Disrespect for dignity is common and harmful. Over half of women giving birth in facilities worldwide experience mistreatment, and more than a third of Africans seeking medical care report being treated with little or no respect. The evidence strongly suggests that this matters — patients will travel twice as far and wait five times longer to be treated with respect, and respectful maternity care halves maternal complications and postpartum depression. This amounts to a profound broken promise by governments and development actors who proclaim dignity as a core value.

We aim to reposition dignity from an aspirational value to a practical experience of citizens encountering public systems. Dignity should be measurably felt, as a consequence of interventions and cultures at scale.

This report presents the evidence and analysis behind four foundational strategic decisions for advancing dignity in public services towards this goal. We draw on published academic evidence, 48 practitioner interviews, and quantitative data from authoritative international sources.

We conclude that:

• Dignity applies in many sectors – but health is the most promising for dignity partnerships now. A structured comparison across five candidate sectors — health, employment, education, social protection, and humanitarian — concludes that while all health possesses a particularly strong foundation for dignity-focused work. It is the only sector with validated measurement tools, WHO-endorsed frameworks, systematic reviews spanning hundreds of studies, and an active advocacy ecosystem that has translated evidence into institutional standards. No other sector offers comparable prevalence data, causal evidence on the consequences of disrespect, or scalable delivery infrastructure.
• A scoring framework applied to 37 low- and middle-income countries identifies four high-ranking countries: Kenya, India, South Africa and Ghana. We select Kenya and India because, among the top-ranked countries, we have the strongest existing relationships and networks. In a further scoring exercise, we identify the most promising states and counties there for exploring such partnerships.
• We diagnose a series of well-documented interlocking failures of systems that together produce indignity. Dignity is widely recognized in law, policy and rhetoric. Yet this recognition has not been operationalized through measurement, feedback and accountability mechanisms. Health workers operate under severe time pressure, volume-based performance targets, and hierarchical cultures that reward compliance over compassion, creating “benevolent indignities”. Interventions to date have been fragmented and subscale. Many people work on dignity, but they do not know one another.
• Therefore, dignity champions need community. A comparative assessment of six intervention models — training, coalitions, advisory consulting, certification, demonstration projects, and fellowships — concludes that fellowships for public sector health leaders offer the strongest pathway to durable change, and the best match for our diagnosis. The theory of change proposes that transformed leaders, equipped with evidence and embedded in a supportive community, can shift institutional cultures from the inside — moving dignity from a rhetorical commitment to a lived reality in the daily interactions that matter most to patients.

This is a moment for dignity. For all the progress the world has made, tens of millions of patients are still preventably dying. The politics of contempt is rampant, public service is being slashed, and health expertise is met with fear and doubt. New tech creates opportunities and dilemmas. There are leaders championing dignity right now. They need community and evidenced solutions, to really make change in their systems. That is the path forward, if we are to repair services, respect citizens and keep the lofty promises proclaimed in our value statements.

With USAID’s closure, thousands of programs have ended, resulting in real and immediate harm. Less visible—but potentially more consequential over the long term—is the collapse of the infrastructure that enabled development and global solidarity at scale.

Rather than attempting to resurrect the flawed systems of the past, we see this moment as an opportunity to build new, more effective and trustworthy models—ones that shift power, ownership, and accountability to local communities and governments.

GDI is exploring how to support the incubation of this localized infrastructure. We are interested in efforts that design for a world without donor-centered infrastructure, including:

• How value is delivered without donor-led supply chains. Approaches that rethink what is delivered, how it moves, and who is accountable—shifting toward locally owned delivery systems and stronger government leadership.
• How initiatives are financed when grants are not the backbone. Models that reconfigure incentives and cash flows through blended finance, cross-subsidization, subscription, or earned revenue.
• How coordination, learning, and accountability function without donor-funded platforms. Locally anchored data, governance, and feedback systems that replace externally imposed monitoring and reporting infrastructure.

We know we don’t have the full picture. We are eager to learn new ways of understanding and addressing the structural gaps emerging in this moment. These efforts may take many forms—product, service, or platform—what matters is their ability to function without reliance on traditional aid. This work is oriented toward system redesign, not funding replacement.

