A background paper developed in preparation of a conference on Family Strengthening and Alternative Care in sub-Saharan Francophone Africa, held 10–11 May 2012 in Dakar, Senegal, organised by Member agencies of the United Nations and several non-governmental organisations. The paper and individual country briefs were commissioned to examine the current status of family support services and alternative care in 18 sub-Saharan Francophone, four Anglophone and two Lusophone African countries (a total of 22 countries). This background paper represents a comparative regional analysis, providing an overview of the current situation and illustrating promising practices, opportunities and challenges. The background paper is a statement (as accurate as possible) of what exists regionally in relation to family support services and alternative care.