For nongovernmental organizations (NGOs) providing health service delivery in Sub-Saharan Africa, prioritizing learning and adaption, has become a necessity as they operate in challenging and complex environments. Organizational learning within these NGOs is increasingly seen as fundamental to improving development performance and impact. However, exactly what the theory of organizational learning means and how it translates into practice remain uncertain. Confusion also exists among NGO practitioners concerning what type of learning environment is most beneficial. Furthermore, NGOs often operate within a customary learning culture that favors action over reflection. This situation poses barriers to learning and has an impact on the ability of all actors (e.g., the organization, collaborative partners, and stakeholders) to reflect collaboratively and envision change. Reflection or reflective learning, often synonymous with triple loop learning, generally involves a process in which all actors step back and reflect on their underlying assumptions and goals. This paper proposes that certain organizational aspects contribute to the realization of triple loop learning within health NGOs: (1) leadership commitment and involvement; (2) a knowledge sharing system that provides for feedback and reflection for those working in the field and at the headquarter level; and (3) sufficient staff and budget to harness knowledge.