<aside>

Purpose:

This page sets out where GOAL 3 is heading: where IMPALA is used today, what positions it for growth and what could slow it down, how we plan to grow commercially and with the GOAL 3 Foundation, and the pathways through which additional funding turns into larger implementations.

How to use this page:

• Section 1 describes the current installed base and how implementations are delivered.
• Section 2 covers what positions IMPALA for further scale-up, and the challenges that may slow it.
• Section 3 sets out the business case and growth channels. Open the toggles for the commercial model, the Foundation's role and product expansion.
• Section 4 shows three pathways to scale, from single hospitals to national and regional programmes, with indicative funding levels for each.
• For how much additional funding GOAL 3 can absorb and at what pace, see Absorption capacity. For how the Foundation allocates philanthropic funding, see Scaling IMPALA Fund.

This page was last updated: October 6, 2026

</aside>

<aside>

1. Current installed base and delivery model

</aside>

IMPALA is currently used in approximately 60 hospitals across six countries (Malawi, Rwanda, Tanzania, Kenya, Gabon and Zimbabwe), covering around 900 IMPALA Monitors. Most implementations have been delivered by GOAL 3 together with local distributors as distributors carry out local distribution and installation. Additionally, local GOAL 3 teams in Malawi, Tanzania, Rwanda and Kenya provide training and ongoing service. Lastly, the international team supports them with logistics, technical back-end and quality assurance.

A growing share of the work now runs through partners. Local distributors, NGO implementation partners and hospital biomedical teams increasingly take on installation, first-line support and training coordination. GOAL 3 remains responsible for implementation standards, technology and quality assurance. This shift is deliberate: it lets delivery capacity grow without building a large field organisation in every country (see Operational absorption capacity).

Two lessons from the current base shape the scale-up approach.

1. Adoption differs by setting, because the same system beds in differently depending on ward type, staffing levels, leadership engagement and local clinical routines. For this reason every implementation includes structured onboarding and adoption follow-up, not delivery alone.
2. Training is continuous, as health workers rotate between wards and facilities, it is necessary to supply refresher training for sustained use. GOAL 3 provides this through ward champions, e-learning and the periodic support built into the service model.

<aside>

2. How well are IMPALA and GOAL 3 positioned for further scale-up?

</aside>

Six characteristics position IMPALA and GOAL 3 to grow from the current base.

• IMPALA fits within existing health systems and procurement structures. It strengthens the wards and workflows hospitals already have, and hospitals can buy it through normal procurement routes rather than a parallel programme structure.
• It can be implemented one hospital at a time rather than only through large programmes. This allows a phased roll-out in which costs decrease as economies of scale are reached.
• IMPALA is designed for its users. In surveys, 98% of users say they would recommend it, and in evaluated wards health workers reported spending about 1.8 instead of 3.3 hours a day on monitoring.
• Its cost-effectiveness (see Rethink Priorities Report and Funding impact: what one implementation delivers), potential cost savings and reduced workload give hospital managers, governments and funders concrete reasons to prioritise IMPALA within constrained budgets.
• GOAL 3's tech-enabled service model allows a small team to support a large installed base. It includes remote monitoring of system use, troubleshooting, e-learning and standardised implementation packages.
• GOAL 3 works within a strong partner ecosystem, including ministries of health in its core countries, large NGOs, distributors and research partners. This ecosystem brings both credibility and delivery capacity.

GOAL 3 currently sees four challenges that may slow scale-up:

• The business model is still new for many hospitals. Paying a recurring service fee for equipment is not yet a standard budget category, and building that habit takes time (see section 2.2 of Hybrid model explained).
• Continuous monitoring is not yet an established priority in many budgets and guidelines. Decision-makers weigh it against many competing demands, so the case still has to be made hospital by hospital and ministry by ministry.
• Regulatory landscapes and supply chains remain fragmented across countries, which adds cost and lead time to each new market.
• Recent global health funding cuts have reduced capacity at ministry level. This slows procurement and partnership decisions, even where the clinical case is accepted.

<aside>

3. Business case and growth channels

</aside>

GOAL 3 Social Enterprise plans its growth from a business case: the model we use to project growth and costs and to test our path to financial sustainability. The business case targets an installed base of roughly 3,000 IMPALA Monitors across approximately 200 hospitals in 2027. That is the point at which GOAL 3 expects to reach break-even, with the investment round planned for Q4 2026 bridging the period until then (see section 2.1 of Hybrid model explained). From there, our ambition is to grow to more than 2,000 health facilities by 2030: roughly 900 hospitals and 1,300 smaller health centres, across an expanding set of countries. These are modelled projections: they extend current results to new settings, including ward types and facility levels where evidence is still being generated, and actual outcomes will depend on local patient volumes and implementation effectiveness.

Since the business case was made, both the evidence and the delivery model have moved on. Clinical results from Malawi, Rwanda and Tanzania, and the independent assessment by Rethink Priorities, show IMPALA clearing every cost-effectiveness threshold tested, even under conservative assumptions (see Rethink Priorities Report). Unmet need for monitoring across the region remains high. Standardisation, digital training and the partner model have made implementation more scalable. GOAL 3 therefore sees room to reach more facilities faster than the business case assumes. Whether that happens depends on two things: the funding and implementation capacity described in Absorption capacity, and progress on the four challenges named in section 2.

3.1. Growth through the commercial model

3.2. The role of the GOAL 3 Foundation in these projections

3.3. Product expansion

<aside>

4. Pathways to scale

</aside>

IMPALA has been designed to scale from individual wards to entire hospitals and national health systems. Current implementations therefore represent a starting point rather than the full potential of each partnership. Three pathways translate additional funding into larger implementations:

• existing hospitals;
• government scale-up plans;
• regional partnerships.

Each can grow incrementally, adding wards, hospitals or countries as funding becomes available and building on existing infrastructure, implementation experience and local partnerships. Together, these three pathways mean GOAL 3 does not depend on a single route to growth:

• An additional $500,000–1 million can support hospital-wide expansion within a major referral hospital.
• Approximately $2.55–3.6 million can fund a first national hospital roll-out such as Rwanda's neonatal and paediatric phase.
• Larger multi-country investments can be absorbed through regional partnerships as individual country programmes become ready.

Absorption capacity sets out what each funding level unlocks and the constraints that determine its pace.

4.1. Hospital-level scale-up

4.2. National scale-up through the Government of Rwanda

4.3. Regional and international scale-up