In China, where parents from rural areas work in urban areas as migrant workers, grandparents provide care to 19 million children whose parents are both away.54 Worldwide, as of 2013, approximately 18 million children under age 18 had lost one or both parents due to AIDS-related causes. However, such a pressing imperative can also result in limiting the choices of those who are expected to provide it. As the need for care evolves and alternatives such as state-provided services do not keep up, these expectations and traditional roles can further circumscribe options, unless structural shifts take place towards a more equitable sharing of such work.