Botswana is a nation in transition, evolving into one of the wealthiest nations in Africa largely as a result of expansion of diamond and copper mining. Despite this growth, the nation also faces a number of serious threats to child and family well-being. The greatest of these is the HIV/AIDS epidemic that has ravished the nation for the past three decades. The nation also exhibits high rates of poverty, lack of access to essential services, and high maternal mortality rates, especially in rural areas. Policy approaches to child and family issues reflect both the considerable threats that the nation faces and the growth in resources and social supports that have accompanied economic growth. This chapter describes examples of macro-level policy approaches to addressing issues impacting child and family well-being and discusses further policy needs in relation to critical national issues impacting children and families.