mez, J. (2015, June). Clean Water for all? (Rep.). Retrieved January 1, 2016, from Lund University website: http://lup.lub.lu.se/luur/download?func=downloadFile&recordOId=8168521&fileOId=8168528

Electricity The MDGs regard energy services such as electricity vital to socio-economic development as they support income generation and have social benefits. 49 Approximately 70% of participants have electricity in Choquecancha. While all houses use wood for cooking fuel and heating in the community, the use of electricity remains limited in the lives of the community’s citizens. The current inefficient energy sources available to the community stall the optimal use of electricity accessible to the community and the socioeconomic advances that can be gained through increased efficiency and connectivity through telecommunications.

Sanitation Only 26% of participants have access to improved sanitation, which denotes that majority of the community does not have a sewage system or a proper latrine in their homes. Improved sanitation facilities are crucial to improving health and living conditions of the poor. As reported by the UN, “Open defecation is one of the main causes of diarrhoea, which results in the deaths of more than 750,000 children under age 5 every year” posing as a serious concern for health and well-being of communities. 50 Moreover, the UN also reports that 7 out of 10 people without improved sanitation were rural citizens indicating that lacking improved sanitation facilities is correlated with rural development. 51 Assets While 14 out of 23 households in Choquecancha own more than one radio, TV, or telephone, none of the households own a mode of transportation (car, truck, motorbike, or bicycle). Even amongst assets, distribution varies where radio and telephone are the most popular with a couple households owning a TV and none of the households own a refrigerator. 49 UN Energy. (n.d.). The Energy Challenge for Achieving the Millennium Development Goals. Retrieved January 1, 2016, from http://www.un-energy.org/publications/50-the-energy-challenge-for-achieving-themillennium-development-goals 50 UNDESA. Access to Sanitation. Retrieved January 1, 2016, from http://www.un.org/waterforlifedecade/sanitation.shtml 51 Ibid.

The MPI survey reveals the many ways in which these communities experience poverty. There are broad patterns which are challenges that need to be addressed on a national scale impacting rural and urban cities alike, whereas other deprivations are community-specific, such as having access to health services, or having dirt floors in the house. In comparison of the national MPI calculated for Peru and the MPI for Choquecancha, it is evident that realities are strikingly different from community members of Choquecancha than urban Peruvians, further supporting the need for research and resource commitment to learning more about the microcosms of the Andes.

Conclusions Through NC’s work in Cuncani and now in Choquecancha, it is evident that clear solution do not exists in solving poverty; however, alleviating poverty requires the cohesive and dedicated efforts in several dimensions in order to sustainably propel development. The MPI has illustrated that deprivations are experienced in many ways by the poor. Poverty does not equate to isolation yet the gravest deprivations experienced by the poor are related to access to basic health, education, and sanitation services and resources. The MPI is important for NC’s work as it demonstrates the ways in which a microcosm experiences poverty multi-dimensionally. While there is no easy method of achieving responsible, sustainable development, addressing all the indicators discussed in this report increases the likelihood of the rural poor experiencing substantial improvement in their standard of living, which is the global goal (MDGs and SDGs). There are families that possessed a radio and cellular device, but do not have an improved sanitation facility. What does this say about poverty? What does this say about the development processes of the communities and their future? How does this affect NC’s work? The implementation of the MPI will aid NC in pinpointing crossroads in development; determine the synergetic relationship across dimensions of poverty which will illuminate program design and the expected outcomes. Additionally, MPI’s categorization of poverty indicators is well-matched with NC’s development model that

