The Global Alliance for Improved Nutrition (GAIN) and Wellspring Development designed and hosted a series of in-person and online consultations with partners of the Dutch Ministry of Foreign Affairs to examine challenges in improved the quality of the diets of population groups living in rural areas of Low and Lower-Middle Income countries. These groups still largely consume unhealthy or even nutrient inadequate diets and face heavy burdens of malnutrition. This fourth paper looks specifically at the challenges of delivering impact at scale. The aim of the discussions was to gather examples of successful project interventions, to understand the decision processes of different organisations,