The HIV/AIDS epidemic continues to exact a staggering global toll; in Sub Saharan Africa 22 million people - two-thirds of the world’s total - are HIV positive. The prevalence of HIV infection among adults is over 15% in seven countries in the region, including South Africa, where 5.7 million people are living with HIV - 1.9 million of them newly infected in 2007 (UNAIDS, 2008). These high prevalence rates, especially among people in their reproductive years, coupled with limited access to health care in general and antiretroviral treatment in particular, have had a profound effect on children and families, causing increasing numbers of children to grow up without one or both parents. Nearly 4 million orphans and vulnerable children (OVC) are affected and/or infected by HIV and AIDS in South Africa (Proudlock, Dutschke, Jamieson, Monson, & Smith, 2008).

This case study documents the activities and services of one program, Childline Mpumalanga, working to address the needs of OVC, their families and communities. Since its inception in 2003, Childline Mpumalanga has sought to prevent child abuse and protect and promote the welfare of all children throughout Mpumalanga province. The program operates two major components, psychosocial support and OVC community development, in a collaborative approach to reach all children and families in Mpumalanga with essential services while also providing targeted programming for OVC. This report draws on lessons learned during Childline Mpumalanga’s program implementation in an effort to offer guidance for future programming efforts in South Africa and around the world.