Targeting health in deprived groups

Targeting the worst off children

This project included an extensive analysis of Demographic and Health Survey (DHS) data to create new measures of human development outcomes – child mortality, stunting, access to water and sanitation – for urban, rural, boys, girls, bottom 40% by wealth, different regions and different ethnic groups.

The new measures are well suited for identifying groups of children who have poor life chances, and which are behind other children in the same country. Save The Children are using it to advocate for interventions to be targeted to those children that need help most.


Grace co-authored an academic paper and an advocacy briefing describing the database and including examples of how it might be used for targeting purposes.

The academic paper was published in Development, the journal of the society for international development, and the briefing presented at the 2014 United Nations general assembly.

Save The Children went on base a report called the Lottery of Birth on this work. It advocates targeting the groups of children which are furthest behind and thereby reducing inequality. Here is what the New York Times said about it, and here is the Gates Foundation blog.

Peer reviewers said

“I think this is a very useful paper.” Frances Stewart, Professor Emeritus in Development Economics, Oxford University

“I think the framing is absolutely excellent. The briefing paper is well written and sets out a very clear diagnosis of the problem allied to clear prescriptions. It powerfully captures the challenges posed by inequality, with a nice link to the post-2015 agenda.” Kevin Watkins, Executive Director, Overseas Development Institute


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