asserts the correlation between health, education, and economic empowerment as the areas of development for Responsible Human Development. NC believes that these three areas are foundational to building sustainable, inclusive, and prosperous societies. By no means does the MPI simplify or replace income-based poverty measurement tools. Extensive research and data collecting methods exist on the regional, national, and international scale, including World Bank Indicators, INEI, UNDP, and OPHI. These sources of information and documents are valuable for capturing the general trends of a region and the overarching challenges for development in particular contexts and geographical locations. However, for the type of work NC conducts at the grass root level, with the organization’s commitment to Responsible Human Development, exploring alternatives, detailed scope of microcosms is necessary. The information gathered in this report is for contrast and complementary purposes to existing sources. NC hopes to initiate the discussion and action for improving the illustration of rural communities in Peru which will inform NC’s work, and further impact our development model and aim for local, sustainable solutions. Contextualizing poverty and the lived reality of Choquecancha’s citizens requires understanding the fabric of culture and norms weaved into the daily practises and perceptions of the community. Language and culture play a huge role in the social exclusion and isolation of Andean microcosms resulting in impoverished conditions. These rural communities predominately speak Quechua with limited proficiency in Spanish which is the commercial language of Peru. There is a strong disconnect between urban and rural centres and the development gap is further exacerbated by language barriers and cultural discrimination. While the MPI does not measure poverty through a cultural indicator, the ways of the community form the backdrop for the circumstances of the people. The responsibilities within a household are also conducted by gender norms; additional factors need to be considered which impact progress and development advances as it begins at the thought level. Through the MPI results, it is evident that culture adds a layer to poverty where access to health and education services is hindered due to misunderstanding and

discrimination experienced by the community and long held beliefs which may be hindering progress. As the MPI is categorized into three overarching dimensions of health, education, and standard of living, it became quickly evident through analysis of the results that even the indicators overlapped and further demonstrated the multidimensional facets of poverty. Sound health is at the core of development impacting educational capacity, and economic opportunity. For example, biomass cooking fuel not only alludes to infrastructural shortfall but also has negative effect on health and labour productivity. Nutrition measured through iron deficiency showed that more than half of the participants have some level of anemia meaning that wholesome and nutrient rich diets are lacking in the community as discovered through research on neighboring communities such as Cuncani. This raises questions of the community’s access to healthy food, knowledge of nutrition, and understanding the importance to health, which inevitably links back to education and access to safe drinking water and sanitation. Also, it was interesting to analyze a shared reality of all participants across particular indicators such as cooking fuel and floors, whereas assets and years of schooling had slight variance. Some of the indicators were very specific to the participant while other indicators were more general at household levels; this should be considered as individual experiences may also be very unique for the community as oppose to household trends. Poverty is complex but through the MPI, NC recognizes that improvements in one indicator can have substantial influence on other aspects of life for citizens in Andean microcosms; little change goes a long way. The MPI serves as an important tool in addressing the interconnection between various aspects affecting one’s quality of life and the magnitude of depravations hindering one’s ability to prosper. This local data of the realities of Choquecancha illustrate a fuller picture of the struggles, needs, and deprivations of the community which vary greatly from an urban

community experiencing poverty. Gaining local data, as this report has attempted to do, help to better inform community development work by providing a closer, more intimate insight into the contextual reality of the communities where we work in an effort to better understand the complexity of poverty and engage in context-specific solutions.

Nexos Comunitarios ÂŠ 2016

Annex The Survey Questions Education 1. How many years of schooling have you had? 2. Can you speak Quechua? 3. Can you speak, read and/or write in Spanish? 4. Do your (older, if they have) children work? What are their ages? Do they still go to school? 5. Do the older children who work, have to miss school for work? How often? Health 1. Has any child died in your family? 2. Do you have health insurance? 3. Do you have access to health services? 4. Do you use the health services? *Nutritional data to be collected through blood tests, and results provided by the Health centre. Standard of Living 1. Do you have access to a safe drinking water? 2. Do you have a sewage system? 3. Do you have floors (in your house)? 4. Do you have adequate external walls? (What are they made of?) 5. How many people live in your house? 6. Do you have electricity? 7. Do you have toilets? (Sanitation) 8. What cooking fuel do you use?

Nexos Comunitarios ÂŠ 2016

9. Do you own any of the following: TV, radio, telephone, bike, motorbike, refrigerator or a car/truck?

Nexos Comunitarios ÂŠ 2016

MPI Choquecancha Calculations "0%" indicates no deprivation in the indicator, while "100%" indicates deprivation in the indicator. Any score above 33.33% is MPI poo.

Nexos Comunitarios ÂŠ 2016

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Nexos Comunitarios ÂŠ 2016