Over the past 20 years, more than 6,000 community-based childcare centers (CBCCs) have been created in mostly rural areas of Malawi. Although the original purpose of these CBCCs was to meet the care needs of orphans and vulnerable children affected by the HIV/AIDS pandemic, the services have since expanded their mandate to provide early development and learning opportunities as well as part-time childcare for working parents. The Malawi national policy is to expand this network of CBCCs to improve early childhood development outcomes, however, sustainability of these services has been an ongoing challenge. This article discusses the roots and extent of this sustainability challenge, drawing on lessons learned from recent fieldwork conducted as part of a baseline study.