Demand for social protection is growing in low income countries and fragile situations. In recent  years, the success of social protection (SP) interventions in middle income countries (MICs) like  Brazil  and  Mexico,  along  with  the  series  of  food,  fuel,  and  financial  crises,  has  prompted  policymakers in low income countries (LICs) and fragile situations (FSs) to examine the possibility of  introducing such programs in their own countries. Flagship programs in countries as diverse as  Ethiopia, India, Pakistan, and Rwanda have shown the adaptability of social protection interventions  to the LIC context. Yet, despite growing levels of support for these initiatives, many challenges  remain. In LICs and FSs, governments are confronted with a nexus of mutually reinforcing deficits  that increase the need for SP programs and simultaneously reduce their ability to successfully  respond. Governments face hard choices about the type, affordability, and sustainability of SP  interventions. The paper reviews how these factors affect SP programs in these countries and  identifies ways to address the deficits. It supports the establishment of resilient SP systems to  address specific needs and vulnerabilities and to respond flexibly to both slow and sudden onset  crises. To achieve this, both innovation and pragmatism are required in three strategic areas: (i)  building the basic blocks of SP systems (e.g., targeting, payments, and monitoring and evaluation);  (ii) ensuring financial sustainability; and (iii) promoting good governance and transparency. These  issues suggest the possibility of a different trajectory in the development of social protection in LICs  than in MICs. The implications for World Bank support include the need to focus on increasing  knowledge  and  operational  effectiveness  of  SP programs,  fostering  institutional  links  between  multiple SP programs, and using community capacity and technological innovations to overcome  bottlenecks in operations.