A doctor at the intersection of women’s health and economic power

As a child growing up in Nairobi’s Kibera, the largest slum in Africa, Dr. Stellah Bosire often woke up with a mission to search for odd jobs to help feed herself and her four siblings. On those mornings, the women in her community would track her down and make sure she went to school.

“[There were many] times when I would not go to school for one reason or another,” she recalls with a laugh, “I was marched off to primary school by these women!” These same women brought food when her mother was too sick to work, displaying a generosity that thrived despite the scarcity around them. “Every time one [woman] came to another’s home, she would never come empty-handed,” Bosire says.

As a young girl, Dr. Bosire endured deeply painful experiences, including sexual violence, underscoring the systemic challenges women in her community faced. She saw women forgo contraception out of fear of upsetting their partners. She saw her own mother, among others, forced to make difficult choices to feed their families, sometimes engaging in commercial sex work that exposed them to serious health risks.

She recognized the immense strength of the women around her and wondered what they could achieve if they weren’t forced into choices that jeopardized their health just to meet their basic needs. “Certain things were more of a priority,” Dr. Bosire says. “For us, it was just having a meal that day. Everything began and ended with: Can we eat today?”

A second chance that changed everything

Bosire knows firsthand how these tradeoffs could derail one’s future. At thirteen, struggling with inconsistent income from odd jobs, she began selling drugs at school. Within just two months, she was expelled. Depressed and isolated, she started using drugs herself. But at the end of the term, she learned that two teachers had fought for her to take her final exams.

With just two weeks to prepare, she studied intensely, cramming in a year’s worth of material. On the day the results were in, too afraid to check her results, Dr. Bosire asked her friend to run ahead and look for her. Before her friend returned, her teachers erupted into cheering and ululation, lifting her onto their shoulders in celebration—she had earned the second-highest marks in the school.

The experience shifted something in her. It gave her the confidence to believe in herself and her own power to shape her future. Later, when she enrolled at the University of Nairobi’s School of Medicine, she received a full scholarship. 

Transforming public health through an intersectional lens

Although Dr. Bosire lived on campus, her community was never far from her mind. Her roots in Kibera shaped her deeply intersectional view of medicine. “From [my] first year to sixth year [of medical school], I never looked at a patient and saw just a disease. I've always situated patients within a community.”

Even as a student, with barely a year of medical school under her belt, she was called back to Kibera frequently to care for those who had fallen ill, visiting at least once a month. “Anyone who got sick in the community, I would be called,” she says, laughing. “I would tell these people, ‘I'm still in my first year doing my preclinicals! I don't even know any medicine!’”

Her medical training emphasized treating disease but did not fully account for what she witnessed daily: the deep structural barriers preventing people from accessing care—what public health experts call the “social determinants of health.” These include economic instability, lack of transportation, and gender inequalities, all of which shape a person’s ability to access and afford care. “One of the primary reasons [people weren’t getting care] was because of poverty,” she recalls. Women attending clinics for preventing mother-to-child transmission of HIV would miss crucial appointments because they had to take last-minute work opportunities. Pregnant women arrived at hospitals in advanced labor because they lacked money for transportation, making it impossible to get care sooner. She realized that simply becoming a doctor would not be enough—she needed to address the systemic causes keeping her community from thriving.

Legal advocacy as a tool against gender inequality

After completing her medical degree, Dr. Bosire took on a leadership role as CEO of the Kenyan Medical Association, where she worked to influence national health policies through an intersectional lens. Her advocacy around gender and the social determinants of health helped shape Kenya’s healthcare system towards a more holistic model—one that considered the full context of patients’ lives. “My privilege around that position was to bring these realities to the table,” she says, emphasizing how she encouraged doctors across the country to integrate these insights into policy discussions.

She continued on this path of advocacy when in 2020, she pursued a law degree to advocate for healthcare as a human right and address the structural inequities that keep women vulnerable. She had already seen how legal frameworks could be a powerful tool for justice, having served as vice-chair for Kenya’s HIV Tribunal years earlier, where she fought for people—often women—who faced discrimination due to their HIV status. “This law degree is a weapon against injustice,” she says. “It equips me [with the tools] to dismantle the barriers that prevent women from accessing the care, resources, and opportunities they deserve.”

From microfinancing to women’s healthcare

As she rose to national leadership and expanded her work in global public health, Dr. Bosire remained deeply connected to her community. Four years ago, she brought the lessons she learned about the intersection of health, economic empowerment, and gender back to Kibera in a way that leveraged the community’s strengths.

Dr. Bosire recognized that improving health outcomes required creating economic opportunities for women. She developed a three-pronged approach: a microcredit lending circle paired with skills-building and financial literacy, weekly discussions on health and nutrition, and community dialogues to challenge restrictive gender norms. The lending circle model was particularly well-suited to Kibera, where, Dr. Bosire says, “There is ownership, there is community, there is familiarity, there is trust.”

She launched the initiative, called HerConomy, with a $13,977 grant from the Israeli ambassador to Kenya, using it to seed projects like sewing reusable menstrual pads, making soap and crafts, and professionalizing women-owned small businesses. Within a few years, the program expanded from 100 members to over 5,000 women.

HerConomy’s revolving fund can also be used for healthcare expenses, underscoring the truth that livelihoods begin with sound health. One woman took out a loan for early surgery on small uterine fibroids—an investment in her own health she couldn’t have afforded alone.

Even as the lending circle empowered women financially, gender norms still posed barriers. Some men resented shifting dynamics and even called Dr. Bosire “the homewrecker” when she visited Kibera. To address this, she invited men to community discussions, encouraging them to reflect on their experiences with gender-based violence and recognize how economic empowerment for women benefits entire families. Over time, their perspectives began to shift.

Many women in the program engage in multiple income-generating activities—running kiosks, making soap, selling juice. Some have scaled their businesses significantly: one is a welder, another owns a shoe company, and another employs rural artisans for her basket weaving business.

The women’s growing economic stability translates to better health outcomes for everyone around them—enabling them to do things like buy water filters to prevent disease or cook more nutritious meals for their families. “The men eat their food and drink their water too,” Dr. Bosire notes wryly.

Scaling women-led economic empowerment in Kenya

Seeing the impact women in her community are creating together, Dr. Bosire is now scaling that work. Her goal is to reach one million women in the next three years. She’s digitizing the experience, building a software platform where women can save, access funds, and build a credit profile for the formal banking system. 

She’s also fundraising to launch Kenya’s first women-led Savings and Credit Cooperative Organization (SACCO), linking similar women’s groups nationwide. Members will be able to borrow money at affordable rates to grow their businesses, invest in education, or meet personal needs.

Beyond focusing on small business owners, Dr. Bosire aspires for initiatives like Kenya’s women-led SACCO to uplift the country’s vast informal caregiving workforce, equipping women with skills and paid opportunities to better balance their caregiving duties. A woman providing unpaid caregiving, for example, might use a loan to take a first aid course, gaining a marketable skill while also becoming a valuable resource in her community. Dr. Bosire stresses, it’s not just about access to capital: “It’s about giving women ownership, independence, and the tools to build better futures for themselves and their families, while impacting their health.”

To Dr. Bosire, this is what true empowerment looks like—women not just surviving, but thriving. She sees a future where women in her community are celebrated for what they build and accomplish—not just for what they endure. “Our grandmothers and mothers were resilient,” she says. “I want to see women thriving!”