This article synthesizes findings from a research project on the governance of national care systems for orphans and vulnerable children (OVC) in low-income countries. The article is based on case studies of Cambodia, Uganda and Zambia, and supplementary evidence from a scoping review of peer-reviewed literature. Evidence from these studies reveals that while the countries under study have strong policies on the books, the governance of OVC care systems—including commitment, leadership, coordination, and capacity—is a different story. Few governments prioritize the care and protection of OVC, resulting in minimal public funding, weak implementation, and heavy dependence on international and non-state actors for resources and service delivery. Adverse sociopolitical and historical circumstances underpin these governance problems, including a legacy of exploitative colonial regimes, weak states that lack service delivery capacity, and kinship care that is eroding. Improving OVC care and protection requires fostering government capacity to exercise stewardship over national systems. Above all else, improved care and protection requires that actors concerned about the well-being of OVC—including involved government agencies, legislators, civil society organizations, international agencies, and the families of affected children—form political coalitions to press states to act.
