Leaving no-one behind: focusing on women with the least social support

Current broad spectrum targeting efforts are failing to reach those who need the most support. An adaptive programming approach was employed to identify under-supported women and address the clustering of child death.


The emphasis on reaching every woman and every child within the Global Strategy for Women’s, Children’s and Adolescent’s Health by 2030 is laudable. But operationalising this commitment, and providing hard evidence that it is working, are key challenges for governments and development stakeholders alike. Current broad spectrum targeting efforts are failing to reach those who need the most support. These efforts focus on generalised categories of people, such as the disabled or people living with HIV/AIDS, or those who are vulnerable according to particular criteria, such as the poor or those living in deprived areas.

This blog piece shows how PRRINN/MNCH, a UK and Norwegian government funded health programme implemented in northern Nigeria between 2008 – 2014, used a more nuanced approach to identify the women who carry the highest burden of mortality. A Clustering of Child Death study found that the factors that had the strongest effect on child mortality were social, in particular women’s perceived lack of respect by and support from husbands and other family members. The programme approach was adapted accordingly to have a stronger focus on identifying and supporting under-supported women. PRRINN-MNCH’s experience highlights the importance of looking beyond generalised categories of difficult to reach or vulnerable persons. It also suggests that the collection of socially stratified data is key to leaving no-one behind.

The PRRINN/MNCH programme was funded and supported by UK aid from the UK Government and the State Department of the Norwegian Government. The programme was managed by a consortium of Health Partners International, Save the Children and GRID Consulting, Nigeria. The consortium included the Mailman School of Public Health at Columbia University, Ahmadu Bello University, Liverpool Associates in Tropical Health and the Health Reform Foundation of Nigeria.

Find original blog here.


‘Adjusting Health Strategies to include women and children with the least social support’. PRRINN-MNCH – Technical Brief (2013)



Cathy Green

Cathy Green

Cathy Green is Technical Lead for Community Health Systems, Gender and Empowerment. A social development expert with extensive experience in the health sector, she has 18 years of experience supporting the design, appraisal and evaluation of health systems strengthening, maternal, newborn and child health, reproductive and sexual health, primary health care, malaria, and eye care projects and programmes in Africa and Asia. She is a specialist in partnership development and engagement strategies.

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