This study is about identifying the constraints in implementing the Child-to-Child program in rural areas in Nepal and strategies to overcome those constraints. I studied the Child-to-Child Program of the School and Community Health Project (SCHP) sponsored by the Ministry of Health (MOH) of His Majesty's Government of Nepal, Japan Medical Association (JMA), and Japan International Cooperation Agency (JICA). The field work for this study was conducted through review of SCHP documents, direct observation and interviews with community people and SCHP staff members. From the research, participants of the Child Initiative program did not practice what the Child-to-Child theory offers exactly, but modified and adopted the approach. This shows that the theory of the Child-to-Child approach has constraints to diffuse in rural Nepal. On top of that, participants felt various constraints when they implemented the program although they modified the theory. Some of the constraints were similar to what had been reported before in other Child-to-Child programs and supports the critiques of the Child-to-Child approach. This research also shows that SCHP lacks of strategic program planning. Since SCHP did not establish concrete collaboration with the initiative and existing community organizations such as Self-Help Groups, the program has not spread within the community. This causes a lack of adult involvement, a crucial factor in the Child Initiative Program's success. Even though this is a child program, the program is not sustainable without adult involvement. Focusing on not only children but on the whole community, is very important. To make the program better, I suggest three possible areas for improvement: 1) Build a network with other organizations which have implemented Child-to-Child programs, such as Redd Barna and Hatemalo Sanchar; 2) Involve the whole community in the program: First, have meetings with Self-Help Groups and identify their roles. A Self-Help Group and a school should be from the same community; and claborate with other infrastructure programs and income generation programs.