This research study uses a sociological and anthropological approach to compare the implementation of Niger's national free health-care policy in three health-care districts. The results show how support from a non-governmental organization proved critical to the success of one district's policy implementation. In districts lacking such support, the policy's implementation remains riddled with problems and its impacts limited as shortages of medicine and a lack of funding hamper healthcare workers' ability to provide care. This study also shows the adaptation strategies that stakeholders use to work around challenges as they roll-out the policy.