Scaling Solutions
How we turn proven innovations into sustainable national systems by working with governments, communities, and markets.
The challenge
Many child health programmes achieve strong results in pilots — then stall. They rely on short-term funding or parallel delivery systems that disappear when programmes end. The impact disappears with them.
Max Foundation addresses this by designing solutions that are built for scale from the start — strengthening the government institutions, communities, and markets that sustain child health outcomes long after a programme ends.
Our approach
Designing for scale, not just for success
Our Evidence for Scale approach ensures solutions are effective, affordable, and capable of embedding in national systems. Rather than scaling programmes, we strengthen the systems that deliver them. This means designing solutions that:
- Integrate into government planning and budgets
- Align sectors such as health, agriculture, and water
- Mobilise private-sector supply chains
- Use data and learning to continuously improve implementation
By addressing these factors early, promising innovations can move beyond pilots and reach millions of children.
The scaling pathway
From pilot to national scale
Max Foundation supports partners through a structured pathway. Promising solutions are tested, refined, and expanded — then embedded in local systems capable of sustaining impact independently.
What makes scale last
Four conditions have to hold at once
A solution only stays in place after support ends when governments, markets, communities, and evidence all carry part of the load.
Governments lead and sustain
We co-design with governments from day one. When a programme ends, the government owns it — and the health gains continue. This is what makes scale possible.
Markets ensure long-term access
By supporting entrepreneurs and supply chains for nutrition, WASH, and sanitation products, communities can access essential goods on their own terms.
Communities drive demand
Community mobilisation creates lasting ownership. Families adopt healthier practices not because they are told to, but because they see the results in their children.
Evidence shapes every step
Our Evidence for Scale approach means continuous learning. What works is documented, shared, and scaled. What doesn’t is adapted early — before it reaches national level.
Proven in Bangladesh — stunting halved
The Healthy Village approach halved stunting rates in rural Bangladesh over five years, based on more than 500,000 measurements of over 75,000 children. The study was published by the Karolinska Institutet in the journal Children. This evidence base is now being applied together with the Government of Ethiopia to develop and scale a national model for ending child stunting.
Example in practice
Ending malnutrition in Ethiopia:
systems strengthening in action
In 2015, Ethiopia made one of Africa’s most ambitious child health commitments: to eliminate child stunting by 2030. Formalised as the Seqota Declaration, this is a government-owned, nationally funded strategy to end chronic malnutrition.
In Ethiopia, Max Foundation works directly with the Government of Ethiopia through the Seqota Declaration. Together, we co-designed the Malnutrition-Free Healthy Village model as a blueprint for national scale-up. The approach integrates nutrition, WASH, maternal and child health, behaviour change, and local market development. Critically, it works within existing government systems — not alongside them. Improvements outlast any single donor cycle. The model is now being prepared for national scale-up across regions as part of Ethiopia’s national strategy.
How it works in practice
Government partnership
Co-designed with the Government of Ethiopia. Aligned with the Seqota Declaration. The Malnutrition-Free Healthy Village will be scaled to 115.5 million people by 2030.
Model woredas
Through model woredas, the approach is continuously tested, adapted to local context, and prepared for national replication.
When child health interventions are designed for scale
- Governments lead and sustain implementation
- Markets ensure long-term access to essential health products
- Communities maintain ownership and demand
- Donor investments generate lasting national impact
Donor investments that generate lasting national impact
When preventive child health interventions are designed for scale from the start, every euro goes further. Governments sustain implementation. Markets maintain access. Communities maintain demand. Impact compounds — without perpetual donor dependency.