African population dynamics are experiencing important shifts with substantial implications for family structure and the vulnerability of dependent populations, especially children, elderly, widows, and disabled in the household. Changing African household structure and living arrangements are likely to have consequences on relationships within the households. The concentration of AIDS deaths in the reproductive age group has significant consequences on the family because most people in this age group are producing and raising young children. When parents of young children die, grandparents and other relatives are not only left with little support but also have to care for the surviving children. Grandparents are becoming the main caregivers to their grandchildren in the absence of the anticipated old-age support from their offspring. Unlike the Western world, Africa does not have adequate public health or financial support systems to supplement resources available to households to cushion the adverse effects of these new intra-household structures. In addition to the impact of HIV/AIDS, social changes associated with urbanization and economic downturns have weakened the traditional role of the family and extended family.
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