CARATULA ingles - Cáritas del Perú

Transcripción

Reducing chronic malnutrition
and child anemia in Ancash
The Ally Micuy Project
2007 – 2010
Cáritas del Perú
President:
Monsignor Miguel Irizar Campos
Secretary General:
Jorge Luis Lafosse Quintana
Development and Projects Manager:
Dr. Hector Hanashiro Hanashiro
Social Development Manager:
Dr. Andres Moran Tello
Reducing Chronic Malnutrition and Child Anemia in Ancash
2007 – 2010
Key Project Technical Team:
Andres Moran Tello
Carlos Villanueva Aragon
Herman Edgar Castillo Ramon
Javier Garay Almonacid
Jose Moran Mendoza
Luis Campo Sanchez
Milton Moreno Cordova
Marlene Rojas Cordova
Nerida Ovalle Mejia
Regulo Canchaya Alvarez
Reynaldo Dongo Adrian
Roberto Canaza Vega
Publication Team:
Andres Moran Tello
Reducing Chronic Malnutrition
and Child Anemia in Ancash
2007 – 2010
Secretarial Assistance:
Mirtha Gavelan Velasquez
Layout and Design:
Impactum Creativos
Printing:
Studio Digital Editores S.A.C.
Telephone: 425-1504
Jr. Chavin 051
Breña, Lima
Print run: 1000
Legal deposit made in the National Public Library of Peru. #2011-10092
Printed in Peru
Please Note
Using inclusive language, i.e. that does not discriminate against or show the difference between men and
women, is something we at our institution take very seriously. However, its practical use in Spanish has created
very different solutions on which linguists have still not come to agreement.
Therefore, and in order to avoid the graphic overload of overusing the Spanish expression “o/a” to refer to both
sexes, we have decided to use the classic general masculine reference with the understanding that it shall always
include both men and women whenever used.
Cáritas del Perú
President:
Monsignor Miguel Irizar Campos
Secretary General:
Jorge Luis Lafosse Quintana
Development and Projects Manager:
Dr. Hector Hanashiro Hanashiro
Social Development Manager:
Dr. Andres Moran Tello
Reducing Chronic Malnutrition and Child Anemia in Ancash
2007 – 2010
Key Project Technical Team:
Andres Moran Tello
Herman Edgar Castillo Ramon
Jose Moran Mendoza
Luis Campo Sanchez
Milton Moreno Cordova
Nerida Ovalle Mejia
Reynaldo Dongo Adrian
Roberto Canaza Vega
Publication Team:
Andres Moran Tello
Reducing Chronic Malnutrition
and Child Anemia in Ancash
2007 – 2010
Secretarial Assistance:
Mirtha Gavelan Velasquez
Layout and Design:
Impactum Creativos
Printing:
Studio Digital Editores S.A.C.
Telephone: 425-1504
Jr. Chavin 051
Breña, Lima
Print run: 1000
Legal deposit made in the National Public Library of Peru. #2011-10092
Printed in Peru
Please Note
Using inclusive language, i.e. that does not discriminate against or show the difference between men and
women, is something we at our institution take very seriously. However, its practical use in Spanish has created
very different solutions on which linguists have still not come to agreement.
Therefore, and in order to avoid the graphic overload of overusing the Spanish expression “o/a” to refer to both
sexes, we have decided to use the classic general masculine reference with the understanding that it shall always
include both men and women whenever used.
Reducing Chronic Malnutrition and Child Anemia in Ancash The Ally Micuy Project 2007 – 2010
Table of Contents
07
Acknowledgements
11
Preface
19
Executive summary
23
1. Introduction
27
27
27
27
27
2. Project objectives
2.1 Project goal
2.2 Project purpose
2.3 Overall objective
2.4 Project activities per result
31
31
31
31
31
31
34
34
34
36
36
3. Baseline study
3.1 Baseline monitoring study objectives
3.2 Methodology
3.2.1 Study population
3.2.2 Sampling method: LQAS
3.2.3 Determining the sample
3.2.4 Data gathering instrument creation and
validation
3.2.5 Baseline and final monitoring study training
3.2.6 Data gathering and supervision
3.2.7 Data processing
3.2.8 Data analysis
39
39
42
45
48
49
52
58
61
62
69
72
4. Results
4.1 Family socio-demographic information
4.2 Access to clean water and basic sanitation
4.3 Improved stoves
4.4 Maternal and newborn healthcare
4.5 Vaccinations
4.6 Breast feeding and infant feeding
4.7 Prevalent childhood diseases
4.8 Hand washing
4.9 Child nutrition and anemia
4.10 Parent participation in child care
4.11 Rights of the child
75
5. Discussion
85
6. Conclusions
87
7. Lessons learned
95
8. References
97
Annexes
3
Table of Contents
07
Acknowledgements
11
Preface
19
Executive summary
23
1. Introduction
27
27
27
27
27
2. Project objectives
2.1 Project goal
2.2 Project purpose
2.3 Overall objective
2.4 Project activities per result
31
31
31
31
31
31
34
34
34
36
36
3. Baseline study
3.1 Baseline monitoring study objectives
3.2 Methodology
3.2.1 Study population
3.2.2 Sampling method: LQAS
3.2.3 Determining the sample
3.2.4 Data gathering instrument creation and
validation
3.2.5 Baseline and final monitoring study training
3.2.6 Data gathering and supervision
3.2.7 Data processing
3.2.8 Data analysis
39
39
42
45
48
49
52
58
61
62
69
72
4. Results
4.1 Family socio-demographic information
4.2 Access to clean water and basic sanitation
4.3 Improved stoves
4.4 Maternal and newborn healthcare
4.5 Vaccinations
4.6 Breast feeding and infant feeding
4.7 Prevalent childhood diseases
4.8 Hand washing
4.9 Child nutrition and anemia
4.10 Parent participation in child care
4.11 Rights of the child
75
5. Discussion
85
6. Conclusions
87
7. Lessons learned
95
8. References
97
Annexes
3
Tables and Graphs
4
32
Table Nº 01:
Number of supervised areas per each project setting in the
2007 baseline study and the 2010 final study
68
Graph Nº 15:
39
Table Nº 02:
69
Graph Nº 16:
40
Table Nº 03:
Percentage of heads of household who are man at the
beginning and end of the project
Percentage of families with proper floors in their houses at the
Percentage of children or mothers registered in the
Comprehensive Health Insurance Program by province
Percentage of families with access to clean water at the
Basic sanitation at the beginning & end of the project
Percentage of families with improved stoves at the beginning
and end of the project
Percentage of institutional deliveries at the beginning and end
of the project
Percentage of children aged 12-23 months vaccinated at the
Percentage of mothers who begin breastfeeding within the
hour of giving birth of her last child aged 6-23 months at the
Percentage of mothers who exclusively breastfeed the last
child aged 6-23 months for the first 6 months at the beginning
Percentage of children aged 6-23 months who eat 4 or more
solid foods per day at the beginning and end of the project
70
Graph Nº 17:
71
Graph Nº 18:
72
Graph Nº 19:
41
Table Nº 04:
42
Graph Nº 01:
44
47
Graph Nº 02:
Graph Nº 03:
49
Graph Nº 04:
51
Graph Nº 05:
54
Graph Nº 06:
55
Graph Nº 07:
57
Graph Nº 08:
59
Graph Nº 09:
60
Graph Nº 10:
62
Graph Nº 11:
64
Graph Nº 12:
65
Graph Nº 13:
66
Graph Nº 14:
Effect of iron sulfate administered twice per week for 2
consecutive six month periods on the prevalence of anemia in
children aged 6-35 months per province
Comparative analysis of anemia levels in children aged 6-35
months who received supervised iron sulfate supplements twice
