The objective of this chapter is to identify in a practical perspective what happens when private foreign enterprises bring knowledge and technology to local nonprofit community-based organizations with the view of scaling and growing their activity and identify what is needed for such mutual interactions to help with innovation and scaling of social ventures, namely involvement of end-users. Founders, end-users, and partners of two start-ups operating in Africa were interviewed over a five-year period in order to improve the understanding of the process of end-user inclusion in the innovation process. The research problematizes the field of social innovation by applying a critical view on the user and customer engagement in social ventures. It encourages more radical approaches and efforts, particularly in one of the innovation areas studied that concerns women’s health.