Hesperian Health Guides

For Health Workers

A health worker visiting a busy mother and her three children If you are a health worker, visit with children regularly. The easiest time for these health visits is whenever the child is due for regular vaccinations, or every couple of months for the first year, then 1 time each year after that.

Visit more often if the child shows signs of trouble, like slow growth. You should also return (or ask the mother to return to you) after treating a child for sickness to see if the child has improved or still needs more care.

While it may be easier to ask mothers to bring their children into a clinic for checkups, it is often better for the health worker to go to the family’s home. It is best to keep new babies and young children away from any sick people who may be at the clinic. Also, some mothers cannot leave their other children or their work, so they do not go to the clinic. These mothers especially need the help of a health worker to check their babies and young children.

The children who need your attention the most are the ones who do not come to you.

As the child grows, keep checking up on her. At these visits:

  • Ask about how the child has been – if she has generally been healthy and is growing well.
  • Look at the child from head to toe. A healthy child is alert and interested. Her skin is clear and her body is growing and strong.
  • Ask how the child eats. Encourage breastfeeding and nutritious food.
  • Weigh the child. Or if the mother has been participating in a growth monitoring program, look at the record of how the child has been growing (on a Road to Health chart or wherever the weights are written down).
  • Look at whether the child is clean and generally has a healthy home. These visits can be a time to teach the family about safety and preventing disease, or to find out what help they need to make the home safer and the child healthier.
  • Be sure to share what you learn with the mother and family.

Caring for children is a way for health workers to earn the trust and respect of their community. As parents see you care for their children, they will feel more comfortable asking questions about their own health. Regularly checking on the health and growth of a child is a good way to make sure the mother and other family members are also well and getting the attention they need.

Take advantage of opportunities to teach children about health. Children talk about everything they learn with their families and other children. They can help create an epidemic of healthy habits in their community.

A growing child is a healthy child

Keep track of a child’s growth on a chart, like the one below. The mother or caregiver should keep the chart. Explain to her how it works, so she understands if her child is falling behind. Click here for a print quality version of the chart.

Image of a child health chart
Image of a chart for keeping track of a child's growth

How to use the chart

Image of the chart with the months of baby's life written at the bottom
Write the month
your child was
born, here:
This chart shows
the baby was
born in April.
Write down the other months, in order,
that follow your child's birth month.
Image of chart with a dot showing the baby's weight in the present month
Each month find your child’s weight in kilograms.
Make a dot on the chart where the child’s weight meets the present month.
mage of the chart with many dots showing the baby's growth over time
Each month weigh the child and put another dot on the chart. Join the dots with lines. If the child is healthy, each month the new dot will be higher on the chart than the last.
In most normal, healthy children, the line of dots falls between these 2 lines.
Image showing good development, with the line of dots going up, dangerous development, with the line flat, and very dangerous development, with the line going down
The most important thing is that she continues to grow.
That the line does not flatten out.
Or go down like this.

If you notice a child is not continuing to grow, visit more often. See if you can help to get her more food. Look for sicknesses that could be slowing her growth.


Development means how a child’s abilities grow. The way he uses his body and the way he communicates and learns to solve problems will be unique to him. But he should always continue to develop instead of getting “stuck.” If a child develops more slowly, he needs more attention.

Why do some children develop more slowly than others? Sometimes there is no reason – differences between people are normal. But sickness and malnutrition can slow development in ways that are not normal. Certain disabilities can affect development too. For example, you may not know right away if a baby is deaf. Instead, you may notice he is not learning to talk as soon as his sisters and brothers did. Watch your child’s development because slow development may be a sign that he has a health problem or disability that needs your attention.

A 3 month old baby should:
  • Smile
  • React to sound and movement
  • Respond to familiar voices and facesA baby lying on its side, playing with its hands
  • Notice his own hands
  • Cry when he is hungry or uncomfortable
  • Breastfeed without much trouble
  • Lift his head when lying on his belly
A baby lying on his belly with his head lifted

A 6 month old baby should:
  • Turn his head toward sounds
  • Roll from his belly to his back,
    and his back to his belly
A man shaking a rattle and his baby, lying on his belly with his head lifted
  • Recognize familiar people
  • Pick things up and put them in his mouth
A baby putting a toy in his mouth

A 1 year old baby should:
  • Understand and copy sounds and simple words
  • Play simple games, like peek-a-boo
A man and a baby playing peek-a-boo
  • Try to put things inside each other
  • Sit up and crawl without help
  • Pull himself to a standing position
A baby using a stool to pull himself up to a standing position

A 3 year old child should:
A girl sweeping with her younger sister
  • Understand and speak simple sentences
  • Do little jobs like sweeping
  • Notice other people’s feelings
A child running
  • Sort objects
  • Run, jump, and climb

If the child develops slowly, you can do 2 things to help:

  1. Ask a health worker to look for any medical causes of slow development.
  2. Give extra attention to the child in the areas she is taking longer to develop.
A woman guiding her child's hands to help her to taste something
Help a child grow in the ways she is falling behind.

See Appendix A for all the child development charts. These charts are useful tools for both parents and health workers to keep track of a child’s development and to help her along.

This page was updated:25 Nov 2019