In regions where infertility has long functioned as a social verdict rather than a medical condition, Dr. Rasha Kelej of the Merck Foundation has spent decades working to dismantle the invisible architecture of shame that keeps suffering hidden. Her 'More Than a Mother' movement recognized that no clinic or scholarship could reach people who had been taught to feel unworthy of care. By weaving together medical training, cultural diplomacy, and media literacy across 42 countries, she offers a model of leadership that treats the visible problem as only the beginning of the work.
Dr. Kelej on Breaking Infertility Stigma: Leadership Beyond Medical Training
Women and couples facing infertility experienced social stigma, discrimination, and isolation, particularly affecting women who were often blamed for a medical condition.
Lasting change rarely comes from solving only the problem you can see.
Mark
So the article is about infertility stigma, but it sounds like the real story is about how she thought about the problem differently than most people would.
Mimi
Exactly. Most organizations would have said: we need more fertility doctors. Build the medical capacity, train the specialists, and the problem is solved. But she kept asking why women weren't seeking care even when it was available. And the answer wasn't medical—it was social, cultural, religious.
Luke
That's a fair observation, but I want to be careful here. The article says she "witnessed" stigma in rural communities. Do we know the scale? How many women were affected? How much did attitudes actually shift as a result of the First Ladies partnership?
Mimi
Those are good questions. The source gives us concrete numbers on the scholarships—800 across 42 countries—which is substantial. But you're right that we don't have metrics on cultural change. That's harder to measure.
Mark
Why did she choose to work with First Ladies specifically? Was there research showing that approach would work?
Mimi
The source doesn't explain the reasoning behind that choice. It just says they partnered with them as ambassadors. It's a smart move—high-profile women with platform and credibility—but the article doesn't tell us whether it was based on evidence or intuition.
Luke
And the media training—how many journalists were trained? What changed in how infertility was covered? Again, we have the principle but not the proof.
Mimi
Right. The article is more about her philosophy of leadership than about measuring outcomes. It's reflective, not evaluative.
Mark
So when she says "lasting change rarely comes from solving only the problem you can see," she's talking about her own evolution as a leader.
Mimi
Yes. She's saying that's what she learned by doing this work. It's not a theory she started with—it's a conclusion she reached.
Luke
Which is honest. But it also means we should be cautious about claiming the movement "broke" infertility stigma. It addressed it. It worked on it. Whether it fundamentally broke it across the regions where it operated—that's a bigger claim than the source actually supports.
Mark
Fair point. But the fact that she's now teaching other leaders this approach suggests she believes it's transferable, that other people can learn from how she thought about the problem.
Mimi
That's the whole point of the mentorship platform. She's not just saying what she did; she's saying how she thought about it, so others can apply that thinking to their own challenges.
The Pulse
- Women across rural Africa faced not only the pain of infertility but communal blame, isolation, and discrimination — a social punishment layered on top of a medical condition.
- Cultural and religious resistance to fertility treatment created invisible walls that no amount of medical infrastructure alone could breach.
- The 'More Than a Mother' movement deployed over 800 scholarships to train local fertility specialists in 42 countries, building expertise where none had existed before.
- Africa's First Ladies, religious leaders, and trained journalists were enlisted as allies, shifting the conversation from shame to understanding at the community level.
- Dr. Kelej has now opened her leadership philosophy to a global audience through a free Substack platform, aiming to mentor women and young leaders across the Global South.
In regions where infertility has long functioned as a social verdict rather than a medical condition, Dr. Rasha Kelej of the Merck Foundation has spent decades working to dismantle the invisible architecture of shame that keeps suffering hidden. Her 'More Than a Mother' movement recognized that no clinic or scholarship could reach people who had been taught to feel unworthy of care. By weaving together medical training, cultural diplomacy, and media literacy across 42 countries, she offers a model of leadership that treats the visible problem as only the beginning of the work.
