The traditional community and kinship structures are being eroded and families are under increased strain due to micro-economic forces driving social change: migration (resulting in absence of a father), chronic poverty, joblessness, food scarcity and illness. Previous research has linked paternal absence with adolescent sexual risk and suggests these adolescents suffer from less social support. Sibling-headed households comprise children of the same generation some of whom may be over 18 years of age. Child-headed households are a subset of this group whose members are all under 18 years. Reciprocity in the sense of mutual care, support, respect and valuing of the other are prioritised by adolescents in their relationships with parents. Several studies from diverse settings corroborate the importance of these parenting qualities, but the details of how these are achieved are poorly understood.