Economic Research Forum (ERF)

Tackling multidimensional poverty in MENA

What does most recent multidimensional poverty assessment of the Middle East and North Africa reveal about health, education, living standards and social security in the region. This column outlines the evidence and potential policy responses.

In a nutshell

The multidimensional poverty index includes measures of health (nutrition and child mortality), education (years of schooling and school attendance) and standards of living (assets, housing, electricity, sanitation, drinking water and cooking fuel).

While the shift to multidimensional poverty assessment is crucial, it is important to note that there is a general lack of information about people's attitudes and views on other unmeasured social dimensions.

Policies aimed at reducing multidimensional poverty should focus on various types and dimensions of deprivation simultaneously.

According to the United Nations’ 2019 Multidimensional Poverty Index (MPI), the poorest people in developing countries live in sub-Saharan Africa, South Asia and the MENA region. In 1985, Amartya Sen’s groundbreaking introduction of the ‘capability approach’ as a theoretical framework for poverty measurement redefined poverty and the classification of people as ‘poor’.

Using this approach, Sen strongly recommended to concentrate on important ‘functionings’ and people’s corresponding capabilities, such as being well-nourished, sheltered, in good health, capable of escaping morbidity and premature mortality, and the ability to move freely, rather than focusing only on income and consumption levels.

Multidimensional poverty

‘Poverty, is not ultimately a matter of incomes at all; it is one of a failure to achieve certain minimum capabilities.’

Amartya Sen (1985)

Based on Sen’s seminal study (1985), poverty has been re-defined using a multidimensional approach and is considered not only as a lack of material possessions, but also as a lack of necessary opportunities to lead a dignified life (Anand and Sen, 1997).

In this regard, new studies on poverty have included health and education as poverty measurement indicators (Anand and Sen, 1994). Moreover, other factors such as work, physical safety, freedom, empowerment, social connectedness, and psychological/subjective wellbeing (Alkire, 2007; Samuel et al, 2017) are also mentioned as important dimensions of poverty.

Although most of these factors were not incorporated into multidimensional poverty indices due to data absence (Alkire, 2007), they at least include measures of basic human capabilities rather than only money-metric measures. For instance, the MPI consists of three main dimensions: education, health and standard of living, which are represented by 10 indicators.

Health is represented by nutrition and child mortality, while years of schooling and school attendance are used as proxies for education, and the standard of living indicators include: assets, housing, electricity, sanitation, drinking water and cooking fuel.

The 2019 global MPI for developing countries reveals data for 101 countries, covering 76% of the global population. Based on the collected data, the index highlights that one third of the global population is multidimensionally poor and the poorest populations live in 49 countries.

Multidimensional poverty varies across these developing regions with 1.1% of the poor populations residing in Europe and Central Asia, 57.5% in sub-Saharan Africa, followed by South Asia and MENA countries with 31% and 15.7% respectively.

Key dimensions of poverty measurement and recommendations


While countries in the MENA region have experienced impressive improvements in the level of school enrolment rates, this achievement does not reflect an increase in the level of individuals’ wellbeing. According to a World Bank report, recent progress in education attainment and school enrolment rates has not successfully contributed to an increase in labour market opportunities for the youth, resulting in the region being home to the world’s highest youth unemployment rate (World Bank, 2018). The report also suggests that the education system should focus more on the learning outcomes of children at early grades.

Accordingly, the qualification of teachers and school principals should be improved with better pedagogical training for the accurate assessment of children’s learning processes. Moreover, governments should implement inclusive policies targeting the educational attainment of all children regardless of gender, race, socio-economic background or ability.

Public sector reforms relating to proper recruitment of teaching personnel are also needed. Labour market reforms that create better systems for matching graduates with jobs and incentivise employers to identify and improve the skills of newly hired graduates are needed in practice.


Food security and adequate nourishment are serious challenges for most MENA countries with the exception of the countries of the Gulf Cooperation Council (GCC), belonging in the International Food Policy Research Institute’s (IFPRI) classified low-risk group. Since nutrition and child mortality are indicators for the MPI’s health dimension, public policies should focus on food consumption habits and adequate healthcare delivery (Marks, 2009).

Moreover, Koç et al (2017) indicate that poor water management leading to excessive waste of irrigation has negative effects on food security in the region. A better alternative policy direction is to transform current social policies, such as cash transfers, fuel and food subsidies, towards improving farmers’ capabilities for the efficient use of production factors and adequate food production.

Regarding child mortality, the region has made significant progress in the decrement of maternal and under-five mortality. However, there is not a balanced improvement within and between countries, and children in different geographical locations have not exhibited equal progress. Compared to low and middle-income countries, high-income countries have better coverage of interventions, such as healthcare visits, skilled birth attendance and vaccination.

Political instability also affects the accessibility of healthcare for many children. War-torn countries such as Syria and Yemen have low immunisation rates in comparison to high immunisation coverage rates in the majority of other MENA countries. Cost-effective, evidence-based interventions such as the Every New-born Action Plan (ENAP) was launched by the World Health Organization in 2014 to design strategic actions for ending new-born mortality and reducing maternal mortality and morbidity; however, public policies should ensure equity in the affordability, accessibility and quality of healthcare services (UNICEF, 2019).

Living standards and social security

Two thirds of the MENA population do not have any kind of formal social security. Public social security policies in the region primarily encompass social safety nets, such as subsidies, cash-transfer programmes and other forms of social assistance. Taking the form of income/cash provision, targeted social safety nets are not always efficient strategies for poverty eradication, unless they target the extremely poor in the short or medium term (Ozdamar and Giovanis, 2016, 2017).

