Hesperian Health Guides

Raising children with understanding

In this chapter:

Much knowledge about how to raise children well and protect them from abuse can be learned from older people in your community, especially women. But when families are stressed or broken apart by sickness, death, loss of land, or migration for work, traditional ways of passing on knowledge or finding help may not work. A family that has difficulties will often not seek help out of a sense of shame or embarrassment.

While many traditional ways of raising children are healthier than modern ways — such as carrying young babies most of the time, close relationships between children and grandparents, or communal childcare — not all traditional ways are healthier. People in many communities are rethinking some common ways of treating children.

HIV CH14 Page 268-1.png

For example, it is becoming no longer acceptable to punish children at school with beatings, shame boys for crying, or feed girls last and least, even if this happened to us as children.

Harsh punishment may seem like good parenting since it sometimes makes a child quickly change his behavior. But these punishments usually do not stay effective, and can also harm the relationship between parent and child.

a woman talking to two young women
Your parents agree with the alternative rite of passage, instead of cutting. Our elders also support it and will perform a blessing at the ceremony.
Does this also mean they will let us wait to marry until we finish school?

Other practices being ended are the genital cutting of girls, and early marriage for girls. Cutting can cause serious health problems — even death — when it is first done to a girl, as well as later in her life. Both cutting and early marriage make sexual relations, pregnancy, and birth more difficult and dangerous for women, and harm their emotional development. And both practices help spread HIV.

To stop genital cutting and early marriage of girls, communities must find ways to agree it is unhealthy and unacceptable, and publicly communicate that women who are not cut are fully acceptable, marriageable, and worthy of status and respect.

How to guide and discipline children

a man talking to a small child
Jin doesn’t know any better. We must teach him, not hit him.

Children experiencing loss may misbehave more to gain attention. With patience, you can find out what a child needs. Handling misbehavior in a kind and effective way is important when caring for very young children.

Sometimes young children misbehave because they do not understand what is expected of them. Be patient. Help them understand when something they do is dangerous or wrong for some other reason. When possible, discuss rules with children to make sure they understand them. Apply rules consistently, fairly, and equally to all the children in your household. Children learn best when we suggest or show them what to do rather than only yelling “No!” or “Stop that!”

a woman talking to a small child
Don’t chase the chickens, Paolo. Help me find the eggs!

A child’s ability to understand and follow directions changes as he ages. Watch children to see what you might explain to them. As they grow, they will understand more. Give children limits that make sense for their ages and abilities.

Notice and praise a child when he or she is behaving well. Show children you see when they are being helpful or making a good effort. Point out what children do well — not just what they do wrong. This builds their confidence and sense of worthiness. It helps them want to do more.

a woman talking to a small child
These glasses are not OK for playing. You can play with this gourd.

Children under 1 or 2 years old do not understand what is safe or acceptable. Remove dangerous things from their reach, and distract them if they are doing something wrong by showing them things that are OK to do.

a woman talking to a small child
Blocking the door to the kitchen was a good idea.

Children from 2 to 3 years old need to be able to explore their world and handle many different kinds of things to develop well.

Children this age cannot understand or remember most rules about what they can play with or where they can go. Safe areas to explore and things OK to play with lessen the need for discipline. Help them learn more words so you can better understand each other.

a man talking to 2 small children
Let’s talk about how to take turns with the ball.
Explain rather than scold if the child wants something she cannot have.

Children from 3 to 5 years old and older want to and can do more things for themselves and with other children. Make sure they understand any rules you want them to obey. Encourage them and talk with them about how to solve problems when they happen.

For more about what children need and can do at different ages, and how to communicate with them as they grow, see Chapter 3 and Chapter 4.

Discipline teaches children better than punishment

Sometimes guidance is not enough and some kind of discipline is necessary. Ignoring a child’s serious misbehavior is not kind or helpful to the child. But using harsh words, cruelty, or physical actions such as slapping, beating, or burning to punish a child are hurtful and may create greater misbehavior.

Effective discipline makes children feel they are cared for and are being guided, even if the person who disciplines them is angry or disappointed with them. The purpose is to encourage respect for others and to learn and understand rules of behavior, which cover everyone. Good discipline does not cause fear. It teaches children necessary limits and the results of good or bad behavior.

a woman talking to a small child
In 2 more minutes you can go out.

These are some helpful ways to discipline a child:

  • Give a child a “time out,” a few minutes away from toys, activities, or other children, to make clear a behavior is unacceptable. Use the same minutes as his age.
  • Take away your child’s privileges for a short time — such as not letting him watch TV, play football, or go to a friend’s house.
  • Talk with the child about the results of his behavior and have him apologize to anyone who was hurt by it.
  • Give the child some kind of useful task to make up for the misbehavior.


Discipline should not take away food, medicine, or other necessities. See more about dealing with a child’s difficult behavior.

Family support for raising children

Community support for families with children can prevent a lot of abuse. When neighbors can talk openly with others about their child-rearing goals and problems, it is easier for everyone to offer and receive help and support.

HIV CH14 Page 271-1.png

Private (anonymous) support can also prevent abuse. In some places caregivers can call a “hotline” for help when they are so angry or upset they feel they might hurt their child. Talking to a sympathetic person or trained volunteer can stop someone from hurting a child and help her consider other ways to respond.

