Living in poverty has lifelong consequences for children. In response to the obvious needs of highly vulnerable, impoverished children and youth in its neighbourhood, Community and Family Services International (CFSI) commenced the Park Avenue Initiative (PAI) which was aimed at addressing the impact of poverty through promoting and testing community-based initiatives in child protection, youth development, and opportunity-creation. Building upon research into the reproductive health (RH) practices of young people in the area, the PAI was expanded to include a new programme addressing RH and the high risk sexual behaviours engaged in by many youth. This article critically examines how poverty is impacting on children. It presents the PAI RH approach as an example of a programme which addresses many of the multiple risks poverty presents for children. The PAI RH programme takes a holistic perspective to address the co-morbidity of poverty risk factors. The programme works with children, their families and the community. The article concludes that programmes need to take an integrated approach to address the multidimensions of poverty and engage with children and their families in actions which are aimed at building individual resilience and strengthening communities.