per week for 2 consecutive six month periods
Percentage of fathers of children younger than 36 months that
play with their children at the beginning and end of the project
Percentage of fathers of children younger than 36 months that do
not drink excessive amounts of alcohol at the beginning and end
of the project
Percentage of children younger than 36 months registered in the
city hall at the beginning and end of the project
Prevalence of diarrhea in children younger than 3 years at the
Percentage of mothers of children younger than 3 years who
recognize 4 or more danger signs of their child being sick at the
wash their hands at the 5 key moments at the beginning and
end of the project
Prevalence of chronic malnutrition in children younger than 3
years at the beginning and end of the project
Prevalence of anemia in children aged 6-35 month
5
Tables and Graphs
4
32
Table Nº 01:
Number of supervised areas per each project setting in the
2007 baseline study and the 2010 final study
68
Graph Nº 15:
39
Table Nº 02:
69
Graph Nº 16:
40
Table Nº 03:
Percentage of heads of household who are man at the
Percentage of families with proper floors in their houses at the
Percentage of children or mothers registered in the
Comprehensive Health Insurance Program by province
Percentage of families with access to clean water at the
Basic sanitation at the beginning & end of the project
Percentage of families with improved stoves at the beginning
Percentage of institutional deliveries at the beginning and end
of the project
Percentage of children aged 12-23 months vaccinated at the
Percentage of mothers who begin breastfeeding within the
hour of giving birth of her last child aged 6-23 months at the
Percentage of mothers who exclusively breastfeed the last
child aged 6-23 months for the first 6 months at the beginning
Percentage of children aged 6-23 months who eat 4 or more
solid foods per day at the beginning and end of the project
70
Graph Nº 17:
71
Graph Nº 18:
72
Graph Nº 19:
41
Table Nº 04:
42
Graph Nº 01:
44
47
Graph Nº 02:
Graph Nº 03:
49
Graph Nº 04:
51
Graph Nº 05:
54
Graph Nº 06:
55
Graph Nº 07:
57
Graph Nº 08:
59
Graph Nº 09:
60
Graph Nº 10:
62
Graph Nº 11:
64
Graph Nº 12:
65
Graph Nº 13:
66
Graph Nº 14:
Effect of iron sulfate administered twice per week for 2
consecutive six month periods on the prevalence of anemia in
children aged 6-35 months per province
Comparative analysis of anemia levels in children aged 6-35
months who received supervised iron sulfate supplements twice
per week for 2 consecutive six month periods
Percentage of fathers of children younger than 36 months that
play with their children at the beginning and end of the project
Percentage of fathers of children younger than 36 months that do
not drink excessive amounts of alcohol at the beginning and end
of the project
Percentage of children younger than 36 months registered in the
city hall at the beginning and end of the project
Prevalence of diarrhea in children younger than 3 years at the
recognize 4 or more danger signs of their child being sick at the
wash their hands at the 5 key moments at the beginning and
end of the project
Prevalence of anemia in children aged 6-35 month
5
Acknowledgements
Acknowledgements
We wish to extend our deepest gratitude to the Antamina Mining Fund (AMF) for
comprehensively funding the Ally Micuy Project and to all the AMF officers for their invaluable
support during its creation, implementation, and activity monitoring.
We also wish to thank the Secretary Generals of Caritas Huari, Caritas Huaraz, and Caritas
Chimbote for having made possible the successful implementation of this project that the
Caritas network saw fit to take part in since it benefitted child nutrition and maternal health in
Peru.
We furthermore want to express our appreciation to the Ancash Department of Health and, by
extension, its health workers who participated actively in drafting project proposals and
strategies and in running project activities, especially related to primary health care.
A special recognition goes to all the mayors, local authorities, and community leaders in the
Ancash Region, the setting in which Caritas Peru conducted Ally Micuy.
Similarly, we want to stress our sincerest gratitude and recognition to all the families and
Community Nutrition Educators, who through their nobility, generosity, and energy
implemented each activity to benefit the children from the Ancash Region.
We would like to give special mention to all the Community Nutrition Educators who through
their effort, commitment, and vocation, contributed to the project's peer counseling strategy
for changing key habits in their very own communities, demonstrating through their
accomplishments that they are very valuable volunteer local stakeholders in reducing chronic
malnutrition in rural Ancash communities.
Finally, we want to thank all the personnel that worked on the project and that showed great
responsibility in achieving the objectives: Adriana Gutierrez Simbron, Alipio Cruz Balabarca,
Amancio Tucno Carhuapoma, Amira Dianelis Marcos Lavado, Amparo Ramirez Castro, Ana
Lescano Alva, Ana Levano Alfaro, Ana Maria Llallahui Velasquez, Ana Maria Llicahua Chino, Ana
Maria Silva Saldivar, Andres Bernuy Azaña, Anyela Sanchez Perez, Beato Salinas Vasquez, Binser
Palacios Lara, Cariño Moran Tello, Carola Pichilingue Diaz, Carol Piscoya Magallanes, Carla
Tatiana Colonia Silva, Carina Cisneros Caycho, Carlos Rubiños Carranza, Cesar Apolin Montes,
Cinthia Quispe Gala, Cynthia Gonzales Horna, Charlie Cordova Rojas, Clarita Cordova Villacorta,
Cleotilde Lezama Zavaleta, David Soto Alba, Deisi Milagritos Valverde Kaiser, Diamira Calderon
Ruiz, Edgar Ruben Arias Rosales, Edith Rosa Del Rio Moreno, Edith Saenz Espinoza, Eduardo Cruz
Cerrate, Edwin Pari Peña, Edwin Vidal Sanchez, Elmer Turpo Castillo, Eliseo Antonio Achahuanco
Huallpamayta, Elizabeth Duniam Paredes, Elizabeth Javier Jara, Elvia Quispe Calla, Erika Alegre
Quito, Erika Quiroz Pineda, Evans Giron Torrealva, Fany Lazo Ccoto, Fanny Velasquez Pita,
Federico Eberth Jesus Ubaldo, Feliciano Castillejo Cacha, Fernando Martel Mamani, Fernando
Mestanza Pera, Flor Cadillo Bazan, Freedman Raul Perez Casas, Freddy Roberto Ricci Leon,
Guadalupe Tadeo Huerta, Guillermina Ramirez Valera, Gloria Ocaña Muñoz, , Hermelinda
Villalba Mamani, Irma Lizet Chumpitaz Garcia, Irma Mendoza Albornoz, Jaime Capillo Mezarina,
Jaime Eber Mendoza Sacarias, James Carhuaz Sanchez, Jesus Caballero Ramirez, , Jimmi Apolin
7
Acknowledgements
Acknowledgements
We wish to extend our deepest gratitude to the Antamina Mining Fund (AMF) for
comprehensively funding the Ally Micuy Project and to all the AMF officers for their invaluable
support during its creation, implementation, and activity monitoring.
We also wish to thank the Secretary Generals of Caritas Huari, Caritas Huaraz, and Caritas
Chimbote for having made possible the successful implementation of this project that the
Caritas network saw fit to take part in since it benefitted child nutrition and maternal health in
Peru.
