The authors present a framework for assessing a company's social and environmental performance based on four levers businesses can use to create impact: (1) the products and services the company develops or sells, (2) the customer segments it targets, (3) changes in operations, and (4) how profits are used. They explain the levers in detail, highlight links to the legacy concepts of ESG and impact investing, and identify tools for assessing a company's performance in each area.

In the summer of 2018, Richard Bbaale sat in a rural village in Uganda, looking over a banana plantation. He recalled the inspiration behind BanaPads as he contemplated what to do next. It had been 10 years since he had founded the non-governmental organisation (NGO) to help women and girls in rural settings overcome the challenges of menstruation - challenges that he had witnessed first as an older brother to his sister and then as a teacher at an all-girls' school.