Reproductive Health Strategy

I was working with a senior program officer at the Buffett Foundation in 2019 who had just completed Stanford’s Executive Design Bootcamp. She wanted to use what she learned to create a multi-sectoral funding strategy for increasing safe abortion access across Nepal. Years later, this is still one of my favorite projects I’ve ever worked on.

I had joined the Global Programs team as a grant analyst a few months prior. We were a very lean team (I was the eighth hire!) managing a $300M annual portfolio across dozens of countries. It was all hands on deck, and a remarkable place to learn the field from the inside. The team held one clear conviction: that lasting public health strategies had to be built with government leadership and a real understanding of the local system, never imposed as a parallel funder agenda.

As we dove into Nepal’s funding strategy formation, I first turned to the data. I synthesized data from sources like WHO, World Bank, and Global Financing Facility, conducted health service delivery cost effectiveness modeling, and traced funding between partner organizations in the country. Equipped with the data, we traveled to Nepal, where these analyses fed into a series of design sprints with health providers and NGOs across the country. We asked folks what they thought could revolutionize access and availability of maternal health services. We imagined what a world would look like with no constraints, and how we could move forward together given the vast cultural and geographic makeup of Nepal.

The product of these sprints was an $8 million multi-year funding strategy for safe abortion services across Nepal’s seven provinces. The Ministry of Health reviewed, recalibrated and validated the work, and took ownership of coordinating the partners who would carry it out. The strategy lived inside Nepal’s national reproductive health framework instead of beside it, built around a “vision of success” endorsed by the Ministry itself and policy objectives we’d co-created with grantee partners.

It was one of the first country strategies of its kind at the Foundation, and it became a model other program teams followed. It also gave me the opportunity to work directly with our emerging Government Engagement team, which focused specifically on providing technical support directly to Ministry of Health officials.