We furthermore want to express our appreciation to the Ancash Department of Health and, by
extension, its health workers who participated actively in drafting project proposals and
strategies and in running project activities, especially related to primary health care.
A special recognition goes to all the mayors, local authorities, and community leaders in the
Ancash Region, the setting in which Caritas Peru conducted Ally Micuy.
Similarly, we want to stress our sincerest gratitude and recognition to all the families and
Community Nutrition Educators, who through their nobility, generosity, and energy
implemented each activity to benefit the children from the Ancash Region.
We would like to give special mention to all the Community Nutrition Educators who through
their effort, commitment, and vocation, contributed to the project's peer counseling strategy
for changing key habits in their very own communities, demonstrating through their
accomplishments that they are very valuable volunteer local stakeholders in reducing chronic
malnutrition in rural Ancash communities.
Finally, we want to thank all the personnel that worked on the project and that showed great
responsibility in achieving the objectives: Adriana Gutierrez Simbron, Alipio Cruz Balabarca,
Amancio Tucno Carhuapoma, Amira Dianelis Marcos Lavado, Amparo Ramirez Castro, Ana
Lescano Alva, Ana Levano Alfaro, Ana Maria Llallahui Velasquez, Ana Maria Llicahua Chino, Ana
Maria Silva Saldivar, Andres Bernuy Azaña, Anyela Sanchez Perez, Beato Salinas Vasquez, Binser
Palacios Lara, Cariño Moran Tello, Carola Pichilingue Diaz, Carol Piscoya Magallanes, Carla
Tatiana Colonia Silva, Carina Cisneros Caycho, Carlos Rubiños Carranza, Cesar Apolin Montes,
Cinthia Quispe Gala, Cynthia Gonzales Horna, Charlie Cordova Rojas, Clarita Cordova Villacorta,
Cleotilde Lezama Zavaleta, David Soto Alba, Deisi Milagritos Valverde Kaiser, Diamira Calderon
Ruiz, Edgar Ruben Arias Rosales, Edith Rosa Del Rio Moreno, Edith Saenz Espinoza, Eduardo Cruz
Cerrate, Edwin Pari Peña, Edwin Vidal Sanchez, Elmer Turpo Castillo, Eliseo Antonio Achahuanco
Huallpamayta, Elizabeth Duniam Paredes, Elizabeth Javier Jara, Elvia Quispe Calla, Erika Alegre
Quito, Erika Quiroz Pineda, Evans Giron Torrealva, Fany Lazo Ccoto, Fanny Velasquez Pita,
Federico Eberth Jesus Ubaldo, Feliciano Castillejo Cacha, Fernando Martel Mamani, Fernando
Mestanza Pera, Flor Cadillo Bazan, Freedman Raul Perez Casas, Freddy Roberto Ricci Leon,
Guadalupe Tadeo Huerta, Guillermina Ramirez Valera, Gloria Ocaña Muñoz, , Hermelinda
Villalba Mamani, Irma Lizet Chumpitaz Garcia, Irma Mendoza Albornoz, Jaime Capillo Mezarina,
Jaime Eber Mendoza Sacarias, James Carhuaz Sanchez, Jesus Caballero Ramirez, , Jimmi Apolin
7
Montes, John Solis Toro, Jorge Obregon Saavedra, Jose Rosales Cabello, Jose L. Alarcon Tenorio,
Jose L. Alvarado Figueroa, Jovana Edith Camones Cano, Jose Luis Rodriguez Bautista, Jorge
Mejia Ayala, Juan Bernardo Herrera, Juan Miguel Escudero Ortega, Juan Romero Acevedo, Judit
Talledo Alcover, Julia Ninaquispe Soto, Julio Guzman Tocto, Jhimer Edgar Castillo Amando,
Kuusela Rodriguez Suarez, Himeron Trujillo Muñoz, Katerin Montes Cruz, Ladislao Roque Quito,
Letty Acosta Collazos, Leslie Rodriguez Angulo, Libia Guerrero Trejo, Liliam Prado Fernandez,
Liliana Rosales Aguilar, Liz Chinchay Obregon, Liz Magally Aranda Morales, Liz Villafana Machco,
Lisset Blas Tapia, Leonel Llacuachaqui Quispialaya, Leonel Quispe Chambi, Lorena Cerna Toledo,
Luciano Guevara Vasquez, Luis Alberto Palomino Remon, Luz Sotelo Leon, Madeleine Chiriboga
Garcia, Maria Elena Quiñones Aranda, Maria Lopez Pomalina, Maria Veronica Jimenez Vasquez,
Marlene Pineda Rodriguez, Martin Alva Diaz, Martha Torres Arce, Matilde Cruz Namay, Maximo
Valverde Pizarro, Melina Moreno Flores, Melissa Lopez Alvino, Melissa Oliva Cuevas, Miguel
Galvez Tarrillo, Milla Zavala Corpus, Mirma Escudero Ortega, Milagros Bedoya Tello, Nancy
Avalos Vasquez, Nancy Illanes Vasquez, Nancy Rodriguez Espinoza, Narciso Antunez Calvo,
Nerida Bertha Ovalle Mejia, Noelia Rios Mayhua, Nury Yanina Garcia Solis, Onelia Portocarrero
Aguinaga, Oswaldo Ruben Blacido Gonzales, Percy Pillaca Cayllahua, Percy Vilcarano Quispe,
Pompeyo Veramendi Huayanay, Ponciano Ticona Lerma, Raul Rodriguez Palacios, Robert
Canaza Vega, Rolando Rojas Jaramillo, Rossmery Zuñiga Pomiano, Ruben Palma Perez, Ruth
Hidalgo Cruz, Samuel Guerra Ruiz, Segundo Isaac Garay Santisteban, Seila Cruz Perez, Silvia
Flores Leveau, Sugeyli Yui Ramos, Susan Ostolaza Espiritu, Teodorico Reynoso Ascencios, Vanesa
Olea Trejo, Veronica Llanos Condori, Victor Aliaga Pari, Vilma Huayaney Valverde, Vladimir
Gonzales Pacheco, Walter Calderon Castillo, Wendy Maguiña Salazar, Yeni Bañez Laurente,
Yesenia Chavez Morillo, Yone Linian Izaguirre, Yonel Gomez Penalillo, Yoni Richard Zuñiga
Gonzales and Ximena Duran Flores.
