This guide assists communities, governments, and civil society organizations to apply Quality Improvement (QI) methods to services for orphans and vulnerable children (OVC). The guide outlines the key steps that organizations can follow to develop evidence-based standards for delivery of OVC core services and improve the quality and impact of OVC programs. The guide also describes other QI strategies that can support the implementation of standards, such as effective supervision, monitoring, process improvement, and developing networks of providers to facilitate rapid sharing of innovations and improvements. Appendices include a description of core OVC services, illustrative OVC services standards, the Child Status Index (CSI) tool, materials for organizing a workshop to develop OVC service standards, and a case study for use in training program staff in how to assessing OVC services using the CSI. The Facilitator’s Guide to Establishing OVC Service Standards is a joint publication of Pact and the USAID Health Care Improvement Project.