The extended family is and should remain the key source of support for children orphaned by HIV/AIDS. When deprived of the opportunity to grow up in a supportive family environment, children receive less stimulation, individual attention and love and are ill prepared for life and healthy social interaction. Children who grow up outside families, whether living on the street or in institutions, often face discrimination and may feel unloved or excluded. In the worst cases, children who lose contact with their families can suffer physical and psychological abuse.

Among the approaches that can be adopted to strengthen the ability of families and communities to care for orphaned children are:

• Fostering the economic well-being of households caring for orphans, for example, by ensuring they are reached by social safety nets as well as poverty-reduction initiatives, including seed funding for small businesses, microfinance projects and methods to improve farming efficiency
• Offering children and their caregivers psychosocial counselling and support
• Improving caregivers’ childcare skills, especially in the area of early childhood development, and making community-based childcare available
• Helping parents to prepare their own wills and identify future careers for their children
• Enabling parents to live longer, better and in greater dignity
• Enhancing young people’s life skills, including how to avoid HIV infection