As of 2014, according to the United Nations Children’s Fund (UNICEF), there were approximately 13.3 million children worldwide who lost one or both parents to AIDS and nearly 80 percent of those children live in sub-Saharan Africa. Many millions more were orphaned for other reasons besides AIDS. Adolescents who are orphaned and made vulnerable by HIV/AIDS are a large and growing population with numerous unmet needs. While the majority of orphans and vulnerable youth live with extended family members, some live in institutions, youth-headed households, or on the streets. While many programs and publicity efforts focus on young children, more than half of all orphans are in their teen years.

Orphans and vulnerable youth face particular challenges. First, the HIV epidemic has decimated the population of teachers, health care works, and other service providers that create strong networks of support for orphans and vulnerable youth. As a result, they have less access to education and health care, show more indicators of psychosocial distress, and face greater degrees of child neglect, abandonment, and abuse. They confront stigma, isolation, economic hardship, malnutrition, and an increased risk of HIV infection.

Research and programs have found that the following approaches can help these vulnerable youth:

  • Address the age-appropriate needs that adolescents have, paying particular attention to the different needs of boys and girls;
  • Provide information on reproductive health and HIV prevention services;
  • Provide psychosocial services;
  • Involve youth themselves, including those who are orphans or vulnerable, in providing services;
  • Help adolescents either stay in school or receive livelihood training; and
  • Develop large-scale partnerships to fund and develop broad-reaching programs and strategies. 

National Social Service Systems for Orphans and Vulnerable Children – Framework for Planning and Monitoring and Evaluation 

This MEASURE Evaluation-developed “guidance is intended for anyone with a stake in a country’s social service system. That includes stakeholders involved in planning, managing, or developing strategy related to social service systems and stakeholders that support the strengthening of social service systems and the delivery of services. Although we developed this guide with USAID’s and PEPFAR’s support, its audience is not limited to these agencies’ partners. Other donors and organizations providing technical assistance to social service systems may also find this guide useful for generating information for programs and policy. Similarly, government ministries, such as a ministry of social services, can use this guide to assess the status of their social service systems, inform planning, and make program and policy decisions. (Revised 2018)”

OVC Survey Toolkit 

MEASURE Evaluation developed indicators and tools with support from the OVC technical working group of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in order to “simplify and standardize the data needed to set measurable goals for an OVC intervention. Program designers and administrators can now answer questions fundamental to the planning and evaluation of OVC programs worldwide. (2016)”

Guidance for orphans and vulnerable children programming 

“The purpose of this guidance is to help PEPFAR country teams and implementing partners develop country operational plans (COPs) and design programs that support vulnerable children in their contexts, align with known best practice, and incorporate potential innovation. It seeks to aid teams in identifying and implementing appropriate, evidence-based, and cost-effective activities that will maximize improvement in the well-being of vulnerable children in the epidemic and close gaps in past programming efforts. Importantly, the guidance clearly places the OVC programming within the HIV/AIDS continuum of response at the country level.” This “document outlines in general terms strategic, evidence-based interventions that PEPFAR OVC programs can consider implementing based on assessed context and need. (2012)”

Measuring the Determinants of Childhood Vulnerability

A UNICEF Synthesis Report that identifies key determinants of vulnerability among children – including those affected by HIV and AIDS – that can contribute to developing an improved global measure of vulnerable children in the context of HIV and AIDS. Household wealth, a child’s living arrangements, and household adult education emerged as the most powerful and consistent factors associated with key health and social outcomes of child vulnerability. Orphanhood status and the presence of a chronically ill adult in the household are also significant for some outcomes. Orphanhood is significant for schooling, child labor, birth registration and DPT3 vaccine (2014).

Mothers Without Borders

Mothers Without Borders serves children in orphanages in Romania, Mexico, Guatemala, Ecuador, Nepal, and Bolivia and those living in the streets in Africa and India. Mothers Without Borders supports the efforts of local communities and nongovernmental organizations to address the needs of orphaned children.

Promoting Quality Education for Orphans and Vulnerable Children

This report documents 12 case studies in Kenya, Rwanda, Swaziland, Uganda, Tanzania, and Zambia that represent a wide range of approaches to addressing the educational rights and needs of orphans and vulnerable children.  As the HIV and AIDS epidemic becomes increasingly complex, and as the personal and social consequences rise, the ways in which societies respond to ensure children's right to quality education must become more integrated, nuanced, and dynamic (2009).


Orphans and Vulnerable Children Wellbeing Tool User's Guide

This tool, a self-reporting measure for individuals aged 13–18, was developed as an answer the elusive concept of wellbeing.  It was piloted during a comprehensive evaluation of orphans and vulnerable children (OVC) programs funded by the President’s Emergency Plan for AIDS Relief (PEPFAR) in Haiti, Kenya, Rwanda, Tanzania, and Zambia and refined after analysis of the results of that pilot. The tool is 36 questions long and takes approximately 20 minutes to administer.  Scoring can be done immediately or via a computer program.  Results can be used to monitor OVC programs over time (2009).

Toolkit for Positive Change: Providing Family-focused Results-driven and Cost-effective Programming for Orphans and Vulnerable Children

This document provides a road map for implementing programs for orphans and vulnerable children (OVC ) and offers evidence-based approaches and tools that could be used to help scale-up services and make them more effective. The donor community can use this toolkit to help make informed decisions about investing their resources. Policy-makers could use it to help determine which interventions and services for OVC would produce the desired outcomes (2009).

Missing: Children without Parental Care in International Development Policy

Research shows the number of children growing up without parental care is growing most rapidly in less developed countries. This report warns that failure to keep children in families, out of residential institutions, and off the streets, will be another barrier to the achievement of the Millennium Development Goals (2009).

Permaculture Design for Orphans and Vulnerable Children Programming: Low-cost, sustainable solutions for food and nutrition insecure communities

Permaculture is a promising development approach for addressing food and nutrition insecurity for orphans and vulnerable children, especially in areas of high HIV-prevalence. In the context of OVC programming, permaculture helps guide communities toward permanent solutions for food and nutrition security, while ensuring that these options exist harmoniously within their environment (2012).