title: Multidimensional poverty in rural Mozambique: a new metric for evaluating public health interventions.
abstract: BACKGROUND
  Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning.
  
  
  METHODS
  Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as "poor" if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation.
  
  
  RESULTS
  In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education.
  
  
  CONCLUSIONS
  Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct poverty conditions. Both permit program implementers to focus resources and critically explore linkages between poverty and its social determinants, thus deriving useful findings for evidence-based planning.
authors.affiliation: Owen Graduate School of Management, Vanderbilt University, Nashville, Tennessee, United States of America; Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee, United States of America.
authors.forename: Bart
authors.initials: B
authors.lastname: Victor
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee, United States of America; Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Meridith
authors.initials: M
authors.lastname: Blevins
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee, United States of America.
authors.forename: Ann F
authors.initials: AF
authors.lastname: Green
authors.affiliation: Friends in Global Health, Maputo, Mozambique.
authors.forename: Elisée
authors.initials: E
authors.lastname: Ndatimana
authors.affiliation: Friends in Global Health, Maputo, Mozambique.
authors.forename: Lázaro
authors.initials: L
authors.lastname: González-Calvo
authors.affiliation: Vanderbilt Center for Latin American Studies and Department of Anthropology, Vanderbilt University, Nashville, Tennessee, United States of America.
authors.forename: Edward F
authors.initials: EF
authors.lastname: Fischer
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee, United States of America; Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America.
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Vergara
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee, United States of America; Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Friends in Global Health, Maputo, Mozambique.
authors.forename: Sten H
authors.initials: SH
authors.lastname: Vermund
authors.affiliation: World Vision International, Maputo, Mozambique.
authors.forename: Omo
authors.initials: O
authors.lastname: Olupona
authors.affiliation: Vanderbilt Institute for Global Health, Vanderbilt University, Nashville, Tennessee, United States of America; Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America; Friends in Global Health, Maputo, Mozambique.
authors.forename: Troy D
authors.initials: TD
authors.lastname: Moon
mesh_terms: D000328:Adult; D002675:Child, Preschool; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D008297:Male; D009073:Mozambique; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data*; D011634:Public Health / Q000191:economics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data