The paper starts with a discussion of the general context of growth and poverty across the region, exposure to risk or crisis, and the nature of vulnerability facing individuals, households and communities. We then examine the social welfare systems that exist across the region, illustrating varied approaches to the design and delivery of social protection, and suggesting some lessons that lower income countries might draw from their more developed neighbours. We go on to discuss the range of programmes and interventions currently being implemented and aimed at extending social protection to vulnerable and low income populations. The paper concludes with a discussion of achievements, gaps and challenges, and the possible role of different institutional actors – including international organisations such as the Ford Foundation – in meeting these challenges.