This study explores the efficacy of child-headed households in caring for orphans and identifies major roles and responsibilities of these children, as well as the underlying factors affecting childrenâ€Ÿs household capability and the role of key actors in the provision of care and support for child-headed households. A combination of quantitative and qualitative methods was employed. Despite what is currently known about the factors that result in children assuming the burden of household responsibilities, very little information is known about the efficacy of household-headed children. The findings of the study showed that child headed household orphans often grow up deprived of emotional and material needs and the structures that give meaning to social and cultural life. The distinctive nature of these problems obligated formulating clear policies and evidence based strategies which leads to complementary and synergy among various care institutions. It is often assumed that the presence of child-headed households in communities entails traditional social support system have wrecked down. In spite of multifaceted difficulties, the majority of child headed households appear to be well-adjusted and more responsible than others in their community. Children require support in the care of their siblings by the government and other stakeholders and much more decisive action is needed to ensure consistent care for child-headed households. Childrenâ€Ÿs capability of running households is imperative inquest which requires solution across multifaceted challenges faced by child-headed household.rnKey words: Efficacy; Child-headed households; Caring; Orphans in Addis Ababa