The authors' main objective of the study was to explore threats to maternal and child well-being in two nonriparian and two riparian communities in the east and west of the Okavango River Basin in Ngamiland District, Botswana. Primary data were collected from a simple random sample of 60 households. Data on women's access to human, financial, physical and institutional capital, productive assets and livelihood activities, household food resources, and social services (education, health, water, sanitation) were collected. Children's nutritional status was also evaluated. Our observations reveal that caregiving is gender biased toward women whose well-being is undermined by their limited access to resources. Further, women's poor access to basic household resources undermines gains made through clinic-based maternal and child welfare nutrition programs. In addition, a significant proportion of children's caregivers have access to low-tier primary health care provision in the study area, but inadequate physical infrastructural development limits their access to specialized care, particularly emergency obstetric services. Childhood malnutrition is also a concern in the study area, and it mostly affects children whose caregivers have limited access to resources. The authors conclude that improving maternal and child access to education and health services remains a challenge in the district. The authors recommend interventions that prioritize sensitive aspects of child well-being, early childhood education, and development.