Sparking Global Connections for Health Equity

AFHE Senior Fellows Ginger Ramirez (2017 cohort), Ana Cecilia Ortega (2021 cohort), and Zulema García Ulloa (2023 cohort) collaborated across Mexico and the Philippines to develop a trauma-informed children’s workbook designed for use in low-resource primary care and community settings. The project emerged from shared learning at the 2022 AFHE Convening on Displacement and Health in Thessaloniki, Greece, where fellows reflected on the disproportionate mental health burdens faced by children living in contexts shaped by poverty, violence, illness, and limited access to psychosocial care.

Children in marginalized communities are particularly vulnerable to adverse childhood experiences, yet child-focused mental health resources are often scarce or nonexistent at the primary care level. In response, Ginger, Ana, and Zule set out to create a practical, culturally adaptable tool that could be used by health workers and community practitioners to support emotional awareness, resilience, and coping skills among children ages 7–9. Grounded in trauma-informed and strengths-based principles, the workbook centers animal characters to create a sense of safety, universality, and inclusion across cultures.

The development process was intentionally participatory. The fellows conducted consultations with children in diverse settings, including rural villages in Chiapas, pediatric palliative care programs in Guadalajara, and deaf communities in Manila. These sessions informed the workbook’s narrative, visuals, and activities, ensuring that children’s perspectives shaped how difficult experiences, fear, comfort, and resilience were represented. Mental health professionals, educators, and community partners also provided feedback to refine the content, language, and flow.

Illustrated and piloted with children and practitioners, the workbook underwent multiple revisions to improve accessibility and usability—simplifying language, expanding opportunities for drawing and creative expression, and adding guidance for adult facilitators when sensitive topics arise. The final product is available in English and Spanish in both print and digital formats, with plans for broader dissemination through partner networks.

Mary Ajwang and Brigit Carter, both from the 2017 cohort, led a pioneering legal empowerment training for 124 health workers at Kawempe National Referral Hospital in April 2025. The need is urgent: Uganda’s maternal mortality rate remains high at 189 deaths per 100,000 live births (2022), with Kawempe alone recording 992 maternal deaths from 2016–2021—84% of which were preventable and mainly due to systemic issues like delayed referrals and limited resources.

Despite these systemic challenges, health workers are often wrongly blamed and face arrest. The training, delivered in partnership with Barefoot Law and the Uganda Law Society, focused on practical legal protections under the Ugandan Constitution, the importance of thorough documentation, and how to access emergency legal aid.

Participants highlighted the need for ongoing legal education and clearer guidelines to help them navigate complex risks and continue providing quality care. This initiative marked a critical step in equipping Uganda’s health workers with the knowledge and support they need to protect themselves and advocate for safer, fairer maternal health care.

In November 2025, Naglaa Fathy and Kate Daugherty from the 2021 cohort presented their collaborative work at the International Conference for Family Planning in Bogotá, Colombia. Their presentation, "Youth Equipped with the Knowledge and Skills Necessary to Make Healthy Life Choices: OSRA Program as Proof of Positive Community Change Towards Better SRH and Voluntary FP Choices," showcased the outcomes of an innovative community-based project that empowers youth and families to make informed sexual and reproductive health and rights (SRHR) decisions. Naglaa led the project in Egypt, and throughout the program, Kate visited Egypt and Naglaa's team three times.

They also participated in the pre-conference Youth Summit, "Voices, Evidence, Action: An Intergenerational Movement for All," which was a crucial space to network and share experiences working with youth around SRHR.

“For both of us, the youth conference offered the most meaningful opportunity to discuss the challenges programs all over the globe are facing in the wake of lost funding from USAID and other grants. It was invigorating to hear the creative ways other programs have been able to continue their work by shifting models and finding innovative funding opportunities.”