/ 23 July 2025

In the time of aid cuts, decentralise women’s health funding

Feature Image Healthcare At Home
Young people understand social media dynamics, peer-to-peer communication and community mobilisation in ways that can be used improve health services. Photo: Bulungula Incubator

As global health budgets tighten and an estimated 14 million people could die because of foreign aid cuts, the development sector faces difficult choices. Traditional models of development, particularly in women’s health, have long relied on well-intentioned but often paternalistic approaches and top-down intervention.

The current funding crisis presents an opportunity to address a fundamental mismatch: while young people comprise up to two-thirds of the population in many regions of the Global South, they remain severely underrepresented in governance and decision-making processes. 

This reality, combined with resource constraints, makes a compelling case for decentralising funding and placing resources directly in the hands of young entrepreneurs and innovators in local communities.

When it comes to health initiatives, young people bring distinct advantages: fresh perspectives, technological know-how and a commitment to social justice. They are less bound by established practices and more willing to challenge outdated paradigms; like those that have long overlooked the critical place for integrating psychosocial support and disability-inclusive approaches into their work. When it comes to women’s health, this translates to innovative approaches to menstrual health education, combating child marriage and addressing adolescent pregnancy.

Young leaders also understand social media dynamics, peer-to-peer communication, and community mobilisation in ways that can be leveraged for health promotion and advocacy. When we exclude them from leadership roles, we waste this potential.

When I founded She Writes Woman to transform mental health stigma across West Africa, I witnessed firsthand the transformative power of locally-led initiatives. With no mental healthcare at primary healthcare centres across Nigeria, and taking into consideration the specific barriers women face in accessing care, we understood that our communities needed access to quality care irrespective of location and a safe online community for education and engagement. So, we launched Safe Place Nigeria, a 24/7 toll-free helpline, free and unlimited teletherapy, and a digital community for mental health support. This wasn’t theoretical knowledge from reports — it was experience translated into action.

In my own work I take inspiration from a host of women and young people across Africa, Asia and the Middle East making meaningful change in their communities — advocating for healthcare capacity building and leading innovative solutions to the persisting health problems they are facing. These leaders don’t need foreign experts to tell them what their communities need; they need resources, support and the freedom to implement solutions they’ve developed from within.

Consider the remarkable work of Jaha Dukureh, who in her twenties played an instrumental role in the banning of female genital mutilation in The Gambia. Her success was rooted in her deep understanding of cultural dynamics, her ability to mobilise communities and her courage to challenge entrenched practices. This is the kind of transformative leadership that emerges when we trust local actors to drive change.

The most important shift required is recognising young people as essential leaders in women’s health rather than just beneficiaries. This means acknowledging that lived experience — whether of gender-based violence, disability, reproductive health problems or mental health conditions — constitutes expertise that no amount of external training can replicate. It means directing funding to youth leaders, recognising their existing initiatives, and creating long-term support rather than one-off interventions.

I’ve recently launched a scholarship to do just this. By providing grant funding up to $25,000 to ambitious young people working on women’s health problems in Africa, Asia and the Middle East, we’re putting resources directly into emerging leaders’ hands. The scholarship includes participation in the One Young World Summit and lifelong membership in its Ambassador Community, recognising that sustainable change requires both financial support and ongoing collaboration networks.

Decentralising women’s health funding isn’t just about efficiency or cost-effectiveness, though it delivers on both fronts. It’s about sustainability and respect for local leaders who understand their communities’ needs most intimately. It recognises that the people closest to problems are often closest to solutions, and that sustainable change must be owned and driven by those who will live with its consequences.

In a world of constrained budgets and complex challenges, backing local leadership isn’t just the right thing to do — it’s the practical choice. The young women leading health initiatives in their communities today are already creating change. Our job is to ensure they have the resources and support to lead.

Hauwa Ojeifo was selected by Melinda French Gates in 2024 as one of 12 global leaders to receive $20 million for her work on women’s health. Ojeifo is investing this funding in young leaders tackling the most pressing problems facing women and girls with The Hauwa Ojeifo Scholarship in collaboration with One Young World.