8
Montes, John Solis Toro, Jorge Obregon Saavedra, Jose Rosales Cabello, Jose L. Alarcon Tenorio,
Jose L. Alvarado Figueroa, Jovana Edith Camones Cano, Jose Luis Rodriguez Bautista, Jorge
Mejia Ayala, Juan Bernardo Herrera, Juan Miguel Escudero Ortega, Juan Romero Acevedo, Judit
Talledo Alcover, Julia Ninaquispe Soto, Julio Guzman Tocto, Jhimer Edgar Castillo Amando,
Kuusela Rodriguez Suarez, Himeron Trujillo Muñoz, Katerin Montes Cruz, Ladislao Roque Quito,
Letty Acosta Collazos, Leslie Rodriguez Angulo, Libia Guerrero Trejo, Liliam Prado Fernandez,
Liliana Rosales Aguilar, Liz Chinchay Obregon, Liz Magally Aranda Morales, Liz Villafana Machco,
Lisset Blas Tapia, Leonel Llacuachaqui Quispialaya, Leonel Quispe Chambi, Lorena Cerna Toledo,
Luciano Guevara Vasquez, Luis Alberto Palomino Remon, Luz Sotelo Leon, Madeleine Chiriboga
Garcia, Maria Elena Quiñones Aranda, Maria Lopez Pomalina, Maria Veronica Jimenez Vasquez,
Marlene Pineda Rodriguez, Martin Alva Diaz, Martha Torres Arce, Matilde Cruz Namay, Maximo
Valverde Pizarro, Melina Moreno Flores, Melissa Lopez Alvino, Melissa Oliva Cuevas, Miguel
Galvez Tarrillo, Milla Zavala Corpus, Mirma Escudero Ortega, Milagros Bedoya Tello, Nancy
Avalos Vasquez, Nancy Illanes Vasquez, Nancy Rodriguez Espinoza, Narciso Antunez Calvo,
Nerida Bertha Ovalle Mejia, Noelia Rios Mayhua, Nury Yanina Garcia Solis, Onelia Portocarrero
Aguinaga, Oswaldo Ruben Blacido Gonzales, Percy Pillaca Cayllahua, Percy Vilcarano Quispe,
Pompeyo Veramendi Huayanay, Ponciano Ticona Lerma, Raul Rodriguez Palacios, Robert
Canaza Vega, Rolando Rojas Jaramillo, Rossmery Zuñiga Pomiano, Ruben Palma Perez, Ruth
Hidalgo Cruz, Samuel Guerra Ruiz, Segundo Isaac Garay Santisteban, Seila Cruz Perez, Silvia
Flores Leveau, Sugeyli Yui Ramos, Susan Ostolaza Espiritu, Teodorico Reynoso Ascencios, Vanesa
Olea Trejo, Veronica Llanos Condori, Victor Aliaga Pari, Vilma Huayaney Valverde, Vladimir
Gonzales Pacheco, Walter Calderon Castillo, Wendy Maguiña Salazar, Yeni Bañez Laurente,
Yesenia Chavez Morillo, Yone Linian Izaguirre, Yonel Gomez Penalillo, Yoni Richard Zuñiga
Gonzales and Ximena Duran Flores.
8
Preface
Knowing the dramatic situation that poor Ancash children are facing, the Antamina Mining
Company decided to use its Antamina Mining Fund (AMF) to design and to implement the Ally
Micuy Project (Good Food) with the resolution to contribute to eradicating chronic child
malnutrition in rural areas and in the remotest small towns across the 20 provinces of the
Ancash Region.
Presentaciones
As a means of guaranteeing the successful implementation of this ambitious intervention, we
decided to partner with organizations that boast well known track records and proven
experience in executing wide ranging social programs that return positive results. After
thoroughly investigating the options and exhaustively researching field experiences, the AMF
identified two institutions with demonstrated efficiency in the fight against chronic
malnutrition: Caritas Peru and ADRA, both of which were invited to become project partners
and implementing agencies.
After several months of intense joint work to design the initiative, we signed a cooperation
agreement with Caritas in June 2007 to launch the project under its supervision in the northern
section of the Ancash Region.
It is fitting that we stress the enormous professionalism, dedication, and leadership of Caritas'
staff that, along with AMF officers, formed a solid working team with a single vision and shared
objectives. However, none of the achievements would have been possible without the
willingness and commitment of the participating families, Community Nutrition Educators,
authorities at the Ancash Regional Department of Health, mayors, and hired professionals. The
coordinated effort from all stakeholders in each of the communities, districts, and provinces
that comprehended the Ally Micuy project setting demonstrates that it is possible to promote
collective action effectively in the struggle against the terrible affliction that is chronic child
malnutrition.
What the project achieved more than justifies that optimistic perspective. In 36 months of work,
Ally Micuy reduced chronic malnutrition by 11 percentage points (39.3% to 27.7%) and anemia
by 16 percentage points (63.2% to 46.6%). The project's success is a clear indication that,
contrary to popular belief, it is possible for malnutrition indicators to decline much faster
through similar interventions, managing to reduce them up to three percent per year.
In the specific case of northern Ancash, the Ally Micuy project involved 19,422 children younger
than three years, 4352 pregnant women, and 17,688 families in its first three years, using a
participatory working dynamic that banked on direct empowerment of mothers from
organized families under the firm belief that “a well fed child guarantees progress”. The
transforming impact of this initiative can be seen in improved eating habits, hygiene, and child
care, and even more importantly, in creating healthier communities. In recognition of the
project's important progress, it received different awards from several institutions, notably the
SNMPE - National Mining, Oil, and Energy Society's 2008 Sustainable Development Award, the
radio station RPP (Radio Programs of Peru) Unity and Integration Award, the BHP Billiton 2009
Merit Award, and the ExpoMina 2010 Corporate Social Responsibility Award.
Finally, Ally Micuy is an important benchmark of good corporate citizenship that proves it is
11
Preface
Knowing the dramatic situation that poor Ancash children are facing, the Antamina Mining
Company decided to use its Antamina Mining Fund (AMF) to design and to implement the Ally
Micuy Project (Good Food) with the resolution to contribute to eradicating chronic child
malnutrition in rural areas and in the remotest small towns across the 20 provinces of the
Ancash Region.
Presentaciones
As a means of guaranteeing the successful implementation of this ambitious intervention, we
decided to partner with organizations that boast well known track records and proven
experience in executing wide ranging social programs that return positive results. After
thoroughly investigating the options and exhaustively researching field experiences, the AMF
identified two institutions with demonstrated efficiency in the fight against chronic
malnutrition: Caritas Peru and ADRA, both of which were invited to become project partners
and implementing agencies.
After several months of intense joint work to design the initiative, we signed a cooperation
agreement with Caritas in June 2007 to launch the project under its supervision in the northern
section of the Ancash Region.
It is fitting that we stress the enormous professionalism, dedication, and leadership of Caritas'
staff that, along with AMF officers, formed a solid working team with a single vision and shared
objectives. However, none of the achievements would have been possible without the
willingness and commitment of the participating families, Community Nutrition Educators,
authorities at the Ancash Regional Department of Health, mayors, and hired professionals. The
coordinated effort from all stakeholders in each of the communities, districts, and provinces
that comprehended the Ally Micuy project setting demonstrates that it is possible to promote
collective action effectively in the struggle against the terrible affliction that is chronic child
malnutrition.
What the project achieved more than justifies that optimistic perspective. In 36 months of work,
Ally Micuy reduced chronic malnutrition by 11 percentage points (39.3% to 27.7%) and anemia
by 16 percentage points (63.2% to 46.6%). The project's success is a clear indication that,
contrary to popular belief, it is possible for malnutrition indicators to decline much faster
through similar interventions, managing to reduce them up to three percent per year.
In the specific case of northern Ancash, the Ally Micuy project involved 19,422 children younger
than three years, 4352 pregnant women, and 17,688 families in its first three years, using a
participatory working dynamic that banked on direct empowerment of mothers from
organized families under the firm belief that “a well fed child guarantees progress”. The
transforming impact of this initiative can be seen in improved eating habits, hygiene, and child
care, and even more importantly, in creating healthier communities. In recognition of the
project's important progress, it received different awards from several institutions, notably the
SNMPE - National Mining, Oil, and Energy Society's 2008 Sustainable Development Award, the
radio station RPP (Radio Programs of Peru) Unity and Integration Award, the BHP Billiton 2009
Merit Award, and the ExpoMina 2010 Corporate Social Responsibility Award.
Finally, Ally Micuy is an important benchmark of good corporate citizenship that proves it is
11
Prologue
possible to achieve positive results when mining companies, NGO's, public institutions, and
communities work together. These partnerships are exactly what enable the AMF to contribute
unquestionably to improving the quality of life for Ancash residents.
