Atlantic Fellows for Health Equity brings together health professionals from around the world and across disciplines to build leaders, combat disparities and create community. Its mission is to develop global leaders who not only understand the roots of health inequities but also have the skills and courage to create more equitable organizations and communities.
Each year, fellows share their reflections through Equity Talks — short presentations that highlight their leadership journey and learning during the fellowship. We are proud to bring some of these insights to the BMJ Leader Blog audience.
The blog below was written by Nandita Thatte, a 2025 Atlantic Fellow for Health Equity.
To watch the recording of this talk, click here.
In global health, we love products. Guidelines are developed, research results are published, tools are created and commodities are procured. And it makes sense. Products can lead to impact. Global guidelines can change policies at the highest levels. Evidence-based interventions grounded in rigorous research have been shown to save millions of lives. Products are tangible. We can measure them. And what gets measured gets funded. And what gets funded gets sustained. But I believe there is something else that is equally important. Something quieter, less visible, and harder to measure. That is Process.
Process is how we get there. Process is how we build trust. Process is how we build and sustain the communities and networks that ensure the products we develop are actually used for impact.
I am currently a technical officer at the World Health Organization, based in Geneva. In my role, I lead a network of civil society organizations working in family planning and sexual and reproductive health and rights. And I believe that investing in process — in network building, in creating spaces, in prioritizing community engagement — is critical to ensuring that the products we develop reflect the lived realities of the communities we wish to serve.
Early in my time at WHO, I was involved in a research priority-setting meeting. The topic was family planning in humanitarian settings — a priority identified by global partners and donors. Most participants were academics from North America or Europe, with a few representatives from international NGOs. I pushed the organizers to include some of our network’s civil society partners based in the region where the research was expected to take place.
During the discussions, the international partners led much of the discussion. But finally, one of our local partners raised her hand from the back of the room. Increasing access to knowledge about contraception wasn’t really the issue, she said. Women in those settings already knew what injectable contraceptives were. They also knew that injectables were what traffickers gave to young girls before trafficking them so that they wouldn’t get pregnant.
Then another local partner spoke up. In the camp where she worked, she explained, pregnancy was perceived as protective. Women believed that being visibly pregnant made them less likely to be raped or assaulted.
The room was silent for a few moments as everyone, myself included, sat with these shocking statements. These were perspectives that many had never heard, let alone ever considered. The focus of the research shifted after that, but the experience stuck with me.
Imagine if those partners hadn’t been in the room? We may have produced another well-intentioned study, possibly even several publications. But those results wouldn’t have been relevant to the people they were meant to serve. And they probably never would have been used.
This is why process is just as important as product.
You are probably thinking: ” Isn’t that obvious?” It is. But the truth is, the global health community still doesn’t do it. Donors, governments, and even the private sector are far more likely to fund the development of a guideline or a research study than to invest in building communities, creating spaces, or ensuring community engagement. These activities are difficult. Messy. And they are hard to measure.
But the consequences of not investing in processes are real: guidelines continue to sit on shelves. Research results go unused. Evidence-based interventions fail to scale or be sustained. And when products don’t reflect the lived realities of communities — or don’t reach them at all — it is the most marginalized who suffer most.
Nowhere is this truer than in sexual and reproductive health and rights, a field that is deeply personal, deeply cultural, increasingly political, and one that affects literally every person on the planet.
Investing in process through network building, partnerships, and community engagement matters for many reasons. But I want to share three that I have experienced directly in my work.
First, it ensures that community needs and priorities are reflected in global guidelines and research. As the example above illustrates, meaningful participation at the design stage changes what questions get asked — and what answers are actually useful. Community engagement also helps address misinformation and enables more nuanced navigation of sensitive topics like sexual health, access to safe abortion or contraceptive services, where context is everything.
Second, investing in process generates critical insights into how products can be better disseminated and used. This can mean something as practical as ensuring materials are translated into languages other than English. Or it can mean working with communities to co-develop training approaches that incorporate locally adapted cultural practices such as storytelling, art, or theatre rather than imposing external formats that may not resonate or reach those communities in need.
Third, and perhaps most importantly right now: investing in process builds resilience that outlasts funding. In 2025, sudden and sweeping global funding cuts hit the sector hard. What’s striking is that it was local grassroots civil society partners — and the networks they had built — that kept the work going. Not because they had money. Most didn’t. But because they had invested in trust, in community connection, and in relationships built over years of process. When the funding disappeared, the infrastructure remained.
Investing in process isn’t just good practice or just the right thing to do. It is a health equity imperative. As we continue on our health equity journey in global health, I hope we can advocate — together — for investing in process as much as we invest in products.
Author
Nandita Thatte
Nandita Thatte is a Technical Officer at the WHO Department of Sexual Reproductive Maternal Child Adolescent Health and Ageing leading the Implementing Best Practices (IBP) Network, a consortium of civil society organizations focused on advancing SRH globally. She is a Senior Atlantic Fellow for Health Equity.
Declarations of Interest
Employee of WHO.