That was another very tough leadership decision - maybe the toughest.
Living Goods began its journey in Uganda, where the need was undeniable.
High child mortality, low vaccination and family-planning coverage, fragile health systems.
We built our proof of concept there and it worked.
Two randomised controlled trials (RCTs) showed a 27% reduction in under-five mortality, achieved at remarkably low cost ($3–4 per capita). The second RCT, at scale and digitally enabled, proved that technology could help sustain quality.
We were proud and rightly so.
But pride can sometimes cloud perspective.
Even with strong results and generous philanthropic funding, we were still reaching only a small proportion of Uganda. And the pathway to real scale - through government - was still distant.
The question became inescapable:
Could we justify continuing to invest heavily in a country where the potential for sustainable scale was limited, while other contexts were ready to move faster?
After deep discussions with our board, team, and funders, we made the difficult decision to significantly reduce our investment in Uganda and focus resources where the potential for durable, government-led impact was highest - in Kenya and Burkina Faso.
It wasn’t a quick or reactive choice.
We planned it carefully, it was part of our strategic plan that kicked off in 2022 – but we only started the process in 2023, implementing through 2024 - well before the dramatic shifts in ODA funding that forced many organisations into sudden retrenchment.
Still, it was painful.
We had to let go of talented, loyal colleagues.
Communities lost access to some of the high-quality services we’d supported for years.
But we didn’t disappear.
We stayed active in two districts, continuing to generate data, demonstrate what good looks like, and influence the national conversation - proving impact at the level government looks at most closely - willing to play the long game.
I had to keep reminding myself, that fifteen + years after we started, the communities we had worked are stronger.
The systems are getting better even if very slowly.
And while the footprint is now smaller, the influence is much deeper.
I share this because scaling isn’t about loyalty to your starting point.
It’s about commitment to where the greatest potential for lasting impact exists.
That means making hard calls - not waiting it out, not hoping conditions will change, but giving your mission its best chance to endure.
It takes courage, clarity, and empathy - and the understanding that leadership is not about being liked, but about doing what’s right, even when it hurts.
💭 Where have you seen organisations hold on too long - or step back at the right time - in the name of lasting impact?
I’d love to hear how you’ve navigated those choices.
This is Part 2 of a three-part series on scaling for impact.
In the final post, I’ll explore another reality we often avoid - the real cost of scale: what it demands of leaders, organisations, and systems, and why being disciplined about value for money matters more than ever.
Warmly,
Liz
Strategic Advisor | Former CEO | Founder, Volante
Based in Kenya, available globally