Parent support groups can help people share ideas about how to handle the difficulties that arise in caring for children. Parents can learn together about how children develop and what babies and children are able to understand and do at different ages. Parent groups can also be places where people can talk about how to balance guidance, discipline, and punishment in raising children to best help them learn and develop. For some examples of parent support groups, see the next 2 sections.

Other kinds of community support can help caregivers be less stressed and have more time and energy for children, including any extra children they have taken in. Providing food assistance, transportation, school fees, basic income, or opportunities to feel included and respected by the community have all been successful in different places. For more about community support, see Chapter 15.

a group of people talking
My nephew is so angry! He fights with the other children, throws stones at the animals, and will not listen to anyone.
He has been through a lot. Maybe he needs to run off his anger sometimes. Can you send him on errands?
My middle son was like that. We realized we gave him no attention when he was good. So we started saying how happy we were with him when he did well, and it helped.

Parenting with love and respect

Plan Uganda’s Parenting Program gives parents and other caregivers a place to discuss how to raise healthy children. They talk about what kind of parents they want to be and the problems they face as parents. The program focuses on 5 ways to help children grow strong, healthy, and smart: talking, playing, eating well, washing hands, and creating love and respect in the family.

a teacher speaking to a group of adults
Let’s pretend you made a bad meal today. If I was your husband, I could say: “You are a good wife, doing so many chores and cooking good food. But this does not taste good. Please don’t make it again.”
Or I could shout: “What a terrible meal! You are lazy and stupid. I work hard all day and come home to this awful food. What kind of wife does this!?


The program helps parents see how conflicts and other difficult problems in life cause stressful emotions, such as sadness, unworthiness, and anger. Parents often cope with these emotions in ways that make them show less love and respect for each other at home. Men often express anger with violence — shouting, throwing things, or hitting. Violence may make the man feel better, but it is very bad for others in the family, especially children and women. Women who are stressed often withdraw from family life — they may stop speaking, hold their emotions inside, or show little interest in their work around the home or in others. This hurts everyone, including the woman, since she stops feeling supported by friends and family and feels less close with her children.

Plan Uganda’s parenting groups discuss what they can do to feel better, and how they can avoid ways of acting that lead to abuse. For instance, they practice communication skills that help parents work out conflicts while showing respect and love for themselves, each other, and their children.

For example, parents might talk about how one form of criticism could cause a child to want to do better, while another kind of criticism might lead her to feel useless, insecure, or angry. They also talk about how it feels to be slapped or praised, or how a child might feel when he is slapped, praised, or hugged.

Father Support Program

In Turkey, the idea for a parenting program for fathers came from a mothers’ support program. The mothers were learning about how to help their children grow well from an early age, and they wanted fathers to learn too. Fathers already felt responsible for supporting their children financially and morally. But few understood how much they could help their children by listening to them, talking and playing with them, and fitting their expectations better to their child’s age and abilities.

a man speaking
I remember when my father slapped me on the face. My brother and I had not finished our homework. I cannot forget this, though it is not how I want to remember my father. As children, these moments enter our bodies and they remain there.


The fathers met every week for 3 months. They started with memories of their own fathers and what their fathers wanted for them as children. Many realized that as children they wished for more closeness with their fathers. Over the weeks, they discussed ways of parenting, communicating effectively with children, and methods of disciplining children based more on helping the child gain inner control than on fear.

By the end of their program, the fathers said they listened more to their children, were better able to control their anger, and had stopped beating and harshly punishing their children. They were surprised that the new ways they had learned often seemed to result in more obedient children!

HIV CH14 Page 273-2.png

Community support can help children in need

Sometimes families are unable to provide good care for their children, but the children are not in great danger. It can make a big difference to a child when someone simply listens to his problems and feelings, and gives him encouragement. This could be someone like like an older friend, a teacher, or a caring person in the community who the family knows.

However, when serious abuse places the child in danger, it may be necessary to involve authorities to protect the child — community or religious leaders, social workers, health workers, or even the police.

Some groups organize and train community members to visit families regularly, to see what they need and how children are doing. These community social workers, who may be paid or volunteer, provide support by offering advice about different ways to help children, and by helping families get the resources and services they need. This support is especially important for an older child taking care of younger siblings.

If you are organizing a child welfare group that will visit families, here are some ideas.

  • Try to identify children and families in need before problems become desperate. See the signs listed in What is child abuse, and How to know if a child has been abused sexually for problems to watch out for. Or your group might prepare and conduct a survey to learn how many children under 5 there are in each household or how many children have disabilities or do not get enough to eat.
  • Pay attention to how each child or family is coping. Do not undermine strategies that seem to be working, but encourage and build on them.


Helping families solve their problems can be difficult, and more so when families are also affected by HIV. Community volunteers who support struggling families may need support groups of their own.

Watching out for children together

HIV CH14 Page 274-1.png

A children’s welfare committee in India worried that orphaned children in the community were being abused. To protect them, the committee found volunteers on each street to give extra attention to households that had taken in children. These “street mothers” approached children and encouraged them to talk with a street mother if they had difficulties. The volunteers also spoke with parents to explain their concerns and enlist support for their project.

HIV CH14 Page 274-2.png


When the “street mothers” heard about a home where children were being treated harshly or neglected, they would go as a small group to talk with the family and try to resolve the problem. If abuse continued, they reported the household to the local police. The local department of education began training teachers and police how to recognize and deal with child abuse. Police, teachers, and the “street mothers” all became important allies for vulnerable children.

This page was updated:19 Mar 2024