How GDI Engages: Where there is mutual interest, GDI partners with teams to incubate new organizations, platforms, or field-level infrastructure over time. This may include:

• Hands-on strategic and operational incubation over 12–36 months
• Organizational design, governance, and leadership support
• Support with talent, narrative, partnerships, and resource mobilization
• Modest seed financing

If you are actively building—or exploring how to build—new infrastructure in this context, we would welcome a conversation. Please reach out to us at reimagining@globaldevincubator.org.

“Migration is often framed as a crisis: When the issue makes headlines, it’s portrayed as a burden, threat, or tragedy, and almost always politically intractable. In reality, migration represents an opportunity and a solution, and it needs to be disentangled from electoral politics. Indeed, we are at the beginning of a multi-decade, global trend of human movement, a trend which can be harnessed to unlock tremendous good for the world. And while the world’s attention is on the most visible symptoms of today’s broken systems, a small but scrappy group of actors is already working to build a better future for people on the move, the countries that welcome them, and the countries they (often temporarily) leave behind.

To understand why we need more and better migration, start with a basic fact: Never in history has there been such a strong link between global income inequality and demographic differentials. If you are in a country like Uganda, with a median age of 16, you are likely to be poor by global standards; if you are in a country like Germany with a median age of 45, you are likely to be rich. For decades, the best predictor of economic prospects is the country a person was born in, accounting for nearly two-thirds of global income inequality. But the gulf between rich and poor countries has also become a gulf between old and young: Even countries in Africa and South Asia with high economic growth rates are still not generating enough jobs to keep up with the youth entering the workforce. Labor Mobility Partnerships predicts that by 2050, 590 million of the 1.4 billion additional working-age people in low- and middle-income countries will have limited employment prospects, even as youth in these countries have an unprecedented awareness of the standard of living on the other side of the global tracks. Throw in the disproportionate effects of climate change on subsistence livelihoods and the fact that workers are paid 10 or 20 times their current wages for equivalent jobs in high-income countries, and little wonder that hundreds of millions across the Global South aspire to migrate to the Global North.”

“Globally, significant strides have been made in recent years to expand affordable financial services to marginalized populations. Services such as low-cost microcredit and mobile money transfers have helped millions of people obtain loans, build credit, and benefit from an advanced, global financial system. Nevertheless, many refugees and other migrants in the Global North can encounter difficulties accessing financial services, due to inadequate identification, discriminatory business practices, and limited financial literacy, among other challenges. These barriers can prevent migrants from fully integrating into their host communities and can have wide ripple effects, given that a bank account is often essential to access formal employment, obtain housing, and manage expenses.

The landscape is uneven and differs for certain migrants in particular regions. For instance, the European Union is generally recognized as a global leader in financial inclusion, and EU regulators and financial service providers have offered lower fees and simplified onboarding processes to millions of displaced Ukrainians since the Russian invasion in 2022, helping these individuals access banks, credit cards, and other financial services. But other groups have tended not to receive the same accommodations, and many refugees and asylum seekers arriving in the region are financially sidelined. The 2014 EU Payment Accounts Directive, which grants refugees and asylum seekers the right to open basic bank accounts, has not been evenly implemented across the bloc. Furthermore, a 2017 study indicated that EU financial institutions lacked both capacity and willingness to serve refugees, even after 3 million asylum seekers arrived in Member States in the three-year period from 2015 through 2017. This reflects a broader tendency across many Western countries to be more receptive to certain groups of migrants over others, due to political leanings, public sentiment, geographic proximity, or other reasons. Globally, 75 percent of refugees and humanitarian migrants reside in developing countries, where access to formal financial services is even more limited.”

In every country, governments, donors, civil society organizations, corporates and young people have mobilized to address youth unemployment, with an increasing recognition that a suite of solutions ranging from demand-driven skilling programs to mentorship and entrepreneurship support will be needed to address the problem at scale. Appropriate mobilization of financing and associated mechanisms is acutely needed to fund these solutions at the scale of the challenge.

