Alethea is a senior program manager at Results for Development, where she leads monitoring, evaluation and learning within the Innovation team. She is also a specialist in gender equity, disability and social inclusion (GEDSI), and helps ensure a comprehensive inclusion lens throughout the Innovation team’s work. Collectively, she works to ensure that innovative approaches bring about equitable impact and are measured and learned from in ways that benefit the change agents involved and the wider ecosystems.

She has worked as a researcher, grant manager and technical expert on public health and gender equality, often with a focus on sexual and reproductive health. She has been a thought leader on menstrual health and has provided expert advice to multiple stakeholders — including UNFPA, ActionAid Malawi, Plan International, AmplifyChange and the Aga Khan Foundation — shaping policy and generating direct impact. For example, she recently guided the Aga Khan Foundation in Uganda to pilot and scale a first-of-its-kind menstrual cup project that produced tangible quantitative uptake results as well as rich qualitative insights. Throughout her work, Alethea has focused on bridging the gap between research and implementation, emphasizing how to capture actionable insights that drive tangible changes responding directly to localized problems.

Before joining R4D, she worked as an independent consultant, providing technical advice on monitoring, evaluation and learning to multiple INGOs and international development actors, including UK Aid Match. From 2020 to 2024, she was a senior technical expert in gender and social inclusion at MannionDaniels, serving on the senior management team. Her responsibilities included working directly with donors such as FCDO, the Dutch Ministry of Foreign Affairs, UNFPA and cross-donor partnerships such as the Global Evidence in Education Advisory Panel to ensure quality results and impact measurement within education, health and climate programming.

Alethea holds a master’s degree in public health from the London School of Hygiene and Tropical Medicine, a master’s degree in Middle East studies from the University of Oxford, and a bachelor’s degree from the University of Exeter.

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As a fellow at Results for Development (R4D), she is currently involved in R4D’s Access PDC project, which aims to strengthen country-led systems for equitable access to essential health commodities. Her role includes supporting stakeholder engagement, policy analysis and evidence generation to inform RMNCH product financing and delivery reforms at the federal and state levels.

Mariya’s past roles include chief of party for USAID’s Frontier Health Markets (FHM) Engage project at Chemonics International, where she led market-driven initiatives to expand access to quality health products and services through private-sector partnerships. Previously, she was technical director for RMNCH on the USAID Global Health Supply Chain Program (GHSC-PSM), managing a portfolio of nine states and pioneering approaches to improve RMNCH product availability through sustainable drug financing and end-to-end supply chain visibility.

Her earlier leadership roles at the Palladium Group and FHI 360 contributed to strengthening Nigeria’s primary health care systems, implementing state-level health financing mechanisms and advancing policy reforms that have shaped reproductive health programming nationwide.

Mariya holds an M.Sc. in reproductive and sexual health research from the London School of Hygiene & Tropical Medicine and an M.B.B.S. from Ahmadu Bello University. She is a recipient of the 120 Under 40: New Generation of Family Planning Leaders award from the Gates Institute.

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Access to essential medicines and other health products is fundamental to achieving Universal Health Coverage (UHC) and improving population health. But recent shifts in global financing — including the reduction of donor support — have exposed the fragility of many domestic systems, resulting in stockpiling, shortages, and inequitable access to life-saving commodities.

Results for Development’s (R4D) recent analytic work revealed that these challenges stem not only from insufficient funding, but from deep systemic disconnects. Without addressing these underlying system weaknesses, simply allocating more funds or trying to ringfence funds with budget lines will not ensure that essential medicines reach those who need them.

Ensuring sustainable, equitable access to essential health commodities requires governments to act across multiple, interconnected domains. They must:

• Set priorities for which services and products to fund
• Forecast needs based on population health and demand
• Shape markets to ensure high quality products are available at affordable prices
• Allocate resources effectively within budgets
• Align payment and pricing systems so that financial flows support reliable supply
• Ensure funds flow smoothly through financing arrangements to reach product suppliers and health care providers
• Procure and distribute products efficiently to the point of care

When any one of these links breaks down, it can cause cascading effects across the system — resulting in stockouts, inefficiencies, and high out-of-pocket costs.

R4D’s Integrated Approach: Bridging Health Financing, Market Shaping and Supply Chain

R4D has long been a leader in both health financing and market shaping, two fields that have often evolved separately. Recognizing the need for a new, integrated perspective, R4D has brought these areas together to understand how their interactions and linkages to supply chains can make or break access to essential commodities.

This intersectional approach was at the heart of R4D’s multi-country rapid assessment, conducted in Ethiopia, Ghana, Nigeria and Tanzania with support from the Gates Foundation. The assessments mapped the critical connections between health financing, market shaping, and supply chain functions and policies — and highlighted where critical misalignments lead to inefficiencies and gaps that undermine access, but also where there are promising practices that can be built on and shared.

Four country-specific briefs, one overview brief and a full report, can be found below:

• Overview Brief — Building Integrated Systems for Financing Essential Medicines and Other Health Products: From Silos to Systems (4 Pages)
• Full Report — A mapping of domestic systems for financing essential medicines and other health products (33 Pages)
• Ethiopia Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (16 Pages)
• Ghana Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (15 Pages)
• Nigeria Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (17 Pages)
• Tanzania Brief — Opportunities to align supply chain, market shaping and health financing functions and policies (16 Pages)

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