The Positive Change: Children, Communities and Care (PC3) Program is a five-year (2004-2009) integrated and comprehensive program designed to provide care and support to more than half a million orphaned and vulnerable children and their families throughout the country of Ethiopia. The Program emphasizes community-based, results-oriented, and family-focused efforts which reduce the negative impact of HIV and AIDS on children, families and communities and increases capacity of local organizations and communities to positively respond to the needs of OVC. The primary motivation prompting the creation of the toolkit is to provide guidance, tips and resources for adapting the PC3 model both locally and internationally. This document provides a road map for OVC program implementation and at the same time offers suggestions and tools on evidence-based approaches which could be applied to facilitate rapid scale-up and effectiveness of services for OVC. Within this document are the building blocks necessary for fostering local expertise and commitment, generating and strengthening partnerships, and empowering communities to successfully respond to the needs of its youngest members affected by HIV and AIDS. The Toolkit is appropriate for use at the donor, policy and practitioner level. The donor community can use this Toolkit to help make informed decisions regarding investment of their resources. Policy makers, such as governments, could use it to inform decision-making regarding the package of interventions and services for OVC which would produce the desired outcomes. For practitioners, this document is a how-to for successful implementation of a comprehensive package of services and interventions which support and empower OVC and their caregivers.