Hesperian Health Guides

Keep your child’s spirit strong

Good health is not just in our bodies. It is in our minds and spirits. Feelings such as being happy, afraid, sad, hopeful, proud, angry, or ashamed affect our health, making it easier or harder for our bodies to be healthy.

3 children crying while looking at their dead mother.
A child feels less safe when he loses his mother. To grow well, he needs a new, loving caregiver he can depend on.

Babies and small children, not just older children and adults, have feelings that help or harm their health. It may seem like babies cannot feel something like worry, because they are too young to understand that idea yet. But feelings can affect us even when we are too young to know what the feeling is. Feelings of fear and insecurity force the body to work harder, make it less able to fight illness, and leave it with less energy and ability to grow and develop.

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Children’s spirits are strongest when they feel loved, safe, accepted, and able to explore and learn as they grow. Affection, guidance, and support with problems are all ways caregivers can help a child have a strong spirit.

Most ways to support a strong spirit in young children will also help older children and even adults be healthier. For more on supporting children emotionally, see Chapters 3, 4, 5, and 6. See ways to have a stronger spirit as a caregiver.

A sense of belonging

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A sense of belonging means children know they have people who like them, care about them, and will help them with difficulties and hurts. When children feel they have family and friends they can depend on, they feel secure and able to grow and learn. You can help a child who is insecure, withdrawn, afraid, or sad because of HIV by reaching out to her and showing that you care for her.

Help children with HIV lead as normal a life as possible. They can play with other children and go to daycare or school. Give them the same responsibilities and privileges as other children their age. Treat a child you bring into your family as fairly and kindly as you do your other children.


Caregivers can help children with HIV live happier and healthier lives by making sure they have ways to play and have fun.

Play is how children learn and develop. The skills they develop through play give them pleasure and confidence — these are important for a strong spirit. Play is how children learn to communicate and how friendships develop. Play is also one way children learn their culture, through games, songs, dances and art. In all these ways, play helps children feel a sense of belonging.

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Give your baby small things she can hold or make noise with. Allow children to run around, climb, and play football and other games. Exercise helps keep them healthy.
a group of children playing.
Make a place for children to play.

HIV sometimes makes it more difficult for children to play. Some children with HIV are sick more often, tire quickly, and spend more time in bed, or at clinics and hospitals.

Sometimes people wrongly fear HIV infection can spread among children and try to keep children with HIV away from others. This is called stigma, and can exclude children with HIV from play activities, celebrations, community gatherings, or school. You may need to teach other parents that children with HIV cannot easily spread HIV infection.

Community-based child care, games, and playgrounds can help children play together and develop well. Playgrounds that welcome all children also fight stigma, and they can offer chances to educate families. See more on challenging stigma.

a woman talking to a child.
Tomorrow is a big day! We will wake up, wash and dress, have our tea, and take our medicine as always. But Uncle is coming, and we will make a dinner to welcome him.


Children (and many adults) like knowing that some things stay the same and happen the same way each day. A routine means that a child has a regular time each day when he eats, does chores, takes medicine, washes, or goes to sleep. When these activities happen each day at about the same time, it helps him feel safe and secure. Babies benefit greatly from routines — eating, sleeping, and going out at similar times each day. Also, when a baby has one main caregiver, this is a kind of routine.

Illness in the family often brings worry and uncertainty about what will happen. Routines can be especially helpful for children in these situations.

When possible, prepare a child for a change in routine. Talk to your child ahead of time about how things will happen differently. Often, this will help the child have less trouble when changes happen.


Children need help when they are mistreated. This includes serious mistreatment, such as physical or sexual abuse, as well as milder but still harmful mistreatment, such as not being fed as much as other children in the family, or being kept separate needlessly, or being ignored or treated meanly.

a child's drawing of an uncle beating children. Children need help when they are being hurt. (Their caregivers do too.)

Becoming involved with a family to protect a child is not easy. But young children cannot protect themselves — they need the help of others when they are being harmed. See Chapters 14 and 15 for ideas about how to work with families, Chapter 14 for how to protect a child from sexual abuse, and Care for children, families, and caregivers for ways to support caregivers to have more patience, energy, and understanding.

Role models

Good role models help children develop a hopeful attitude and healthy habits. Knowing older children and adults living well with HIV gives children hope for the future. And knowing people who are fighting for the rights of people with HIV gives us all hope for the future, including children.

Children learning and playing together support each other
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In Rwanda, young people raising their younger brothers and sisters after their parents died formed associations to help each other, linked by a group called CHABHA. Each week, children and their older brothers and sisters together, to play games, sing, dance, eat together, and take part in discussions and skits. All dealing with the same problems because of HIV, they look forward each week to the break from their difficulties, to have fun and support each other. Many association leaders are now older children who grew up in these groups. Learn more about CHABHA.

This page was updated:24 Jan 2020