About Child-to-Child

Child-to-Child is an innovative educational methodology in which school-age children learn ways to protect the health and well-being of other children, especially those who are younger or have special needs. Child-to-Child was launched during the International Year of the Child, 1979. It is now used in more than 60 developing countries, as well as in Europe, the USA, and Canada. Many early Child-to-Child activities were developed in Project Piaxtla in Mexico, the villager-run health care program that gave birth to PROJIMO. Key to this adventurous approach was Martín Reyes Mercado, a village health promoter who worked with Piaxtla, and then with PROJIMO, for 2 decades. Martín now works with CISAS in Nicaragua, facilitating Child-to-Child throughout Latin America.

The Mission of Child-to-Child

Children can be either cruel or kind to the child who is different. Sometimes it takes only a little awareness-raising for a group to shift from cruelty to kindness. One of Child-to-Child’s goals is to help non-disabled children understand disabled children, be their friends, include them in their games, and help them to overcome difficulties and become more self-reliant.

To give school-aged children an experience of what it is like to have a disability, a few of them can be given a temporary handicap. To simulate a lame leg, a stick is tied to the leg of the fastest runner in the class, to give him a stiff knee. Then the children run a race and the “lame” child comes in last. The facilitator asks this temporarily handicapped child what it feels like to be left behind. Finally, all the children try to think of games they can play where a child with a lame leg can take part without experiencing any handicap: for example marbles or checkers.

A variety of activities can also be designed to help children appreciate the strengths and abilities of the disabled child, rather than to just notice their weaknesses. For this, skits or role-plays can be helpful. Various role plays, games, and activities to sensitize children to the feelings and abilities of children with different disabilities can be found in the Child-to-Child chapter in the book, [Disabled Village Children].

Host a Child-to-Child Event

Rigoberto Delgado Zavala (fomerly the Spanish Teacher at PROJIMO Coyotitan) is actively running a Niño-a-Niño (Child-to-Child program) in Sinaloa as well as helping to identify child recipients for wheelchairs for the PROJIMO wheelchair workshop in Duranguito.  He can be reached at  teacherigo30@gmail.com


See Rigo’s story in Newsletter #68:

As part of his Community Based Rehabilitation work, Rigo helps disabled children and their families to access supportive services, and be included in school and community. When poor families have trouble covering the child’s disability-related costs, Rigo has a way to help with some of the expenses. He can do this thanks to an agreement with Stichting Liliane Fonds (SLF), a charitable foundation in Holland, for whom he functions as a local “auxiliary mediator.”
Rigo has helped access services for children with a wide variety of needs—both physical and social. Such things as medical evaluation, medication for epilepsy and other disabling conditions, orthopedic appliances and other assistive devices, urinary catheters and bags, and even surgical correction of foot deformities. If a child has difficulties in the neighborhood or school, often he uses Child-to-Child activities to help gain greater understanding and good will.

The Need to Include Disabled Children in Activities Concerning Disability

Many examples of Child-to-Child activities have been discussed in two of David Werner’s earlier books: Helping Health Workers Learn and Disabled Village Children. Some of the activities focus on what children can do to prevent accidents. The books also suggest enjoyable ways in which school children can test the vision and hearing of those who are beginning school, as well as things they can do so that the handicapped child can participate and learn more effectively.

Unfortunately, in many countries, disability-related Child-to-Child activities are frequently conducted in ways that do not include disabled children in central or leading roles. Too often activities are about disabled children, not with them. In Child-to-Child events led by PROJIMO, disabled children often play a central role. They make it a point to involve school-aged children—disabled and non-disabled together—as helpers and volunteers, and as “agents of change” among their peers.

Child-to-Child, at its best, introduces teaching methods that are learner-centered and “discovery-based,” not authoritarian. It encourages children to make their own observations, draw their own conclusions, and take appropriate, self-directed action. This problem-solving approach emphasizes cooperation rather than competition. PROJIMO makes an effort to get disabled children into normal schools. It uses Child-to-Child activities to help both school children and teachers appreciate and build on the strengths of disabled children. It designs activities to address the needs, barriers, and possibilities of individual disabled children in the school and community setting. Disabled activists—some of whom are disabled school children—often take the lead in this process.

Encouraging Disabled and Non-Disabled Children to Play and Learn Together

Two of the project way that are being done to encourage interaction between non-disabled and disabled children are:

A Playground for ALL Children

The idea for making a low-cost rehabilitation playground came from a refugee camp in Thailand. That playground had a wide range of fine equipment, made with bamboo … But when we visited the playground, there was one big problem: no children! The playground was surrounded by a high fence with a locked gate. The reason, the manager explained, was that the local, non-disabled children used to play there, and constantly broke the equipment. So the local kids were locked out. Too often, however, so were the disabled children! To avoid such a problem, PROJIMO, in Mexico, invited local school children to help build and maintain a playground, with the agreement that they could play there too. The children eagerly volunteered, and the playground has led to an active integration of disabled and non-disabled kids.

