Healthlink Worldwide

Lessons Learned: Child-to-Child Approaches

The Child-to-Child approach involves children and adolescents in promoting the health and well-being of their families and communities. It is being used world wide to enable children to take an active role in preventing HIV infection in their peer group and in supporting children whose families are affected by HIV and AIDS.

Through Child-to-Child activities children find out how health and social issues affect their communities. They then plan what they can do, individually and as a group, to help solve these problems. By participating in this active way, children link health knowledge with their real lives. They develop life skills such as problem-solving, decision-making, and communication skills which help them to put their learning into practice.

Child-to-Child approaches aim to make learning about, and acting on, health issues enjoyable and interesting for children. They have shown that children can support the health and development of younger children while also having fun and learning themselves. Children can play a powerful role in influencing attitudes and behaviour amongst children of their own age, as well as in their families and wider communities.

Child-to-Child approaches are now used all over the world in formal and non-formal schools, at health centres, in youth groups – in fact, anywhere where children and adolescents gather together. Child-to-Child is a practical way to enable children to participate in making decisions and taking action in their families, schools and communities.

Child-to Child and HIV and AIDS education
Sexual health and HIV and AIDS are sensitive topics which many adults find difficult to teach. Yet everyone recognises that it is essential that young people know about these issues in order to make healthy choices and keep themselves safe. Adults need time to discuss and plan how they can help children and adolescents learn about these issues in an appropriate and effective way.

The most effective teaching starts with finding out what children already know and feel about a topic. Learning activities can then be based on the knowledge children have and on their creativity and ability to analyse situations. Children behave responsibly when we trust them and promote their self-respect and their respect for others. When used well, Child to Child approaches can help children to reflect on their own attitudes and behaviour and to then make positive decisions.

The six steps to learning and doing
Over the years, a model has developed for planning Child to Child activities called the Six Step Approach. The six steps in the model begin with children understanding about a topic or problem, and then finding out how it affects their own community. Then they plan and take action and, finally, evaluate their work.

For example, when children at a number of primary schools in Uganda wanted to support each other in coping with the impact of HIV and AIDS, they followed these steps:

• Step 1. Understanding the issue: Learning what happens to children when their parents or guardians have HIV and AIDS by reading and discussing stories and newspaper articles.
• Step 2. Finding out more about how it affects their community: Children discuss with their friends in class or in the health club about the problems faced by themselves and other children in families affected by HIV and AIDS. Some children are directly affected in their own families. Other children know friends, neighbours, teachers and other people who are living with HIV and AIDS. School children visit those who have dropped out of school because their parents are sick or have died and learn about their problems and the help they need. They also find out what support is available for children from community-based organisations and local faith-based organisations.
• Step 3. Discussing findings and planning action: Children discuss what they have learnt and plan what action they can take to support each other at school and to help those children who are not able to come to school. They prepare posters, songs and a drama to show the situation of children affected by HIV and AIDS in their families. They also plan what practical help they can give to each other at school and to orphans and other vulnerable children who cannot come to school. The head teacher and Child-to-Child teacher provide support for the children’s plans.
• Step 4. Taking action: Children organise a special event for other children at school and for children and adults in the community, where they display their posters, perform their drama, teach their song to others and hold discussion groups. Their teachers support them in facilitating discussion with adults. Children tackle discrimination and seek to ensure that all children are included in learning and play activities at school and at home.
  Children also make contributions to a small fund that can be used to help fellow students who have difficulties in paying for expenses such as stationery. They motivate their families to help other children in need with food, clothing and emotional support. They also seek help from local organisations for material support for child-headed households.
  
• Step 5. Evaluating action: Children discuss about changes at school and in the community amongst themselves. They again visit the children who have dropped out of school to find out whether they now receive more support and understanding from other children. They discuss what further action needs to be taken and what they can do better.
  
• Step 6. Doing it better: Children continue with these activities using all opportunities, individually and as a group, to help each other to cope with the impact of HIV and AIDS.

In another example, children learned about the role of good nutrition in keeping people healthy and what it means for people who are sick, including those with HIV and AIDS. They found out from a health worker what food that was locally available at low cost would be particularly beneficial for people who were ill. They collected some of this food to show to their families or neighbours who had someone sick at home. They also learned about helping sick children by encouraging them to eat. After a few weeks the children got together to discuss whether they had been able to make a difference and began to plan what else they could do.

This active learning approach can be applied to any issue related to HIV and AIDS, including supporting each other to learn about HIV and AIDS and to make safe decisions, helping children who are bereaved, supporting children in child-headed households, and tackling discrimination so that all children are included in school and play activities.