Scaling a Nurse-Led Model in South Africa

How we worked with Unjani Clinics to scale access to quality, nurse-owned primary healthcare across South Africa and test new ways to deepen impact.

Scale Strategy, Lean Testing| Health, Women’s Economic Empowerment | Sub-Saharan Africa

Unjani Clinic operates a growing network of primary healthcare settings, owned and led by mainly black women nurses, delivering affordable, high-quality care to underserved communities while generating employment and fostering local leadership.

Challenge

Unjani Clinic had a successful model and bold ambitions, with a goal of reaching 600 care settings across South Africa. But scaling further raised critical questions about direction, sustainability, and how to grow without overstretching a nurse-led workforce operating in underserved communities.

They needed clarity on where to focus, how to manage operational and financial risks, and how to strengthen their internal systems for the long term. They partnered with Spring Impact to align their strategy, address these challenges, and prepare for the next stage of scale.

272

operating

care settings

 

 

131,190

consultations

per month

 

 

50

new care settings

added each year

 

 

3

new ideas tested to widen

impact beyond care settings

 

 

Our Approach

To help Unjani Clinics scale sustainably and deepen their impact, our support spanned three years and focused on three key areas:

- Learning what works 
- Focusing and gaining strategic clarity for scale
- Refining the scale model and embedding what is core to achieve impact at scale

Designing for sustainability

We helped map the operational, financial, and workforce risks that come with Unjani Clinic’s audacious goal of operating at scale with 600 care settings. This resulted in a forward-looking plan to strengthen internal systems, make better use of technology, and engage key government actors to support long-term success.

Building Strategic clarity

Facilitated organisation-wide workshops to align Unjani Clinic’s leadership and operations teams around a bold vision for scale. This led to a clear direction and shared language for impact, which now guides decision-making and onboarding across the organisation.

Faster learning through testing

We introduced lean testing methods so Unjani Clinic could trial new ideas—like community screening and referral partnerships, without heavy upfront investment. This enabled rapid feedback and helped the team pivot early, based on what worked.

“Our greatest fear of “scaling too quickly” was allayed by the structured process followed with Spring Impact in helping map our path to scale.

Lynda Toussaint, CEO Unjani Clinics NPC

OUTCOMES

Clarity of vision – The team shares a bold vision for impact, helping them prioritise and stay focused as they grow. Being strategic about what to, and what NOT to focus on. 

Diverse Scale Model – Unjani Clinic developed a diverse scale model, aligning on how to have even more impact beyond care settings in a wide-reaching, sustainable and accessible way whilst also creating more impact for those they already reach.

Foundations for scale – Unjani Clinic identified key risks and created a plan for growth that includes workforce strategy, improved systems, and stronger government engagement.

Smarter innovation – New ideas are being tested and adapted through lean methods, helping the team learn fast and focus on what works.

NEED SUPPORT ON YOUR OWN PATH TO SCALE?

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