Importantly, a range of new models have emerged to address scalability, effectiveness and sustainability issues that often affect grant-funded programs. However, youth employment stakeholders lack familiarity with these financing solutions and have expressed the need for guidance on how and where to use these products. Finally, there have been limited opportunities for stakeholders to come together to share knowledge and coordinate interventions. The FinYouth report addresses these issues by:

1. Providing a comprehensive review of financing mechanisms for youth employment and entrepreneurship;
2. Identifying financing models proven to be the most effective, scalable and sustainable over time; and
3. Recommending products for stakeholders to consider launching and scaling in their markets.

As the first installment of this series, we spoke with two members of our US-based Strategy and Build team, Alizah and Ben. Within their roles, Strategy and Build team members support the design and implementation of new initiatives GDI works on, identifying opportunities and paths forward for the organizations. Some of the initiatives Alizah has supported include the Home Based Child Care Initiative, Usha Lesizalo, and the African Technical Apprenticeship Network (ATAN). Ben is currently working on People on the Move, Public Mind, and Justice Rising initiatives. Alizah and Ben both work to shape their respective initiatives, and their different backgrounds come together to create human-centered approaches to shape social impact at GDI. 

Alizah Merali, Manager, Global Development Incubator 

Problem-solving and creativity are key ingredients in social impact, and they’ve supported my experience in consulting projects and developing learning programs for children. 

In undergrad, I studied Health Sciences and Business, which provided me with a unique and complementary experience: I learned about the social determinants that drive health challenges for populations around the world while also developing a strategic toolkit on how to critically assess and solve problems in a data-driven, human-centered and financially-sustainable manner. I built on this skillset working at a private sector consulting firm, where I learned the importance of not shying away from multi-faceted problems and instead identifying what key information, resources, and processes are needed to solve a problem in a way that can be sustainable for all parties involved. 

I consider my degrees and private sector experience my “traditional career path”. However, during that time I was also increasing my involvement in a separate passion of mine: developing and delivering experiential learning programs for kids aged 6-12 to prepare them for an evolving future. I work with Apollo as a part-time Program Director to create programs that focus on teaching kids about world problems, future technologies, and life skills, helping them to apply their knowledge to solve problems individually and collaboratively.  

Developing and delivering learning programs for children involves considering their needs, interests, and developmental stages. As a Program Director at Apollo, I design programs with the end-user in mind, ensuring they are tested and refined based on children’s feedback, and are considered useful for creating long-lasting mindsets.

Our work at GDI focuses on improving life outcomes for vulnerable populations. My experience with Apollo has helped me approach social impact initiatives with empathy and design programs that are tailored to the specific needs and aspirations of the communities we aim to serve. This user-centered and participatory approach can lead to more inclusive and effective solutions, ensuring the most important voices are heard in the design and implementation of social impact programs. For example, in the Home Based Child Care (HBCC) initiative, GDI helps design and implement pilot programs in Kenya, India, and Rwanda to deliver outcomes that will impact children, women, GDP, and wider society. By gaining feedback in focus groups, interviews, and visits to parents, our team better understands lived experiences and uses our learnings to ensure a user-centered approach in pilot design and implementation.

Embracing the curious and creative mindsets of children helps me to infuse the social impact world with a spirit of innovation and open up possibilities for transformative change.

Additionally, working directly with kids gives me a front-row seat to their natural curiosity, creativity, and flexibility. These qualities often result in them questioning existing norms and assumptions – they have a knack for asking “why” and challenging the status quo. This is an inspiration in itself and serves as a reminder in my daily work to elevate these qualities in our approach to designing social impact initiatives. I can step into the shoes of an inquisitive and imaginative 8-year-old and ask myself – What are the out-of-the-box, unconventional solutions that we can explore to address social challenges? What is the status quo (e.g., entrenched beliefs, biases, and systems) and how can it be challenged to address the root causes of social problems? Embracing the curious and creative mindsets of children helps me to infuse the social impact world with a spirit of innovation and open up possibilities for transformative change.

Ben Savonen, Manager, Global Development Incubator 

I was struck by how many of the tech companies trying to hire us were focused on developing solutions to incrementally improve the standard of living of the wealthiest of people but largely ignored everyone else.

