Lessons Lessons learned from OVC programs have revealed the need to improve service quality and to strengthen harmonization across partners around the questions: How can our programs make a measurable difference in children’s well-being? What are the essential actions that we all agree need to be part of a service to best to mitigate the impact of HIV/AIDS on children and families, in the pursuit of efficiency, effectiveness, equity, reach, and scale and sustainability? In response to the observed need to improve the quality of services provided to orphans and vulnerable children, in 2007, PEPFAR, through the United States Agency for International Development (USAID), sought to create a regional initiative to support countries and implementing partners in improving the quality of OVC programming. With support from the USAID Health Care Improvement Project (HCI), a regional OVC quality improvement initiative was organized. The initiative, which has come to be known as Care that Counts, has engaged national stakeholders, program implementers, and donor agencies throughout sub-Saharan Africa in improving the quality of OVC programming. 

This short report describes the efforts of the Care that Counts Initiative to support to implementers at the country level to:
1) Build constituencies and commitment for quality in OVC programming,
2) Develop OVC service standards through consensus processes involving key stakeholders, including children and their families,
3) Undertake quality improvement activities at the point of service delivery with community-based volunteers and organizations, and
4) Gather evidence that standards and other quality improvement approaches have a measurable impact.