In carrying out its commitment to help save lives and brighten the prospects of Africa's children, UNICEF has found the Special Initiative on Africa to have "a dynamic multiplier effect." Through collaboration with various partners, UNICEF has been able to achieve great progress in ensuring the survival, protection and development of needy African children in the last few years.
Photo: UNICEF
In its work in Africa, UNICEF collaborates particularly with other UN agencies, including the World Bank. It is working closely, for example, with the World Health Organization (WHO) to combat childhood diseases through the strategy known as the Integrated Management of Childhood Illnesses (IMCI). The two agencies are working together to reduce maternal mortality and to renew the struggle to eradicate malaria.
Through IMCI, health providers are trained, with emphasis on prevention and health promotion within the family and at community level. UNICEF is involved in sector-wide health programmes in Ethiopia, Kenya, Mali, Senegal, Tanzania, Zambia, and in Ghana where the government is working closely with the UN agency and other partners including DANIDA, the Department of International Development in the UK and the World Bank.
"One of the most important and successful collaborations in history has been the drive to immunize the world's children, which saves the lives of three million children each year," Ms. Bellamy says. But the child killer diseases do not succumb easily and hundreds of thousands of children under five years of age still die from measles every year. For this reason UNICEF, in collaboration with WHO, has placed renewed emphasis on measles control.
Measles mortality is still very high in sub-Saharan Africa but, through the IMCI strategy, UNICEF is ensuring that families and communities understand the importance of measles vaccination and vitamin A supplementation and have skills to look after children with measles at home. The agency also promotes special measles vaccination campaigns for children in high-risk age groups. UNICEF and WHO also support eradication of polio in Africa, where it is expected that over 100 million children will be immunized during the 1997-98 campaigns. "Preliminary data from 25 countries which have conducted National Immunization Days as of March 1998," Ms. Bellamy says, "show that coverage is well over 80 per cent."
Malaria in sub-Saharan Africa is another preoccupation of UNICEF and other partners. The majority of efforts are directed through country programmes. Several countries, including Angola, Comoros, Ethiopia, Gambia, Ghana, Nigeria, Senegal, Rwanda, Tanzania and Zambia, are undertaking community-level programming and evaluation activities which are helping to refine drug policies and approaches, improve case management, and increase the use of impregnated bednets and community participation.
In countries with recent or continuing emergencies, UNICEF plays an important role in the provision of humanitarian assistance and in the rehabilitation of basic social services. UNICEF concentration is primarily in the areas of health, nutrition, education, water and sanitation, the demobilization of child-soldiers, family tracing and psycho-social support for child-victims of war.
Progress in basic education remains uneven and millions of children are still denied their right to basic education. Enrolment rates are generally higher, but access is still a major problem especially for girls, poor and marginalized children. Girls comprise two-thirds of all school-age children not currently in school, although in some countries, the rates of boys' enrolment and retention are also falling. UNICEF is collaborating with the World Bank, UNESCO and other partners to raise enrolment and improve the quality of primary education in the 15 countries identified as having particularly low enrolment levels.
Photo: UNICEF / Maggie Murray-Lee
There are programmes to reach deprived communities in Botswana, Eritrea, Kenya and Mali, for example. In Zimbabwe, parents and communities are helping improve schools, and in Zambia, the curriculum is under review to ensure that it responds to the learning needs of boys and girls and overcomes the gender bias that characterizes so many curricula.
Because of widespread discrimination against girls and deep-rooted attitudes of parents in the way they look at the education of a girl child, child labour and early marriage, UNICEF is fostering community partnerships as a key element in basic education programmes. Special areas of cooperation with NGOs and civil society organizations include implementing the recommendations of the Stockholm conference on the sexual exploitation of children, campaigning to ban landmines, the African Girls' Education Initiative and the International Network on Juvenile Justice.
The spread of HIV/AIDS and its social and economic impact is especially acute in many East African countries. A dramatic reduction in life expectancy as a result of HIV/AIDS is projected for several countries of the region. In most countries, greater attention is being given to communication for behaviour change through the diversification of communication and information channels and greater participation of youth. UNICEF is focussing on supporting the development of alternative care models and protection of children orphaned by HIV/AIDS. These include community-based alternative care programmes, cooperative day care, feeding programmes, income-generation programmes and strengthened preventive health services.
For water supply and sanitation, a memorandum of understanding has been signed between UNICEF and the World Bank to strengthen country-level cooperation. This memorandum broadens the scope of collaboration in water and sanitation projects already under way in Malawi, Madagascar, Benin, Burkina Faso and Burundi. In this context, for example, UNICEF is assisting in the management and implementation of the World Bank-funded 500 Water Points programme in Madagascar. Of special note are three national training events on low-cost sanitation technologies which took place in Burkina Faso, Guinea-Bissau and Nigeria for governments, NGOs, and private sector professionals from 18 African countries. In Eastern and Southern Africa, training sessions on hygiene evaluation procedures took place in Asmara, Eritrea. Particular attention was paid to gender issues in relation to water supply and sanitation. UNICEF country programmes in countries such as Liberia, Angola and Mozambique continue to focus on improving water supply systems and sanitation in urban slum areas. In collaboration with Habitat, UNICEF is developing a handbook for field-level operation on how to select and apply appropriate urban sanitation technologies.
Increasingly, UNICEF country programmes are addressing gender as a cross-cutting issue and are helping to support the implementation of the Convention on the Rights of the Child and the Convention on the Elimination of All Forms of Discrimination Against Women as a means to overcome gender inequalities. Most new country programmes approved by the UNICEF Executive Board in 1997 emphasize support for efforts to make real the principle of women's rights, with a number having concrete actions for addressing violence against women.
In several countries, national programmes of cooperation to reduce maternal and neo-natal mortality and morbidity, supported by UNICEF and other partners, are expected to show positive results in the next two-to-five years. Through extensive dialogue with WHO, UNFPA and the partners of the Safe Motherhood Initiative, the organization is now confident that the most effective short-term strategy to reduce maternal mortality is one that combines efforts to ensure women's access to essential obstetric services with strong promotion of women's health and development rights, along with other activities to create mother-friendly movements at community and national levels.
UNICEF promotes family and community support for delayed marriage and child-bearing, for expanding girls' access to quality education and training, and broadening the range of women's income-earning opportunities. Tanzania, for example, has developed a programme which demonstrates that low-cost community-based approaches to safeguarding the wellbeing of children in the first years of life can improve their chances of success in school.
UNICEF continues to work with the World Bank, UNDP and other partners to develop indicators and methods to monitor poverty and progress under the Special Initiative. The indicators for monitoring maternal mortality were endorsed at the Safe Motherhood Conference in Colombo in October 1997 and are now being applied in many countries.
The agency also adopted a modified allocation system for general resources in 1997 which gives greater priority to low-income countries with high under-five mortality rates. This is seen as a simple and effective way of targeting the most disadvantaged children and the countries in greatest need.
All in all, the UN Special Initiative on Africa has provided UNICEF with an excellent framework for consolidating and expanding the reach of its efforts on behalf of needy women and children in Africa.
*******