See: “Rehabilitation Playground” from Newsletter #15.

Outreach In Schools

Schools are visited by a team of disabled volunteers (school age ones as well if possible). The children are introduced to the volunteers and maybe a story or two are told about accidents that led to a volunteer being disabled. The children particpate in various activities in order to become more familiar with what life is like for a disabled person. For example they explore the school with wheel chairs experiencing for themselves the accessability issues. They also do an accident prevention exercise in groups discussing different ways that accidents can result in becoming disabled. Each group then presents their ideas to the others. It is hoped that this program raises the compassion and understanding of the issues that their disabled peers must deal with every day. It also hopes to prevent abled youngsters becoming disabled.

The Children’s Toy-Making Workshop

The Children’s Toy-Making WorkshopThe children’s toy-making workshop at PROJIMO serves a number of purposes. It helps disabled young people to develop manual dexterity and useful skills. It attracts local school children to come make fascinating playthings together with disabled children. And it provides a supply of simple, attractive, early-stimulation toys and wooden puzzles. These are useful for children who are developmentally delayed or who need to develop hand-eye coordination. The sale of some of the playthings also brings in a modest income. The toy shop is coordinated by teen-age village girls and disabled young women, who produce high-quality toys themselves and who guide the work of the younger children. They have an agreement with the local children: the first toy a child makes goes to a disabled child who needs it. The second toy she makes can be taken home for a younger brother or sister. (After all, early stimulation toys and activities enhance the development of any young child. This way, the process of children helping children—Child-to-Child—extends into the wider community.) A wide range of toys and playthings are made. Some of the simplest toys are rattles and brightly colored objects that can be shaken or hung in front of a baby or a child whose development is slow.

Selected Workshops

Activities Gallery

COMING SOON: We will gather a collection of images from Child-to-Child workshops from the Newsletters.

Notes on the History of Child-to-Child

David Morley’s Vision

from “Child-to-Child” in The Return of Health for All

David Morley (above left). And (right) how child-to-child care works—children work out how to enable a disabled friend to get to school, and in this way they make a game meaningful.


One of the most exciting developments to emerge out of the people-centred struggle for health is the child-to-child initiative. The concept grew out of an international gathering of health educators in 1979, convened by David Morley, a British paediatrician with long experience in rural Africa, and a leading pioneer in primary health care in least resourced environments.

The idea for child-to-child emerged from the fact that in very poor families older siblings, especially girls, are often kept out of school, because they are needed to care for younger children while their mothers are working. A variety of child-to-child ‘activity sheets’ were developed to help children learn preventive and curative skills. Early activities addressed diarrhoea, lowering fever, getting enough to eat and to drink, cleanliness, and prevention of accidents.

As it was developed in Africa, child-to-child was effective, but in some ways conventional Health workers and educators in Latin America helped to transform it into a liberating learning experience which encourages children to make their own observations, draw their own conclusions, and take collective action to solve problems in their own homes and communities.

Since its modest start, the concept of child-to-child expanded in a number of ways. It is now practiced in more than 70 countries. And the range of activities has grown to include such diverse activities as tree planting, recycling garbage as fertiliser, and caring for the elderly.

Latin America has contriuted to child-to-child by helping to transform it from a useful but fairly orthodox teaching tool to a liberating learning experience. The transformative potential should not be underestimated, either for children or for schools. Child-to-child, in its more liberating form, encourages children to make their own observations, draw their own conclusions, and take collective action to solve problems in their own homes and communities. When practiced in schools it can help make schooling more relevant.

Actually, the children begin by doing their own community diagnosis. This helps them look at the larger picture of sickness and health in their community and to visualise how the various health problems are linked together. Often, based on their findings, the children choose which health problem about which they want to learn first, and about which they want to explore possible solutions.

HealthWrights’ Contribution

HealthWrights has not only played a role in developing Child-to-Child internationally through workshops and books Disabled Village Children and Nothing About Us Without Us, but was present at the movement’s conception. David writes in Newsletter #13:

At the invitation of David Morley of the Institute of Child Health in London, I [David] joined an international group of educators and community health people in England last April in order to plan the CHILD-to-Child Program, which will be a part of the International Year of the Child (1979). Together we drafted a dozen or so possible “activities” based on our diverse ideas and experiences from working with village children in many corners of the earth. The activities looked good on paper—but they still needed to be tried out.
Back in Mexico, the health workers of Project Piaxtla, the primary school teachers, and the school children of Ajoya helped in the pilot testing of several of these activities. The response of the children, teachers, and health workers was enormous. I have included with this newsletter an English translation of an article on the Ajoya school children’s involvement in the CHILD-to-Child Program. (I recently prepared this article for inclusion in El Informador, a periodical publication of the Guatemala-based “Comité Regional de Promoción de Salud Rural,” of which Martín and I are members.)
The most exciting outcome of the CHILD-to-Child trials in Ajoya is that these Mexican village school children have taken tangible action to help school children in other parts of the world.