I personally wish to take this opportunity to underscore the profound commitment of Caritas
Peru to improving the health of the poor in the Ancash Region and to extend my deepest
gratitude for its valuable contribution.
Pablo de la Flor Belaúnde
Vice President of Corporate and Environmental Affairs
Antamina Mining Company
This document is an opportunity for the country to have proof of the efficiency and
effectiveness of a variety of interventions that, being properly adapted to each reality, shall
produce similar successful outcomes because they implement those “practices” that boast
demonstrated global efficacy. However, this experience also shows how important it is by
placing on the table valid, but chiefly appropriable, strategies for realities like ours. In other
words, strategies that guarantee their sustainability and, therefore, their replication, when
incorporated by the different community, health sector, and government stakeholders.
The executed interventions share the same approach, which is comprehensiveness throughout
childhood and the inclusion of health determinants and community participation, aspects that
are defined in Peru's Health Ministry's comprehensive care model that has been in force since
2001.
Because I believe it is important, I should like to highlight four of the fifteen lessons learned:
1. Solutions to a community's problems are found within:
This follows the principle of subsidiarity, i.e. nobody better implements interventions than
the people who live closest to the problem. And this project set out three levels: 1) the family,
by prioritizing counseling through home visits and by engaging husbands in the gender
equity approach, 2) community agents, through peer education, and 3) community
authorities and leaders, by having them commit to monitoring the health of the people they
represent.
2. Using information to make decisions:
No one intervenes in a situation if he does not see it as his problem since this is one facet of
appropriation; afterwards, he leverages his knowledge and resources to solve it.
I am, of course, referring to information given to people in a simplified form that moves them
to accept lifestyle changes because it is related to the love parents have for their children.
These are the so-called key habits for a person's own good, coupled with brief and
understandable instructions and community commitment that is promoted and monitored
by the local authority.
This information, locally applied, puts a twist on the traditional perspective of “writing
reports and producing data to send to the central level”.
3. Supervision and technical assistance through teamwork:
It is a confirmation of the proverb: “While the cat's away, the mice will play”, whereby
progress is properly monitored and, in particular, actions for overcoming difficulties and
deviations or biases in the implementation are chosen by a group.
The experience has proposed a “certain number of working hours per staff member” for
supervision per level, which is an input to be taken into consideration during resource
planning. We all know there is a huge dearth of professional health resources in terms of
12
13
Prologue
possible to achieve positive results when mining companies, NGO's, public institutions, and
communities work together. These partnerships are exactly what enable the AMF to contribute
unquestionably to improving the quality of life for Ancash residents.
I personally wish to take this opportunity to underscore the profound commitment of Caritas
Peru to improving the health of the poor in the Ancash Region and to extend my deepest
gratitude for its valuable contribution.
Pablo de la Flor Belaúnde
Vice President of Corporate and Environmental Affairs
Antamina Mining Company
This document is an opportunity for the country to have proof of the efficiency and
effectiveness of a variety of interventions that, being properly adapted to each reality, shall
produce similar successful outcomes because they implement those “practices” that boast
demonstrated global efficacy. However, this experience also shows how important it is by
placing on the table valid, but chiefly appropriable, strategies for realities like ours. In other
words, strategies that guarantee their sustainability and, therefore, their replication, when
incorporated by the different community, health sector, and government stakeholders.
The executed interventions share the same approach, which is comprehensiveness throughout
childhood and the inclusion of health determinants and community participation, aspects that
are defined in Peru's Health Ministry's comprehensive care model that has been in force since
2001.
Because I believe it is important, I should like to highlight four of the fifteen lessons learned:
1. Solutions to a community's problems are found within:
This follows the principle of subsidiarity, i.e. nobody better implements interventions than
the people who live closest to the problem. And this project set out three levels: 1) the family,
by prioritizing counseling through home visits and by engaging husbands in the gender
equity approach, 2) community agents, through peer education, and 3) community
authorities and leaders, by having them commit to monitoring the health of the people they
represent.
2. Using information to make decisions:
No one intervenes in a situation if he does not see it as his problem since this is one facet of
appropriation; afterwards, he leverages his knowledge and resources to solve it.
I am, of course, referring to information given to people in a simplified form that moves them
to accept lifestyle changes because it is related to the love parents have for their children.
These are the so-called key habits for a person's own good, coupled with brief and
understandable instructions and community commitment that is promoted and monitored
by the local authority.
This information, locally applied, puts a twist on the traditional perspective of “writing
reports and producing data to send to the central level”.
3. Supervision and technical assistance through teamwork:
It is a confirmation of the proverb: “While the cat's away, the mice will play”, whereby
progress is properly monitored and, in particular, actions for overcoming difficulties and
deviations or biases in the implementation are chosen by a group.
The experience has proposed a “certain number of working hours per staff member” for
supervision per level, which is an input to be taken into consideration during resource
planning. We all know there is a huge dearth of professional health resources in terms of
12
13
Presentation
primary care, a situation that needs to be reduced in order to meet the health-related goals.
Yet, a major portion of the work rests on the shoulders of the Community Nutrition
Educators – CNE (community agents qualified in health and child nutrition matters);
moreover, a proposal has been validated so that CNE's are promoted and funded by the local
government, and fifteen of the fifty-eight local governments in the project setting might
have agreed upon implementing it. We need to join forces here with a) the Strategic
Coordinated Nutrition Program since it has assigned guidelines for this type of work that are
under the authority of the local government and not being used and b) the budgets
allocated to the Local Government Incentive Program, which should be maintained and
improved.
“Caring for children is an eloquent testimony of love for
human life, particularly for the life of those who are
weak and dependant on others in all things and for all
things… For her part, the Church – always, but
especially when a child's life is at stake – is prepared to
offer cordial collaboration with the intention of
transforming the whole human civilization into a
“civilization of love”. (HH BENEDICTUS PP. XVI, Feb. 2009)
4. Community-based approach to promoting child growth and development:
We could talk about a “community-based CRED” (Child Growth and Development), which
would imply empowering parents to monitor the “proper growth of their children” and the
“development of their complete potential”. Once again, the principle of subsidiarity plays an
important part here: the person who is constantly with the child will recognize
developmental deficiencies sooner. Involving parents and/or guardians who manage
suitable knowledge contributes to developing a child's potential. We still need to involve
teachers and health workers, who are trained with standardized, shared early stimulation
methods, to a greater degree.
Supporting the process to build a pro-life society and culture from the reality of the poorest and
most vulnerable population is a moral imperative for the entire society and the state; and for us
Christians, it certainly represents a public testimony of our faithfulness to the God of life.
Lastly, and assumed from the outset, we are showing through this experience that chronic
malnutrition health indicators drop as we address health determinants and when all directly
involved sectors (health, education, women and social development) and the civil society work
together using a comprehensive approach that encompasses the life cycle (stages of life).
Another way of putting it is that we are promoting health care as a right and a responsibility as
well as advocating an organized demand with a territorial focus, transformed into a
government policy. One required aspect is accountability to a multi-stakeholder forum, which
in my opinion should be local, thereby adding to and energizing initiatives already underway,
such as the Roundtable in the Fight against Poverty and the program, Mining United with the
People. We acknowledge the valuable contribution given by the Antamina Mining Fund since it
opened the way for implementing this encouraging experience which should continue as an
ongoing policy within the framework of the principle of solidarity.
