The governance of national care systems for orphans and vulnerable children in Cambodia, Uganda, Zambia and other low and formerly low-income countries: Findings and implications

• Millions of orphans and vulnerable children in low-income countries face abuse. • Many low-income countries have strong policies on the books. • But few governments give the issue priority or have strong care systems. • Increasing priority requires formation of national political coalitions. • Improving care requires building government capacity to exercise stewardship. 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.