Women overwhelmingly benefit from context-specific, community-focused interventions.
The Trump administration’s recent attempt to freeze federal funding has sparked renewed debate about government efficiency and program effectiveness. While the freeze was quickly reversed following public outcry, it highlights a fundamental tension: how to balance fiscal responsibility with essential support for vulnerable populations. There’s a proven approach that could satisfy both imperatives: place-based programming.
Place-based programming focuses on aligning projects to specific locations—such as neighborhoods or regions—by addressing the unique needs and strengths of the people and environment there. This approach has been effective in tackling complex challenges, from reducing extreme poverty in Kenya to preventing mother-to-child transmission of HIV and empowering women in South Africa, while ensuring efficient use of resources through targeted interventions and reduced duplication of efforts.
As Nigerian medical doctors with decades of experience improving health in underserved communities, we have witnessed firsthand the challenges faced by women. Women often bear the brunt of these difficulties, serving as caregivers but lacking decision-making power in patriarchal societies. These experiences highlight the necessity of context-specific, community-focused interventions that maximize impact while minimizing waste.
A Lifetime of Challenges for Women
From birth, girls face obstacles to thriving. In some parts of the world, pregnancies are terminated due to societal undervaluation of girls. If born, girls may receive inadequate childcare, face barriers to education and be relegated to irregular, low-paying jobs in the informal sector. Throughout their lives, they navigate environments threatened with violence and discrimination.
Globally, progress has been made—governments build clinics closer to communities, laws empower women to open bank accounts and seek justice and initiatives aim to increase school attendance. Yet, these interventions often address isolated issues, neglecting the interconnected nature of challenges women face. This fragmented approach has delayed gender equality by 130 years, a gap likely to persist into the lives of today’s millennials’ grandchildren. Beyond moral failings, this carries economic costs—countries lose $172 trillion in wealth due to gender disparities in lifetime earnings. The urgency to act cannot be overstated.
Fortunately, successful models for addressing these challenges already exist. Below are three impactful place-based programs addressing localized challenges and empowering women, families and communities.
1. South Africa’s Mothers2Mothers (m2m)
In South Africa, women face disproportionate HIV risk, with prevalence twice as high among young women compared to men. The drivers of this disproportionate HIV prevalence among women include unfair treatment, violence, poverty and biological reasons that make them more at risk. m2m addresses these challenges through place-based programming that reduces HIV transmission rates while ensuring economic empowerment.
Working with the Mentor Mother Model, m2m engages local women living with HIV as community health workers to provide integrated primary health care services to women and their families. These services include HIV prevention, care and treatment, as well as education and screening for noncommunicable diseases, tuberculosis and malaria.
2. Kenya’s Hunger Safety Net Programme (HSNP)
In Kenya, 34 percent of households are female-headed, with rural areas facing higher poverty rates. Nearly 32 percent of the population lives below the food poverty line, unable to afford basic meals, while rural communities bear the brunt of these challenges.
The HSNP is a government initiative targeting Kenya’s most vulnerable households in arid counties like Turkana and Mandera. Through regular cash transfers, HSNP improves food security, reduces poverty and empowers households economically. Women-headed households, in particular, benefit by investing in income-generating activities and gaining financial stability. During crises like droughts, emergency payments help families recover quickly. HSNP’s focus on marginalized groups (the elderly and persons living with disabilities) ensures equitable support and strengthens resilience.
3. Rwanda’s Girinka Programme (One Cow Per Poor Family)
In Rwanda, where cattle and milk production have deep cultural significance, women play crucial roles in cattle rearing and milk production within the dairy value chain. It is within this contexts that Rwanda’s Girinka Program (One Cow Per Poor Family) operates. As a successful place-based program, the Girinka Program increases milk production by providing cows to vulnerable households, ensuring access to milk for both consumption and sale. This improves nutrition, particularly for children, by offering a regular source of protein and essential nutrients. Also, families generate income through the sale of milk, manure and calves, helping to reduce poverty.
While these programs face challenges, their success lies in the effective application of three principles. For instance, they embrace complexity and localization through a commitment to understanding how factors affecting women’s well-being differ by location and interact with each other. As a result, their scope crosses traditional boundaries between health, education and economic development—and considers each community’s specific needs and assets.
Also, they measure success differently by expanding measurement beyond just health, learning or income—to one or more of these dimensions to capture thriving, akin to the Gates Foundation’s Gender Equality Toolkit. A thriving woman has the autonomy, resources and societal support to make decisions about her life, body and future. While individual metrics like financial inclusion or property ownership matter, progress on any single measure isn’t enough.
Furthermore, these programs reflect a shift in funding from single-issue interventions to a focus on the interconnected results that bring us closer to ensuring every woman thrives, a classic example being Fondo Semillas in Mexico. Because money shapes behaviour, organizations then respond by collaborating across sectors towards results that really matter—women’s comprehensive well-being.
Reimagining U.S. Programs for Greater Impact
Recent uncertainty around federal funding for programs like WIC demonstrates both the vulnerability and importance of women-focused initiatives. Rather than broad funding freezes, the administration’s new focus on “government efficiency” could be leveraged to promote smart, place-based approaches. These approaches can actually save money by reducing duplication, encouraging institutional collaboration and ensuring programs reach those who need them most.
For instance, WIC could evolve beyond nutrition assistance to become a hub connecting local childcare providers, job training programs and educational institutions. This integrated approach, already proven successful in global contexts like Rwanda and Kenya, could deliver more value per federal dollar while better serving women and families. The Administration has an opportunity to demonstrate how efficiency and effectiveness can go hand-in-hand through place-based solutions.
Place-based programming offers a powerful framework for lasting change by tapping into local strengths, partnering across institutions, measuring what matters and addressing unique challenges.