Dr. Rasha Kelej, CEO of the Merck Foundation, has published a leadership reflection on her work confronting one of global health's most entrenched challenges — not the absence of fertility medicine, but the stigma that prevents people from ever seeking it. Traveling through rural communities across Africa, she witnessed how infertility operated as a social catastrophe, with women routinely blamed regardless of medical cause, and entire communities resistant to treatment on cultural or religious grounds. She concluded that medicine alone could not solve what culture had constructed.
The 'More Than a Mother' movement she built was designed to work on every layer at once. More than 800 scholarships trained local fertility specialists and embryologists across 42 countries, creating expertise in regions that had never had it. Simultaneously, the foundation partnered with Africa's First Ladies as community ambassadors, engaged religious and civic leaders in dialogue, and trained journalists to report on infertility with accuracy and sensitivity. The result was not a medical program with messaging attached, but an integrated ecosystem where clinical capacity and social acceptance grew together.
Kelej frames this as a core leadership lesson: lasting change demands engaging not just the obvious problem, but all the invisible layers surrounding it. She has since launched a broader mentorship platform — 'Beyond Power; Leadership, Global Influence and Impact' — freely accessible on Substack, drawing on 32 years in global health to guide the next generation of leaders, particularly women and young people across Africa, Asia, and the Global South.
Dr. Rasha Kelej, CEO of the Merck Foundation, has published a leadership article examining how she approached one of the most intractable problems in global health: the stigma surrounding infertility. The piece, titled "Leadership Beyond the Obvious: How I Worked to Transform Fertility Care and Break Infertility Stigma," reflects on her work creating and directing the "More Than a Mother" movement—an initiative that began with a simple observation: the barriers preventing people from accessing fertility care ran far deeper than the absence of trained doctors.
Kelej's insight came from direct experience. She traveled to rural communities across Africa and witnessed firsthand how infertility functioned as a social catastrophe, particularly for women. In many places, women were blamed for infertility regardless of the actual cause, facing discrimination and isolation from their communities. Some regions harbored cultural or religious resistance to fertility treatment itself. These encounters convinced her that any meaningful intervention would require working simultaneously on multiple fronts—not just medicine, but also culture, communication, and belief.
The "More Than a Mother" movement reflected this layered approach. The foundation distributed more than 800 scholarships to healthcare providers from 42 countries, training local fertility specialists and embryologists in regions where such expertise had never existed before. But Kelej understood that training physicians alone would accomplish little if women and couples remained too ashamed or afraid to seek care. So the movement expanded its scope. The foundation partnered with Africa's First Ladies to serve as ambassadors, leveraging their influence to shift community attitudes. It engaged ministries, religious leaders, and community figures in conversations about infertility. It worked with local media societies to train journalists and media professionals in how to report on infertility with accuracy, sensitivity, and responsibility.
What emerged was not a medical program with a communications component tacked on, but an ecosystem designed to function as a whole. Medical capacity and social acceptance were built in tandem. Kelej framed this as a fundamental leadership lesson: lasting change rarely emerges from solving only the visible problem. A leader must identify the many layers surrounding it and work on all of them at once. In this case, that meant recognizing that infertility was simultaneously a medical challenge, a cultural barrier, a communication problem, and a source of deep human suffering rooted in belief systems that required respectful engagement rather than dismissal.
Kelej has now launched a broader mentorship and leadership platform called "Beyond Power; Leadership, Global Influence and Impact," available through Substack. The platform is designed to be freely accessible to aspiring leaders, particularly women and young leaders in Africa, Asia, and countries of the Global South. Through it, she shares insights from 32 years of work in global health and development. The leadership article sits within this larger effort to mentor the next generation of leaders by examining not just what she accomplished, but how she thought about the problems she encountered and the unconventional approaches she took to solving them.
Notable Quotes
Leadership meant looking at the problem from every direction. If there were no trained specialists, we had to build medical capacity. If stigma prevented women and couples from seeking care, we had to change perceptions.— Dr. Rasha Kelej
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