2021: David Werner’s Memories of Child-to-Child

Editor’s Note: Having noticed what I perceived to be irregularities in the historical record, I asked David Werner and Jason Weston about the role of HealthWrights in the development of Child-to-Child.



Who was at the meeting where Child-to-Child began in 1979?

David Werner:

Unfortunately, I don’t remember the names of most of the people there. I certainly remember [Dr.] David [Morely] and [Dr. Hugh] Hawes and I knew quiet well and stayed in touch with them for years and years. And there was a prerson by the name of Mike Babbage[?] from Africa who was there and was a really good participant too. But I can’t rememebr who else… oh… I’m trying to remember… somebody that had written a whole book on…. health education with children or something like that. And I can’t remember his name, unfortunately.


Would you say you had an instrumental or incidental role in the development of Child-to-Child?


I would say definitely instrumental. After our initial meetings, uh—well in that initial meeting, for instance, one of the things in Child-to-Child that has been most used around the world is the gourd baby. And I was the one that came up with that idea. We created the gourd baby in Piaxtla and developed the activity around it. And we in project Piaxtla at that time, actually developed a lot of the first activities—they all had activity sheets with illustrations and how to pursue them, involving the childrne, getting them to make their own observations, drawing their own conclusions, and all of that.

But we had a great deal to do with the early development of Child-to-Child. As the process went on, Child to Child became, I guess, more institutionalized, with a group in England—of educators. And it became less creative and less revolutionary in the sense that part of the original vision of it and—I certainly was very much involved in that—we felt that Child-to-Child could be a way of helping transform education of children who had processed rather than competing with each other with the best grades and this sort of things. [Instead], the kids would work together and cooperate. And rather than learn about other countries and continents, they would look at the situation and problems an analyze the needs and look for solutions themselves in their own communities.

Somehow things kind of drifted back to a more standard educational approach, where the kids were being taught through clever little stories and things like this and little storybooks and so on, to teach them about the health problems and action that they could take. But again, they were the recipients of the information rather than the discoverers. And it lost a lot of that vision of helping to transform education into something that would really help children grow up to analyze the real needs in their own communities and work together to improve their situation.

And so David Morley, who was the author of Pediatrics: Priorities in Developing Countries, he and I formed a very very close friendship which lasted until his death, and we worked together on things. And he was caught in the middle of that standard education and education of liberation approach, but he very much went along with me. But he kind of got out-voted by the mainstream.

In the later years, Child-to-Child kind of the organization, uh, in England, and I didn’t have as much to do with each other as we used to, even though I have run Child-to-Child work shops in 40[?] different countries at this point.


Did they expect you to lead Child to Child in Mexico?


Me and Martin Reyes, who was the leader of Piaxtla, the local leader, were very excited and involved in Child-to-Child and did some workshops in different places, too. He actually got an Ashoka Fellowship—I think it was three years it got extended—to do so in Latin America, working in different countries. He worked closely with Maria Zuniga on that.

Jason Weston:

Wasn’t he in Bolivia?


He was in Bolivia, Peru, I think, and a bunch of different coutnries. He even got as far as India.


Was Morley and Hawes aware of the Child-to-Child pilot project in Piaxtla? It’s not part of the official history.


I was in communication constantly with David Morley, less so with Hawes.


Did you make any substantive contributions to the Child-to-Child Resource Book? I noticed two mentions of your work, but nothing more than that.


A lot of the ideas that are in the books I was involved in the development of. But they had different writers and illustrators and so that really took charge of the process and sort of the second-line people did not communicate that much with me. They didn’t have the vision of Child-to-Child as a process of liberation of children and education process, and this kind of thing.


The official history of Child-to-Child mentions 1990 as the date when Nino-a-Nino began in Mexico. Were you or anyone in your organization involved in that development?


We were the first people to start Child-to-Child in Mexico, and we held some workshops in Ajoya, inviting people from different health programs from Mexico and mainly Central America to take part in it.

Note: The gourd baby was first introduced in print in Helping Health Workers Learn (chapter 11, page 11) in 1982.

In 1983, David published an article titled “Child-to-Child Trial Program” in the Journal of School Health:

David also wrote about Child-to-Child in Disabled Village Children in 1987.

More About Child-to-Child