In her talk, Julie explores how many healthcare systems in Sub-Saharan Africa are trapped in a vicious cycle: low-quality care leads to low trust, low trust reduces willingness to pay, and without funding, quality does not improve. Her central argument is that trust is not a side issue in healthcare. It is the foundation that makes the whole system work.
Using the story of Grace, a pregnant woman living outside Dar es Salaam, Julie shows what this crisis looks like in practice. The real question, she argues, is not whether care exists, but whether women can trust it, afford it, and rely on it when they need it most.
She then presents how connected care models such as MomCare can begin to break this cycle. Through digital registration, shared health records, teleconsultation, and incentives for better-quality care, the system becomes more accessible, accountable, and patient-centered. The result is not only better outcomes, but growing trust.
Julie’s talk is ultimately a call to rethink global health not only in terms of medicine or funding, but in terms of the infrastructure of trust that allows care to reach people and truly matter. Julie Fleischer is a Dutch global health innovator, designer, entrepreneur and engineer working to improve maternal and child health systems in low-resource settings. She leads innovation for the PharmAccess MomCare program, which has improved financial access to and quality of care for over 100,000 women.
With a Master’s degree in Biomechanical Engineering from Delft University of Technology, Julie combines design thinking, data, technology, and partnerships to develop scalable solutions that strengthen healthcare delivery and financing for underserved communities. This talk was given at a TEDx event using the TED conference format but independently organized by a local community. Learn more at https://www.ted.com/tedx