Dr. Luis Miguel León García
Comprehensive Health Care Director
Department of Human Health
Ministry of Health
The Ally Micuy Project, which purposes to improve the health and nutrition of children younger
than three years in eleven provinces in the Ancash Region, is one of Caritas Peru's most
representative experiences in terms of child and pregnant women's health and nutrition in
poor, socially marginal areas.
Doubtlessly, this project, which is implemented by the Huaraz, Huari, and Chimbote Caritas
Diocesans and made possible with the financial support of the Antamina Mining Fund, is
furthermore a landmark and instructive experience, and in the spirit of the words of HH Pope
John Paul II, a fine example of the “imagination of charity”. Dozens of health and education
professionals, agricultural engineers, and others, along with hundreds of female community
volunteers, Community Nutrition Educators (CNE's), thousands of family mothers, and
community, city, sub-national, and health sector authorities joined forces to reduce the
prevalence of child malnutrition and to create a healthy environment where the lives of children
will flourish in the dignity and beauty that is its very own.
It has been three years of immense dedication, enormous effort, and great sacrifice for Caritas,
but it has also been a very fruitful time of serving and accompanying each one of the diocesan
technical teams for the purposes of building their technical capacities and of encouraging and
living the spirit of brotherly and unified communion. We are aware that Pope Benedict XVI asks
us through his Encyclical Letter “Deus Caritas Est” that the work carried out by Catholic church
institutions must be done with professional competence, but even more important, it must be
distinguished by the “dedication to others with heartfelt concern, enabling them to experience
the richness of their humanity.” Consequently, in addition to their necessary professional
training, these charity workers need a “formation of the heart”. (DCE 31 a)
The professional intervention coupled with fraternity and solidarity with the Ally Micuy
participating individuals and families enables us to show truly encouraging results, such as:
reducing chronic child malnutrition by 10% (37% to 27%), counseling and home visits had a
positive impact of increasing the number of deliveries performed in health centers by 17.5%,
increasing the number of vaccinated and exclusively breastfed children (more than 10.9%), and
lowering the number of child diarrhea cases.
14
15
Presentation
primary care, a situation that needs to be reduced in order to meet the health-related goals.
Yet, a major portion of the work rests on the shoulders of the Community Nutrition
Educators – CNE (community agents qualified in health and child nutrition matters);
moreover, a proposal has been validated so that CNE's are promoted and funded by the local
government, and fifteen of the fifty-eight local governments in the project setting might
have agreed upon implementing it. We need to join forces here with a) the Strategic
Coordinated Nutrition Program since it has assigned guidelines for this type of work that are
under the authority of the local government and not being used and b) the budgets
allocated to the Local Government Incentive Program, which should be maintained and
improved.
“Caring for children is an eloquent testimony of love for
human life, particularly for the life of those who are
weak and dependant on others in all things and for all
things… For her part, the Church – always, but
especially when a child's life is at stake – is prepared to
offer cordial collaboration with the intention of
transforming the whole human civilization into a
“civilization of love”. (HH BENEDICTUS PP. XVI, Feb. 2009)
4. Community-based approach to promoting child growth and development:
We could talk about a “community-based CRED” (Child Growth and Development), which
would imply empowering parents to monitor the “proper growth of their children” and the
“development of their complete potential”. Once again, the principle of subsidiarity plays an
important part here: the person who is constantly with the child will recognize
developmental deficiencies sooner. Involving parents and/or guardians who manage
suitable knowledge contributes to developing a child's potential. We still need to involve
teachers and health workers, who are trained with standardized, shared early stimulation
methods, to a greater degree.
Supporting the process to build a pro-life society and culture from the reality of the poorest and
most vulnerable population is a moral imperative for the entire society and the state; and for us
Christians, it certainly represents a public testimony of our faithfulness to the God of life.
Lastly, and assumed from the outset, we are showing through this experience that chronic
malnutrition health indicators drop as we address health determinants and when all directly
involved sectors (health, education, women and social development) and the civil society work
together using a comprehensive approach that encompasses the life cycle (stages of life).
Another way of putting it is that we are promoting health care as a right and a responsibility as
well as advocating an organized demand with a territorial focus, transformed into a
government policy. One required aspect is accountability to a multi-stakeholder forum, which
in my opinion should be local, thereby adding to and energizing initiatives already underway,
such as the Roundtable in the Fight against Poverty and the program, Mining United with the
People. We acknowledge the valuable contribution given by the Antamina Mining Fund since it
opened the way for implementing this encouraging experience which should continue as an
ongoing policy within the framework of the principle of solidarity.
Dr. Luis Miguel León García
Comprehensive Health Care Director
Department of Human Health
Ministry of Health
The Ally Micuy Project, which purposes to improve the health and nutrition of children younger
than three years in eleven provinces in the Ancash Region, is one of Caritas Peru's most
representative experiences in terms of child and pregnant women's health and nutrition in
poor, socially marginal areas.
Doubtlessly, this project, which is implemented by the Huaraz, Huari, and Chimbote Caritas
Diocesans and made possible with the financial support of the Antamina Mining Fund, is
furthermore a landmark and instructive experience, and in the spirit of the words of HH Pope
John Paul II, a fine example of the “imagination of charity”. Dozens of health and education
professionals, agricultural engineers, and others, along with hundreds of female community
volunteers, Community Nutrition Educators (CNE's), thousands of family mothers, and
community, city, sub-national, and health sector authorities joined forces to reduce the
prevalence of child malnutrition and to create a healthy environment where the lives of children
will flourish in the dignity and beauty that is its very own.
It has been three years of immense dedication, enormous effort, and great sacrifice for Caritas,
but it has also been a very fruitful time of serving and accompanying each one of the diocesan
technical teams for the purposes of building their technical capacities and of encouraging and
living the spirit of brotherly and unified communion. We are aware that Pope Benedict XVI asks
us through his Encyclical Letter “Deus Caritas Est” that the work carried out by Catholic church
institutions must be done with professional competence, but even more important, it must be
distinguished by the “dedication to others with heartfelt concern, enabling them to experience
the richness of their humanity.” Consequently, in addition to their necessary professional
training, these charity workers need a “formation of the heart”. (DCE 31 a)
The professional intervention coupled with fraternity and solidarity with the Ally Micuy
participating individuals and families enables us to show truly encouraging results, such as:
reducing chronic child malnutrition by 10% (37% to 27%), counseling and home visits had a
positive impact of increasing the number of deliveries performed in health centers by 17.5%,
increasing the number of vaccinated and exclusively breastfed children (more than 10.9%), and
lowering the number of child diarrhea cases.
14
15
A worthy aspect we need to stress and that shows child health indicators can be significantly
improved is that we lowered the prevalence of anemia on average by 33.2%.
We are proud to share in this document, the fruit of these three years of pro-child health and
nutrition work. This good news is the outgrowth of trust, dialogue, and joint work among the
Caritas Peru network, private enterprise, government authorities, and the organized
community. We are putting this on the discussion table, where stakeholders interested in
comprehensive human development sit, with the expectation that it shall become a support
tool for other initiatives that look to contribute to building a more unified, just, brotherly, and
reconciled Peru.
Ing. Jorge Luis Lafosse Quintana
Secretary General
Cáritas del Perú
16
A worthy aspect we need to stress and that shows child health indicators can be significantly
improved is that we lowered the prevalence of anemia on average by 33.2%.
