Botswana's 2008 National Guidelines on the Care of Orphans and Vulnerable Children define a vulnerable child as any child under the age of 18 years who lives in an abusive environment, a poverty-stricken family unable to access basic services, or a child-headed household; a child who lives with sick parents or outside family care; or who is HIV positive. Due to challenges in creating an effective response that corresponds to this broad definition, there are no available estimates of the number of children rendered vulnerable as a result of HIV, poverty, and other causes in Botswana. Since 2006, Task Order 1 of the USAID | Health Policy Initiative has worked closely with the Government of Botswana and USAID/Botswana to strengthen the OVC policy environment and improve access to high-quality OVC services. In 2010, the Health Policy Initiative, in partnership with the Department of Social Services (DSS) of the Ministry of Local Government (MLG), applied the Program Implementation Barriers Analysis (PIBA) tool in Botswana to assess policy-related barriers that affect implementation of the country's OVC program. The partners selected the OVC program because Botswana is in the early stages of implementing two new key policies to guide and strengthen the country's OVC program: the National Guidelines on the Care of Orphans and Vulnerable Children (2008) and the updated Children's Act (2009). This report describes the PIBA application in Botswana and shares findings and recommendations for strengthening implementation of the OVC program in relation to these policies. This analysis is intended to help inform and build consensus for ongoing efforts to draft a National OVC Policy and finalize the country's Long-term Plan of Action for Orphans and Vulnerable Children.