The social determinants of health approach focuses on factors – apart from biomedical care – that have linked poor health outcomes to questions of socio-economic inequality and social injustice. Social determinants of health are complex and can be difficult to measure; thus, more work needs to be done to support the actionable application of the social determinants of health into global health programming. One possible application is the Pathways vulnerability approach. The Pathways approach consists of a vulnerability framework, population-representative household segmentation solutions, and a set of qualitative stories and insights that bring the framework and the segmentation to life. The goal of this approach is to enable health system actors to stratify their users according to the social, environmental, and cultural vulnerabilities associated with poor health outcomes across a range of reproductive, maternal, newborn child health, nutrition, and women’s health and well-being outcomes. In this viewpoint article, we reflect on the role that we played using design methods to bring a more woman-centered approach to understanding how women are made vulnerable by the social and cultural systems in which they are embedded and the differentiated effect this has on specific health outcomes.