In our final chapter, we focus on the support needs of children and young people who care for parents with HIV and discuss local and global strategies and responses. The previous chapters have highlighted positive and negative outcomes of young caring for children, young people and parents and have analysed the structural, relational and individual factors that influence young people's caring roles in the context of HIV/AIDS. In this chapter, we discuss the implications of these experiences for the needs and requirements for support of families affected by HIV/AIDS. First, we examine the perspectives of young people, parents and service providers on their support needs in Tanzania and the UK. We discuss providers’ views of the development of services and support for this hidden group of young people and their suggested improvements to existing service provision. We explore debates about targeting support for children caring for parents/relatives with HIV, issues of disclosure of HIV status for accessing services, and providers’ views on whether efforts should be focused on preventing children being drawn into caring roles or on responding to children's support needs once they have taken on caring responsibilities. We also examine some of the limitations of service provision and the barriers to the development of services and support, based on the perspectives of young people, parents/relatives and service providers. The final section raises pertinent issues and concerns that have emerged from our findings in Tanzania and the UK in relation to policy responses to young caregiving in the context of HIV/AIDS and suggests future directions for policy and practice at the local and global levels.

Needs and requirements for support

In the context of experiences of extreme poverty among the majority of interviewees, most children and parents in Tanzania saw their practical needs predominantly in terms of financial and material support for the family, as Table 10.1 shows. Children's access to education and vocational training was identified as a key priority by most young people and parents. As Judith, one mother, commented: ‘I just wish my children could get as much education as possible. Equipped with a good education they will be able to lead good lives.’ Similarly, Neema emphasised the importance of education for young people's future employment prospects: ‘They should receive education. This is very important because when someone gets an education, they can manage their life.’