Building healthy families involves not only the choice of institutional pathways but is also rooted in specific values and cultural traditions. Drawing on case studies from China, the United States, Brazil, and Thailand, this paper systematically compares four distinct pathways to building a healthy family: top⁃level standard guidance, data science⁃driven, door⁃to⁃door delivery at the grassroots level, and endogenous growth within the local community. China excels in top⁃level design but faces challenges in sustainability and internalization. The United States unites consensus through scientific goals, yet struggles to overcome structural inequities. Brazil promotes equity through door⁃to⁃door services, but is constrained by funding limitations. Thailand achieves broad coverage through community volunteers, yet confronts pressure for professionalization. Healthy family construction requires the effective integration of the strategic forces of top⁃level design, the technical support of professional services, and the internal driving force of the grassroots society. China can draw on international experience and continue to focus on areas such as legal protection, regional responsibility systems, and the cultivation of community human capital. This will help promote healthy family construction from administrative mobilization to legal protection, and from meeting standards to internalizing behaviors.

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