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Report based on a workshop on the proliferation, and expansion, in terms of impact and coverage, of orphan and vulnerable children (OVC) initiatives in east and southern Africa. Three levels critical to successful scale-up of activities were identified: community, facilitation, and policy/resource. The respective roles of community groups and CBOs, intermediary NGOs, government, international NGOs and donors are explored. Special consideration is given to the role of intermediary NGOs: those which provide technical and/or financial support to other NGOs/CBOs. Brief case studies are drawn on as examples