The Vistaar Project was successful in providing strategic technical assistance to the Governments of Jharkhand and Uttar Pradesh in taking knowledge to Practice at scale. The project produced new evidence in health systems strengthening and advocated for further scale up of successful approaches. The Project experience reinforced that improving performance of frontline workers and supervisors is critical for quality MNCHN services and simple and cost-effective systems improvements can have significant impact on district coverage and quality of MNCHN services. Further, district-level ownership needs to be backed by support at state and national level for sustainability and scale-up. The documents and tools developed by the Project can serve as useful resources for Government of India and the state Governments for improving the MNCHN status in India.