Government Engagement & Reform Design
We turn complex challenges into a shared vision and roadmap for reform – driving stronger alignment and lasting outcomes.
We turn complex challenges into a shared vision and roadmap for reform – driving stronger alignment and lasting outcomes.
We look across end-to-end delivery to find bottlenecks and expand what already works, making sure strategies solve real-world problems.
We translate key findings into practical plans – helping leaders prioritise workstreams, set realistic timelines, and lock in ambitious targets.
We unite political, programmatic, and financial stakeholders around a single vision and the practical plan needed to pull it off.
April 9, 2026
3 min read
In late 2025, a senior health official in Sokoto was shown a series of photos from a local health clinic. He saw a rusted delivery bed and a room with…
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March 10, 2026
3 min read
In July 2025, a senior public health leader in Kano, Nigeria, sat before a screen flashing red. The data revealed an uncomfortable truth: two urban ar…
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February 23, 2026
3 min read
In a remote village in the DRC, I recently slept in a health centre 200 km from any urban hub. My goal was to see what was really happening on the gro…
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February 3, 2026
4 min read
Children and adolescents living with HIV in Nigeria face a six- to eight-fold higher risk of developing cervical cancer. Protecting them against HPV –…
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November 24, 2025
4 min read
When we began working with the Government of Sindh on maternal and newborn health, the challenges were daunting – overstretched facilities, unreliable…
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November 13, 2025
4 min read
When we began work in Punjab, Pakistan in 2014, one in eleven children died before their fifth birthday – far worse than in Punjab, India, where focus…
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October 17, 2025
4 min read
Every day across Africa, women and children die from causes we already know how to prevent. The real challenge is not lack of innovation, but connecti…
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September 24, 2025
2 min read
Delivery can transform how governments achieve results, but its success is highly context-dependent. Across countries, some delivery efforts drive rap…
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September 5, 2025
2 min read
Delivery is often credited with driving rapid improvements, but do those improvements last? Can they survive changes in leadership, funding cycles, or…
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August 13, 2025
2 min read
At its heart, delivery refers to a set of approaches, tools, and guidelines used to help governments improve services for citizens. It’s about moving…
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August 13, 2025
1 min read
How do you get every school to be a good school? How, with thousands of schools and hundreds of thousands of teachers, do you get every lesson to be a…
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July 18, 2025
3 min read
In March 2020, the world locked down overnight. No pilots. No randomised controlled trials. Just bold action in the face of uncertainty. Because the s…
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June 6, 2025
4 min read
Adversity doesn’t stop leaders. It reveals them. When systems are strained and budgets tight, political commitment makes the difference between well-i…
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May 23, 2025
4 min read
Off the main stage at the World Health Assembly in Geneva, a small side event carried a big idea: What if crisis isn’t a setback – but the spark we’ve…
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April 25, 2025
3 min read
On World Malaria Day 2025, the call from the World Health Organization (WHO) is to Reinvest, reimagine, and reignite. The burden is felt heaviest in A…
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April 7, 2025
3 min read
On World Health Day 2025, the theme is healthy beginnings, hopeful futures. In light of increasing development sector spending cuts, Susan Mackay – He…
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September 12, 2024
2 min read
Pre-primary education has not always had the attention it needs to improve in low- and middle-income countries. It is time to turn a corner. Large num…
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August 19, 2024
2 min read
Labour services have not always been up to the standards needed for expectant mothers, but significant improvements are being made in low- and middle-…
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July 10, 2024
3 min read
Investment in primary education is falling short of targets in many low- and middle-income countries (LMICs). But there are proven strategies to turn…
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June 14, 2024
2 min read
Some of the world’s best organisations are seeing positive change by letting frontline workers take the lead in suggesting and creating solutions. Und…
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June 11, 2024
2 min read
Governments and donors often want to address major health and education issues with one large policy adjustment. But it is the small, daily, improveme…
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March 9, 2023
3 min read
The province of Sindh in Pakistan ran one of the largest Measles-Rubella (MR) vaccination campaigns, reaching around 20 million children in two weeks.…
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December 5, 2022
3 min read
Most governments recognise the need to improve health and education outcomes but fail to act. Data-driven advocacy led by local champions can help dri…
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August 9, 2022
2 min read
Have you ever thought you don’t understand the decisions ministers take? Sometimes they didn’t seem to really care about the people; other times it fe…
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July 5, 2022
2 min read
Northern regions in Ethiopia have been operating with reduced or disrupted health services. We supported regional administration and the government in…
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May 10, 2022
3 min read
Mozambique’s strong performance is gaining recognition regionally and internationally, despite initial constraints of vaccine supply, in-country deliv…
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February 22, 2022
2 min read
Here are a few insights I gained from my experience that I would like to share with the thousands of young public officials who have to make decisions…
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November 23, 2021
3 min read
Around 90% of children in sub-Saharan Africa cannot read a basic sentence by the time they turn ten. Often this is due to the poor use of evidence in…
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June 8, 2021
2 min read
Even before the Covid-19 pandemic, nine out of ten children in Sub-Saharan Africa were unable to read and understand a simple text by the age of ten.…
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May 12, 2021
3 min read
It can be challenging to provide consistent health services in urban slums, which often contain populations with some of the lowest levels of access t…
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May 11, 2021
3 min read
The rollout of the Covid vaccine is unlike any other. For most public officials involved, it will be the most complex challenge they will ever face in…
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May 10, 2021
3 min read
To help reduce the rate of under-immunised children in Mozambique, the government launched new digital supervision tools to help manage service delive…
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