I left college with a mechanical engineering degree, but no desire to enter the industries that most of my classmates were in. I was mostly struck by how many of the tech companies trying to hire us were focused on developing solutions to incrementally improve the standard of living of the wealthiest 10-20% of people but largely ignored everyone else. 

In the years following, I was driven by a desire to see the field that I had naturally fit into (engineering) better leverage itself in support of social impact. For much of the last 12 years, I have bounced back and forth between working within development/humanitarian initiatives and going back to engineering school (MS in environmental engineering and Ph.D. in mechanical engineering), trying to bridge the spaces between tech innovation and social impact wherever I could. In more recent years, after co-founding my company Kijenzi, I became more and more interested in how to apply some of the skills that I had picked up along the way in support of broader business models and strategy development rather than having just a strictly technology focus.

I’d like to think that my eclectic mix of experiences has made me adaptable and creative, being comfortable with the ambiguity that comes along with the launch of new projects and initiatives, and adding structure where there is none. While I don’t use much from my thermodynamics or kinematics classes day to day, I think the years of engineering education provided me with a strong set of analytical skills, critical thinking, and general practicality.  My Ph.D. work primarily focused on human-centered approaches to technology design and implementation, yet these perspectives are highly relevant for driving social impact more broadly.

When applying human-centered design in engineering, it revolves around understanding the mindset of the end-users who will utilize the widget or app you are creating. The engineer must not only ensure that the technology solves the user’s problem but also seamlessly integrates into their daily lives. It also means being very aware of all possible scenarios, as users may employ your product in unexpected ways or diverse environments you hadn’t foreseen.

At GDI, we coach initiative leaders to keep their target beneficiaries at the core of their business model, consider all possible outcomes, and collaborate with them in testing, prototyping, and incorporating feedback into their strategies. While some of our initiatives do have some technology-element (such as Public Mind’s AI-driven tools), most of our initiatives call for very different forms of innovation. For instance, my current collaboration with Justice Rising aims to develop pedagogy and school management frameworks for improving education outcomes in conflict zones. 

Though these frameworks we are building do not introduce entirely new products or practices, we have seen that most of the existing solutions on the market overlook the realities experienced by educators in conflict zones (i.e., they were not adequately designed with the user or their goals in mind). Thus, while this incubation does not require any level of technology development (at least in the traditional sense of the word), my skills and experiences with human-centered design, honed in an engineering context, still regularly come into play during GDI incubation as we define a more user-friendly solution.

India is in a unique place with a young population and steady economic growth. However, young people in India – especially rural youth – are still struggling to find productive work. GOYN’s report, “Rural Youth at Work – A Place Based Approach to Connect Young India to Economic Opportunity,” outlines a ‘place-based’ approach to connect these rural youth to dignified work so they can participate in and drive India’s economic growth, contextualized for rural India context.

Aceli’s Year 2 Learning Report reflects on their engagement with lenders in support of 713 loans totaling $85M to agri-SMEs across Kenya, Rwanda, Tanzania, and Uganda.

Key takeaways:

• Relative to Aceli’s pre-launch projections, we have shifted our approach to smaller loan sizes – this translates into lower capital mobilized on the one hand, but higher capital additionality and, we believe, a higher impact than envisioned.
• There is a need for increased evidence across the sector about what works in terms of both mobilizing finance for agricultural SMEs and how to steer capital to where it can have the greatest impact. Aceli and our learning partners are undertaking several studies to fill these knowledge gaps.
• Our initial experience suggests that shifting lending behavior among commercial banks (which collectively are the highest volume lenders to agri-SMEs but by no means the only ones) requires: i) senior-level commitment; ii) defined agriculture strategy; iii) empowered middle manager; iv) awareness and internal alignment across departments; and v) dissemination of the model and engagement at the branch level as well as headquarters.
• The response from lenders is palpable. In the words of Sabasaba Moshingi, CEO of Tanzania Commercial Bank: “Your vision helped us develop the appetite for ag. Previously, we would have been thinking twice before doing agri-lending. You guys are giving us courage.”