For this report, our team examined the grantees’ reflections on their work using an equity and systems change framework to understand their challenges, their solutions to those challenges, and the overall impact of the solutions. The framework, adapted from FSG’s The Water of Systems Change, breaks down possible strategies for systems change into explicit levers (readily apparent approaches and strategies that can be leveraged for immediate and impactful change) and underlying levers (connections and ways of thinking that create the conditions for change) that were employed by grantees in their work. The following sections of this report describe the strategies grantees used for systems change in relation to these levers and their reflections on next steps and sustainability. (author abstract)