Outline India conducted a multi-country delivery review for the Global Alliance for Improved Nutrition (GAIN) to assess how recent organisational and structural changes affected programme delivery. The engagement combined organisational diagnostics and research methods, reviewing budgets, planning systems, team structures, and results frameworks while consulting over 20 stakeholders. Insights were consolidated through systems-mapping and leadership sessions to identify enablers and barriers across people, processes, culture, and structure. The outcome was a comprehensive report and a practical change roadmap with recommendations on leadership, planning, budgeting, learning systems, and KPIs to strengthen accountability, efficiency, and long-term impact.