With the purpose to improve health counselling a child health promotion project was carried out between 1997-1999 as participatory action research. The project followed the health action process and district nurses and researcher participated in all stages from investigation to evaluation. The investigation showed that health counselling is a multi-faced work with several interacting factors and therefore actions and improvements involved routines for child health services, collaboration and health counselling. When the project was finished, the developing work continued as parts in the ordinary development and quality work. During this time the researcher followed the action process and participated in yearly health counselling discussions and evaluations. During 2003-and 2004 the developing work was evaluated in purpose to get understanding for the developing working process, outcomes and impact on health counselling as well as strains and obstacles for maintaining.