English | Français
First-hand accounts from over 1,800 health workers reveal global patterns of inequity
From Trinidad to Togo, from Nigeria to Pakistan, health workers report strikingly similar patterns across continents: wealthy patients receive prioritized treatment, rural communities lack essential services, and marginalized populations—particularly women—face systemic barriers directly affecting health outcomes.
“In our hospital, people who appear wealthy or more educated receive faster and more polite service,” explains a nurse from Nigeria. “This leads to poor health outcomes as some people would rather not seek medical care than face discrimination.”
These firsthand accounts from practitioners working in resource-constrained settings will take center stage at an upcoming global learning event hosted by The Geneva Learning Foundation. With over 1800 participants registered from more than 70 countries, the event will connect those experiencing healthcare inequities with those positioned to change them.
A new kind of global dialogue between research, policy, and practice
“When we share what we see in our work, we can learn together,” notes one participant from DRC.
What makes the upcoming event unique is its approach to bridging divides between those who plan health systems and those who implement them. “This is not just another webinar on equity,” explains Reda Sadki, the Foundation’s Executive Director. “We are creating a dialogue where frontline health workers can directly share insights with global policymakers and researchers – perspectives that might otherwise never reach decision-making tables.”
- For researchers, the event offers unprecedented access to communities affected by research practices.
- For policy makers, it provides a reality check on how high-level commitments translate to ground-level implementation.
- For practitioners, it offers validation and practical tools to address challenges they face daily.
“Research funders and institutions have significant power to reshape research culture,” adds TGLF’s Deputy Director, Charlotte Mbuh. “Those who join this conversation will gain practical tools to translate their equity commitments into action, particularly in regions where top-down approaches have struggled to gain traction.”
Economic injustice is interwoven with multiple inequities: Health workers document bias across borders
“I witnessed an elderly woman being ignored at the hospital despite arriving before others. Despite her frailty, she was sidelined while younger, well-dressed patients who spoke fluent English were attended to promptly,” shares Joseph Ngugi, a public health specialist from Kenya.
After intervening in this situation, Ngugi helped implement a fairer queuing system that dramatically improved patient satisfaction and trust. His experience is one of over 100 stories submitted by health workers, revealing how bias affects healthcare delivery worldwide—and what communities are doing about it.
The experiences shared by practitioners reveal how bias operates across national and cultural boundaries. In Cameroon, Basile Ngontcha describes witnessing two new mothers detained at a health facility because they could not pay their medical bills.
“They were forced to work as hospital cleaners, washing laundry and making beds of other patients,” he reports. The situation was only resolved when media exposure prompted an anonymous donor to cover their expenses.
Financial exclusion appears repeatedly in practitioners’ stories. “The poor patients are left behind,” notes a nurse from Democratic Republic of Congo, while a doctor from Pakistan states bluntly: “There is no equity especially in the private sector because of poverty.”
Gender, geography, and poverty: A troubling intersection
These financial barriers intersect with other forms of marginalization. Dr. François Acakpo from Benin explains how geographic isolation disproportionately affects women’s health outcomes: “In my district, many communities do not have access to care. Pregnant women cannot access antenatal consultations, children miss routine vaccination, and the sick are left to their sad fate.”
In Madagascar, Dr. Orimbato Raharijaona points to the “non-motivation of health personnel” due to “small salaries, unsatisfactory living conditions” as a fundamental obstacle to quality care.
Marion Mutange, a community health worker from Kenya, notes that even with government insurance programs specifically designed for women, vulnerable populations still struggle: “Even if they have what we call in Kenya ‘Linda mama,’ which is an insurance cover for expectant mothers, they still cannot afford other important things for her and the baby such as proper hygiene and nutrition.” This example highlights how programs focused solely on gender—without addressing poverty, nutrition, and other factors—fail to fully meet women’s comprehensive needs.
“This event creates a unique space for health workers to analyze these experiences through multiple, intersectional lenses,” explains Charlotte Mbuh, Deputy Director of The Geneva Learning Foundation. “What might seem like isolated incidents are revealed as systemic patterns once practitioners begin sharing across contexts.”
Beyond gender analysis: A comprehensive framework to move from insight to action
The special event will introduce participants to the BIAS FREE Framework, a practical tool developed by Margrit Eichler and Mary Anne Burke to identify and eliminate social biases in health research and practice. Unlike approaches that focus on just one dimension like gender or disability, this framework examines how multiple forms of bias intersect.
While many health programs now incorporate gender analysis—an important advancement—the event organizers emphasize that looking at gender alone misses critical issues affecting health equity. As Mbuh explains: “A person is never just their gender. They also have an age, a physical ability or disability, a tribal or ethnic identity, a location, an education, a wealth status, religious beliefs.”
The event emphasizes that while gender-focused approaches have been valuable, they can inadvertently reinforce other biases when gender is prioritized above all other factors. “When we focus only on gender, we might collect sex-disaggregated data but continue to treat male experiences as the norm” says Mbuh. “We might improve women’s access to services without questioning why systems were designed without women in mind.”
“If we treated everyone exactly the same way, we would have missed applying equity,” notes a health worker from Burkina Faso. “With equity, the specific needs of each person can be taken into account.”
This insight resonates with practitioners like Alain Dakam, who works with an international medical NGO. He describes witnessing discrimination against migrants in Niger: “While the host population benefits from relatively more fluid access to health services, migrants often face administrative, financial, and social barriers.” His team is responding by developing community outreach programs and training healthcare providers to recognize their own biases.
The Framework categorizes biases into three types: maintaining hierarchies, failing to examine differences, and employing double standards. “By giving people language to describe these patterns, the framework can help practitioners move from frustration to practical solutions,” explains Reda Sadki, Executive Director of The Geneva Learning Foundation.
Intersectional approaches generate more effective local solutions
Dr. Youssou Mbaye from Senegal shares a solution that acknowledges multiple dimensions of community experience. When a health campaign was struggling, he took a different approach: “After a situational analysis, I decided to tour 33 villages to directly meet the populations and community leaders. We took the time to clearly explain our strategy… At the end of this journey which lasted 3 days, the mass drug distribution campaign recorded its best results during the last 5 years.”
This example illustrates the event’s core premise: when interventions recognize communities as complex entities with multiple overlapping identities and experiences—not just defined by gender or a single characteristic—they achieve better outcomes. Mbuh explains: “When someone belongs to multiple groups, their problems are not just added together—they multiply and create unique challenges.”
Those interested in the special event can register through The Geneva Learning Foundation’s website at https://www.learning.foundation/bias
Participants will receive the complete BIAS FREE Framework and earn a certificate based on their contributions to the peer learning process. The event aims to build connections that help move from identifying problems to developing solutions that work in resource-constrained environments.
The Geneva Learning Foundation is a Swiss non-profit that connects frontline practitioners with researchers and policy makers through innovative learning approaches. This special event is part of an ongoing effort to create systematic pathways from principle to practice in global health equity.