We are proud to share in this document, the fruit of these three years of pro-child health and
nutrition work. This good news is the outgrowth of trust, dialogue, and joint work among the
Caritas Peru network, private enterprise, government authorities, and the organized
community. We are putting this on the discussion table, where stakeholders interested in
comprehensive human development sit, with the expectation that it shall become a support
tool for other initiatives that look to contribute to building a more unified, just, brotherly, and
reconciled Peru.
Ing. Jorge Luis Lafosse Quintana
Secretary General
Cáritas del Perú
16
Executive Summary
Executive Summary
The Ally Micuy Project was conducted in all provinces of the Ancash Region under the program,
Mining United with the People. It was financed by the Antamina Mining Fund and implemented by
Caritas Peru, in coordination with Caritas Chimbote, Caritas Huaraz, and Caritas Huari, in eleven
provinces in the northern section of Ancash from September 2007 – November 2010. This report
shall present project results from data analyzed from the initial baseline study of family
knowledge, attitudes, and practices on child health and nutrition matters as well as from the July August 2010 final study.
Project purpose was to improve health and nutrition in children younger than three years in
communities spread throughout eleven provinces of the Ancash Region.
Methodology: Both studies were conducted randomly, following the LQAS (Lot Quality Assurance
Sampling) method that is recommended for baseline studies and social program and project
monitoring. Baseline study surveys were applied by district project managers, who were health
professionals, under the direction of provincial coordinators and project supervisors. Final study
surveys were applied by specially hired interviewers. Prior training on methodological procedures
and interviewing was provided to the interviewers and supervisors. The results were processed
using software the Caritas central team specifically designed.
Results: 71% more families with children younger than three years have an improved stove.
Deliveries performed at health centers increased from 60.1% to 77.6%. Basic vaccinations (polio,
DPT, BCG, and measles) increased slightly in children aged 12-23 months from 78.8% to 84%. The
percentage of mothers who breastfeed their child within the first hour of delivery increased from
65.8% to 79.9%. The percentage of mothers who exclusively breastfeed their child to the sixth
month increased by 10.9%.
The percentage of children aged 6-23 months who receive four or more solid foods per day
increased from 10.4% to 36.2%. At project launch, no mother could recognize four danger signs of
a sick child. By the end, 27.2% could recognize four or more. Prevalence of diarrhea in children
younger than three years decreased from 29.1% to 24.5%. At project launch, no mother with a
child younger than three years washed her hands during the five key hand washing moments. By
the end, 16.3% were doing so.
Prevalence of chronic child malnutrition in children younger than three years dropped from 37%
to 27%. In children younger than five years, the figure fell from 42.2% to 34.8%.
From 2009 to 2010, anemia in children aged 6-35 months dropped from 63.1% to 51.8%. The 2929
children who took iron sulfate supplements for two six month periods recorded a 33.2% decrease
in anemia, from 69% to 35.8%. These same children also recorded a notable decrease in the
prevalence of severe and moderate anemia. The percentage of fathers who play with their child
younger than three years increased from 43.7% to 60.2%.
19
Executive Summary
Executive Summary
The Ally Micuy Project was conducted in all provinces of the Ancash Region under the program,
Mining United with the People. It was financed by the Antamina Mining Fund and implemented by
Caritas Peru, in coordination with Caritas Chimbote, Caritas Huaraz, and Caritas Huari, in eleven
provinces in the northern section of Ancash from September 2007 – November 2010. This report
shall present project results from data analyzed from the initial baseline study of family
knowledge, attitudes, and practices on child health and nutrition matters as well as from the July August 2010 final study.
Project purpose was to improve health and nutrition in children younger than three years in
communities spread throughout eleven provinces of the Ancash Region.
Methodology: Both studies were conducted randomly, following the LQAS (Lot Quality Assurance
Sampling) method that is recommended for baseline studies and social program and project
monitoring. Baseline study surveys were applied by district project managers, who were health
professionals, under the direction of provincial coordinators and project supervisors. Final study
surveys were applied by specially hired interviewers. Prior training on methodological procedures
and interviewing was provided to the interviewers and supervisors. The results were processed
using software the Caritas central team specifically designed.
Results: 71% more families with children younger than three years have an improved stove.
Deliveries performed at health centers increased from 60.1% to 77.6%. Basic vaccinations (polio,
DPT, BCG, and measles) increased slightly in children aged 12-23 months from 78.8% to 84%. The
percentage of mothers who breastfeed their child within the first hour of delivery increased from
65.8% to 79.9%. The percentage of mothers who exclusively breastfeed their child to the sixth
month increased by 10.9%.
The percentage of children aged 6-23 months who receive four or more solid foods per day
increased from 10.4% to 36.2%. At project launch, no mother could recognize four danger signs of
a sick child. By the end, 27.2% could recognize four or more. Prevalence of diarrhea in children
younger than three years decreased from 29.1% to 24.5%. At project launch, no mother with a
child younger than three years washed her hands during the five key hand washing moments. By
the end, 16.3% were doing so.
Prevalence of chronic child malnutrition in children younger than three years dropped from 37%
to 27%. In children younger than five years, the figure fell from 42.2% to 34.8%.
From 2009 to 2010, anemia in children aged 6-35 months dropped from 63.1% to 51.8%. The 2929
children who took iron sulfate supplements for two six month periods recorded a 33.2% decrease
in anemia, from 69% to 35.8%. These same children also recorded a notable decrease in the
prevalence of severe and moderate anemia. The percentage of fathers who play with their child
younger than three years increased from 43.7% to 60.2%.
19
Conclusions
First, families with children younger than three years with an improved stove in the home
increased sharply. Secondly, household organization and the use of simple technologies for better
food preservation and handling improved. Next, the percentage of institutional deliveries
increased, which is also seen as successfully promoting the demand for health services. Third,
child vaccinations also rose. Other important achievements dealt with increased hand washing
during the key moments, better knowledge of the danger signs of a sick child, and a greater
number of children aged 6-23 months eating solid foods at least four times a day. The project
furthermore attained an important increase in exclusive breastfeeding of children up to the sixth
month of life. The prevalence of diarrhea in children younger than three years dropped, yet that
situation could improve if families had greater access to clean water and basic sanitation.
Moreover, the project recorded an important decrease in the prevalence of chronic malnutrition
in children younger than three years and, in children younger than five years, a somewhat smaller
drop. We demonstrated that properly supervised iron sulfate supplements, administered twice a
week, are an effective means of reducing anemia in children aged 6-35 months. In large part, what
the project accomplished is owed to the dedicated work of the CNE's, who received a small stipend
based upon their performance. These individuals proved the efficacy of peer-to-peer nutrition
counseling in the fight against child malnutrition and nutritional anemia.
20
Conclusions
First, families with children younger than three years with an improved stove in the home
increased sharply. Secondly, household organization and the use of simple technologies for better
food preservation and handling improved. Next, the percentage of institutional deliveries
increased, which is also seen as successfully promoting the demand for health services. Third,
child vaccinations also rose. Other important achievements dealt with increased hand washing
during the key moments, better knowledge of the danger signs of a sick child, and a greater
number of children aged 6-23 months eating solid foods at least four times a day. The project
furthermore attained an important increase in exclusive breastfeeding of children up to the sixth
month of life. The prevalence of diarrhea in children younger than three years dropped, yet that
situation could improve if families had greater access to clean water and basic sanitation.