For example, accessible public transport systems (that is, installing ramps and wheelchair stations in buses and underground stations) could be more efficient than providing cash disability benefits. In Afghanistan, for instance, wheelchairs are generally not available except in the main cities and well-operating public transportation systems or paved roads rarely exist (Tirani et al, 2011). Therefore, the provision of these public services, in addition to flexible employment opportunities catering to diverse disabilities may more justly contribute to the improvement of people’s capabilities, in comparison to targeted social safety nets.

Non-contributory social assistances also target other vulnerable groups, such as orphans, widows, divorced women, and the elderly. Social assistance is commonly provided in the form of cash and in-kind transfers, school feeding programmes, housing benefits, non-contributory health insurance, healthcare benefits, and food and energy subsidies.

Yet, public policies should expand beyond the non-contributory social assistance, such as employment-based or contribution-based social security programmes, which function based on the idea of eliminating the main causes of poverty rather than simply relieving them.

In addition to provision of basic services and flexible employment schemes, community-based public service projects, which create jobs for the poor in local communities, can also be a solution to achieving poverty reduction. The related projects first aim at improving the skills of deprived groups by providing necessary trainings and then employing them in newly created jobs, such as childcare workers, school nutrition workers, school caretakers, school clerical workers, cooks, gardeners, food security workers, and construction workers.

Considering gender inequality in employment, rising female literacy and educational attainment has not translated into an increased level of female labour force participation in the majority of countries in the MENA region (Assaad et al, 2018). Thus, it is also critical to enforce equal opportunity laws, regulations and necessary interventions for women’s empowerment.

According to a recent World Bank report (2019), women are still banned from working in specific industries in some MENA countries. In fact, working outside the household premises is sometimes assessed as an immoral behaviour for women. Compared to men, women generally bear the burden of unpaid housework, including taking care of children, the sick and elderly relatives. Therefore, social and economic policies are required to mitigate this burden towards gender justice in the region.

Missing data and unmeasured dimensions

While the shift to multidimensional poverty assessment is crucial, it is important to note that there is a general lack of information about people’s attitudes and views on other unmeasured social dimensions. These could include psychological and physical wellbeing, freedom of mobility, freedom of expression, social connectedness and isolation, social norms and cultural values. Such dimensions are generally lacking in commonly cited and used surveys such as the Household Income, Expenditure and Consumption Survey (HIECS).

For that reason, policies aimed at reducing multidimensional poverty should focus on various types and dimensions of deprivation simultaneously. The impact of these policies should be evaluated, using sophisticated datasets, to understand what works and to identify the reasons and mechanisms for decreasing the level of multidimensional poverty. The related datasets should cover all important dimensions of poverty, in addition to variables related to material possessions.

This column was originally published by Alternative Policy Solutions at the American University in Cairo. Read the original article.

Views and opinions expressed are those of the authors only and do not reflect the opinions of The American University in Cairo or Alternative Policy Solutions.

Further reading

Alkire, S (2007) ‘The missing dimensions of poverty data: Introduction to the special issue’, Oxford Development Studies 35(4): 347-59.

Alkire, S, P Conceição, A Barham et al (2019) ‘Global Multidimensional Poverty Index 2019: Illuminating Inequalities’, United Nations Development Programme and Oxford Poverty and Human Development Initiative.

Anand, S, and A Sen (1997) ‘Concepts or human development and poverty: A multidimensional perspective’, In Poverty and Human Development: Human Development Papers, United Nations Development Programme: 1-20.

Assaad, R, R Hendy, M Lassassi and S Yassin (2018) ‘Explaining the MENA Paradox: Rising Educational Attainment, Yet Stagnant Female Labor Force Participation’ (No. 11385, Institute for the Study of Labor (IZA).

Koç, AA, O Ozdamar and P Uysal (2017) ‘The Economic Determinants of Food Security in the MENA Region’, International Journal of Food and Beverage Manufacturing and Business Models (2(1): 1-19.

Marks, S (2009) ‘Health, Development, and Human Rights’, in: A Gatti and A Boggio (eds) Health and Development toward a Matrix Approach, Palgrave Macmillan: 124-39.

Ozdamar, O, and E Giovanis (2016) ‘The Effect of Survivors’ Benefits on Poverty and Health Status of Widowed Women: A Turkish Case Study’, Journal of Applied Economics and Business Research 6: 232-50

Ozdamar, O, and E Giovanis (2017) ‘The causal effects of survivors’ benefits on health status and poverty of widows in Turkey: Evidence from Bayesian Networks’, Economic Analysis and Policy 53: 46-61.

Samuel, K, S Alkire, D Zavaleta, C Mills and J Hammock (2018) ‘Social isolation and its relationship to multidimensional poverty’, Oxford Development Studies 46(1): 83-97.

Sen, AK (1985) Commodities and Capabilities, North-Holland: Elsevier Science.

Sen, AK (1999) Development as Freedom, Oxford University Press.

Trani, JF, P Bakhshi, N Bellanca, M Biggeri and F Marchetta (2011) ‘Disabilities through the Capability Approach lens: Implications for public policies’, Alter 5(3): 143-57.

UNICEF (2019) Health in MENA.

World Bank (2018) Expectations and Aspirations: A New Framework for Education in the Middle East and North Africa.

World Bank (2019) Women, Business and Law.







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