Project ID: 103211

Status: Active

Duration: November 2005- November 2008

IDRC Funding: 300,650

Recipient Institution: Group of Analysis for Development (GRADE)

The Peruvian society has been historically marked by high levels of poverty and inequality, entangled with the systemic exclusion of the vast majority of the population with indigenous ethnic backgrounds. The mechanisms that perpetuate these inequities for the indigenous and Afro- Peruvian population can be traced to the times of the Spanish domination and were later reaffirmed during Republican times. This situation leads to a significant disadvantage for these populations in terms of their levels of income, schooling and health. It also means increased difficulty in access to formal services such as credit and social security. One reason this exclusion has persisted through time is that the issues of race and ethnicity have remained largely hidden from the majority of civil society and policy-makers in Peru. This project recognizes the need for this to change in order to eliminate the discriminatory practices that lead to gaps in access. It is important to understand the nature of the systematic exclusion from health services of people of indigenous origin in order to work towards policy alternatives in favour of the elimination of ethnic gaps in health and the discriminatory practices associated with the delivery of care.

PROJECT OBJECTIVES

The main objective of the project is to use a multidisciplinary approach to raise awareness in Peruvian society and among key stakeholders on the importance role of race and ethnicity in the existence of persistent health inequities in Peru.

Specifically this project aims to:

• Measure the size of ethnic gaps in health status, access to healthcare, and health financing using different ethnic markers that will be created for the study
• Identify the predominant discriminatoryexperiences faced by different ethnic and racial groups and the coping strategies they use
• Clarify the role of racial and ethnic identities and the resulting discrimination as determinants of health inequalities
• Identify the mechanisms through which racism is manifested during the delivery of health care in public health facilities and its effects on service quality
• Combine the research component with advocacy activities to effectively raise awareness of the magnitude and nature of ethnic gaps in health status, access to health care and health financing
• Make key stakeholders aware of the project, its methods, and results as a means of promoting equity in health

METHODOLOGY

The project will combine qualitative and quantitative research methods, institutional and regulatory analysis and a significant improvement in the ethnic and racial indicators included in the current household and health surveys in Peru. The research process will include primary and secondary data analysis and case studies and in-depth interviews and focus groups in the cities of Lima and Cusco. The research results will be disseminated to key stakeholders by means of a set of publications, workshops and conferences. The intention of the project and the dissemination of results is not only to raise awareness of the nature of factors that generate and perpetuate the racial/ ethnic gaps but also to work on the identification and implementation of policies that can create change, specifically in the health sector.

The project results will involve the participation of stakeholders from its early stages. This will be accomplished though workshops and the formation of a consultation group that will work closely with the research team. The team will also work closely with the Observatory on Health Rights in order to learn from their experience with mobilizing around health rights issues and interacting with the public and with major actors.

EXPECTED OUTCOMES

The expected results and outcomes of this project include raising awareness among different groups of stakeholders so as to create a recognition of the need to act against factors that perpetuate health inequalities associated with race and ethnicity. The planned dissemination of results will also help to identify gaps, generate change and inform policy with regard to specific public health facilities. This will help to make the public health sector in Peru more accessible to the racial/ ethnic groups that have been traditionally marginalized in Peru.

PROJECT CONTACT

For more information about the project, the participating institutions and researchers, please contact the project leaders at the following addresses:

Martin Valdivia

Group for the Analysis of Development (GRADE)

PeruAv. del Ejército # 1870

Lima 27, Perú PO Box 18-0572

jvaldivi@grade.org.pe