Moreover, the project recorded an important decrease in the prevalence of chronic malnutrition
in children younger than three years and, in children younger than five years, a somewhat smaller
drop. We demonstrated that properly supervised iron sulfate supplements, administered twice a
week, are an effective means of reducing anemia in children aged 6-35 months. In large part, what
the project accomplished is owed to the dedicated work of the CNE's, who received a small stipend
based upon their performance. These individuals proved the efficacy of peer-to-peer nutrition
counseling in the fight against child malnutrition and nutritional anemia.
20
Introduction
Introduction
Financed by the Antamina Mining Fund, the Ally Micuy Project ran from September 2007 to
November 2010 in the Ancash Region. Caritas Peru worked in eleven northern provinces.
If we were to order the regions of the country by greatest to least prevalence of chronic
malnutrition in children younger than five years, then Ancash would fall within the intermediate
group. Likewise, close to 20% of mothers with children younger than three years living in this
region's rural communities are illiterate.
Small scale farming is the main economic activity in most of the communities, and there is
limited access to markets. In communities above 3500 m., raising livestock is the most
important activity; in those above 3000 m., farmers raise crops using a rainfed system, which is
why cropland productivity is low and there is only one harvest per year.
At the end of 2006, the program, “Mining United with the People”, was created through an
agreement between the Peruvian government and the largest mining companies in which the
latter would contribute funds on a voluntary, extraordinary, and temporary basis since at that
time their earnings were incredibly high due to the international price of metals. In keeping with
the law that gave birth to the program, its funds had to be invested primarily in child nutrition,
education, health, production chains, and social infrastructure. Its purpose was to contribute to
improving the living conditions of populations living in each mine's sphere of influence. For
investment purposes, each company had to establish a local and a regional setting and to invest
most of the funds at the local level, defined by the district or province in which the mine was
located. The Antamina Mining Company in the San Marcos District, Huari Province, Ancash
Region, was the country's largest contributor to the total amount allocated to the program.
In this context, the project Reducing Chronic Malnutrition and Child Anemia in Communities in
the Ancash Region, given the shorter name Ally Micuy – a Quechua phrase for “Good Food” or
“Well Fed” – was formulated. After several months of discussions among the three parties: the
Antamina Association (entity created to manage the AMF), ADRA, and Caritas Peru, a bilateral
agreement was signed by AMF and Caritas Peru in August 2007. One month later, the Caritas
network, formed by Caritas Chimbote, Caritas Huaraz, and Caritas Huari and led by Caritas Peru,
launched the program in the northern sector of Ancash.
The area over which Caritas Peru was to oversee was northern Ancash, comprised of eleven
provinces and assembled into two settings: the local and the regional. The local setting
encompassed these provinces: Carhuaz, Huaylas, Mariscal Luzuriaga, Pomabamba, Sihuas, and
Yungay, while the regional encompassed these provinces: Casma, Corongo, Huaraz, Pallasca,
and Santa. We chose districts in these provinces featuring the greatest levels of child
malnutrition, according to the 2005 Student Height and Weight Census.
Then, we picked close to ten communities in each district. In short, project setting was
comprised of eleven provinces, fifty-eight districts, and four hundred twenty-seven
communities, more than half of these located above 3000 m. As shown by the provinces that
made up the local and regional settings, the local Ally Micuy setting was not just the province
where the donating company operated, but also several other provinces with elevated levels of
23
Introduction
Introduction
Financed by the Antamina Mining Fund, the Ally Micuy Project ran from September 2007 to
November 2010 in the Ancash Region. Caritas Peru worked in eleven northern provinces.
If we were to order the regions of the country by greatest to least prevalence of chronic
malnutrition in children younger than five years, then Ancash would fall within the intermediate
group. Likewise, close to 20% of mothers with children younger than three years living in this
region's rural communities are illiterate.
Small scale farming is the main economic activity in most of the communities, and there is
limited access to markets. In communities above 3500 m., raising livestock is the most
important activity; in those above 3000 m., farmers raise crops using a rainfed system, which is
why cropland productivity is low and there is only one harvest per year.
At the end of 2006, the program, “Mining United with the People”, was created through an
agreement between the Peruvian government and the largest mining companies in which the
latter would contribute funds on a voluntary, extraordinary, and temporary basis since at that
time their earnings were incredibly high due to the international price of metals. In keeping with
the law that gave birth to the program, its funds had to be invested primarily in child nutrition,
education, health, production chains, and social infrastructure. Its purpose was to contribute to
improving the living conditions of populations living in each mine's sphere of influence. For
investment purposes, each company had to establish a local and a regional setting and to invest
most of the funds at the local level, defined by the district or province in which the mine was
located. The Antamina Mining Company in the San Marcos District, Huari Province, Ancash
Region, was the country's largest contributor to the total amount allocated to the program.
In this context, the project Reducing Chronic Malnutrition and Child Anemia in Communities in
the Ancash Region, given the shorter name Ally Micuy – a Quechua phrase for “Good Food” or
“Well Fed” – was formulated. After several months of discussions among the three parties: the
Antamina Association (entity created to manage the AMF), ADRA, and Caritas Peru, a bilateral
agreement was signed by AMF and Caritas Peru in August 2007. One month later, the Caritas
network, formed by Caritas Chimbote, Caritas Huaraz, and Caritas Huari and led by Caritas Peru,
launched the program in the northern sector of Ancash.
The area over which Caritas Peru was to oversee was northern Ancash, comprised of eleven
provinces and assembled into two settings: the local and the regional. The local setting
encompassed these provinces: Carhuaz, Huaylas, Mariscal Luzuriaga, Pomabamba, Sihuas, and
Yungay, while the regional encompassed these provinces: Casma, Corongo, Huaraz, Pallasca,
and Santa. We chose districts in these provinces featuring the greatest levels of child
malnutrition, according to the 2005 Student Height and Weight Census.
Then, we picked close to ten communities in each district. In short, project setting was
comprised of eleven provinces, fifty-eight districts, and four hundred twenty-seven
communities, more than half of these located above 3000 m. As shown by the provinces that
made up the local and regional settings, the local Ally Micuy setting was not just the province
where the donating company operated, but also several other provinces with elevated levels of
23
malnutrition. The entire project was carried out in twenty Ancash provinces, eleven of which sit
within the Caritas Peru work zone. One other fact we would like to underscore is the AMF's
decision to be part of the project in all the Ancash provinces and not just in its direct sphere of
influence.
At the beginning of the project, Caritas conducted its own baseline study, assuming that one
the government would have carried out through the INEI or another institution might have
taken too long to complete or not have had sufficient desegregation, facts that were effectively
confirmed. We initiated the baseline study in September 2007 and concluded it in October
2007, basically two months before we launched the project.
We furthermore conducted a baseline monitoring study, following the same methodology, at
project conclusion, between July and August of 2010.
24
malnutrition. The entire project was carried out in twenty Ancash provinces, eleven of which sit
within the Caritas Peru work zone. One other fact we would like to underscore is the AMF's
decision to be part of the project in all the Ancash provinces and not just in its direct sphere of
influence.
At the beginning of the project, Caritas conducted its own baseline study, assuming that one
the government would have carried out through the INEI or another institution might have
taken too long to complete or not have had sufficient desegregation, facts that were effectively
confirmed. We initiated the baseline study in September 2007 and concluded it in October
2007, basically two months before we launched the project.
We furthermore conducted a baseline monitoring study, following the same methodology, at
project conclusion, between July and August of 2010.
24

CARATULA ingles - Cáritas del Perú

Transcripción

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