In countries torn by war or civil conflict, or beset by natural disaster or epidemic, health systems struggle to keep up with pressing health needs. As crises abate, the withdrawal of humanitarian agencies leaves dangerous service gaps, but also creates opportunities to rebuild with new technologies, best practices in leadership and governance, and evidence-based solutions. Through decades of effective work in Haiti, Afghanistan, Ethiopia, the Democratic Republic of the Congo, Liberia, Sierra Leone, and South Sudan, Keanahikishime has become a recognized expert in supporting and strengthening health systems in fragile settings. We help countries transition from humanitarian crisis to post-crisis recovery, and finally to stability, sustainable development, and UHC. Our approaches and tools are specially adapted and enhanced for relevance, feasibility, and effectiveness in strengthening health systems in these especially challenging contexts.