unicefUnited Nations Children's Fund

•^aJLEO- / o

UNICEF Executive BoardI August 1992 to M July 1993

OFFICERS FOR 1992/1993:

EXECUTIVE BOARD:CHAIRMAN:

Mr. Frederick Ward (Canada)FIRST VICE-CHAIRMAN:

Miss MaymuunFi Dtup (Senegal)

SE< :OND V I U - - C H A IKMAN;

Dr. Vaclav Vacek (Czech Repuhlic)THIRD VICE-CHAIRMAN:

H.E. Dr. Jayaraj Acharya (Nepal)

RlURTH VICE-CHAIRMAN:H.E. Dr. Lucille Mair (Jamaicn)

PROGRAMME COMMITTEE:CHAIRMAN:

H.E. Dr. Rnhertn MuyorjKa-Cortes (Nicaragua)VICE-CHAIRMAN: (vacant)

COMMITTEE ON ADMINISTRATIONAND FINANCE:

CHAIRMAN:

Ms. Birte Poulsen (Denmark)

VICE-CHAIRMAN:

Miss Khadijatii Mansaray (Sierra Letme)

MEMBERS OF THE BOARD:AngolaAustralia

BulgariaCanadaCentral African

Republic

Colombia

O.&ia RicaC:ech RepublicDenmarkEthiopia

Germany

Indonesia

Jamaica

Li her i;i

Mozambique

NetherlandsNicaraguaNorwayPakistanRepublic of

RussiiinFederation

SenegalSierra Leone

Sri LankaSwedenSwitzerlandUnited Kingdom of

Great Britain imdNorthern Ireland

United Republicof Tanzania

United Sraresof America

Uruguay

Yugoslavia

Cover photographs

I'MrrWi UNICtF.'H«-iX*.St:lTVt[fL-j/fHrrn r̂ UNICEHVILH'19/HurwtLxirriefi UNU;t:[-.««.(09/Uira^ni:LoiiwnK/it. LtNICEFJOW/^Tiurtiunn

1993 LNICEF ANNUAL RETORT

CONTENTS

INTRODUCTION

INTRODUCTION BY THE EXECUTIVE DIRECTOR, JAMES R GRANT 3

PROGRAMMES

1992 - A REVIEW 7

CONFERENCE PURSUES GOALS

FOR AFRICA'S CHILDREN 10

CHILD SURVIVAL AND DEVELOPMENT \\

PRIMARY HEALTH CARE JI

THE BAMAKO INITIATIVE 11

UNIVERSAL CHILD IMMUNIZATION 15

ACUTE RESPIRATORY INFECTIONS 15

CONTROL OF DIARRHOEAL DISEASES 15

AIDS AND CHILDREN 16

NUTRITION 18

SAFE MOTHERHOOD AND FAMILY

PLANNING , ..21

BREASTFEEDING .....:,.. .*•, 23BASIC EDUCATION ...... 24

WATER AND ENVIRONMENTAL SANITATION ..,.27

SUSTAINABLE DEVELOPMENT—

THE ENVIRONMENT , . , . . . ; . . . H

URBAN BASIC SERVICES ... 33

CHILDHOOD DISABILITY 55

CHILDREN IN ESPECIALLY DIFFICULT

CIRCUMSTANCES 3 6

WOMEN IN DEVELOPMENT ., 38

EMERGENCY RELIEF AND REHABILITATION 40

SOCIAL MOBILIZATION/FACTS FOR LIFE 42

EVALUATION AND RESEARCH 43

INTER-AGENCY COOPERATION 45

DEVELOPMENT WITH A HUMAN FACE 46

WORLD BANK -UNICEF COOPERATION

IN INDIA . . . . , ; : . . . . . . . ., 46

EXTERNAL RELATIONS

MOBILIZING FOR CHILDREN 49

CONVENTION ON THE RIGHTS OF THE CHILD . . 53

PUBLIC PARTICIPATION 54

NATIONAL COMMITTEES -.-. , . . 55

NON-GOVERNMENTAL ORGANIZATIONS 56

FUND-RAISING 57

PUBLIC ADVOCACY 57

G R E E T I N G C A R D A N D R E L A T E D O P E R A T I O N S . . . 59

RESOURCES

UNICEF FINANCES, 1991-1993 61INCOME (..x ; ; . . 61

EXPENDITURES 62

FINANCIAL PLAN AND PROSPECTS 62

BUDGET ESTIMATES ...,-.-•..-.. •„. .•<...,-. 62

LIQUIDITY PROVISION ; .< 6 6

INFORMATION RESOURCES

MANAGEMENT 66

HUMAN RESOURCES MANAGEMENT 66

SUPPLY MANAGEMENT 68

PROFILES

CHILD-FRIENDLY VILLAGES 29

DEVKALI'S DIARY: HOPE FOR AN URBAN SLUM . . 34

EDUCATE A GIRL, EDUCATE A NATION „,... 39

HOPE RESTORED IN YEMESSOA 12

BRIGHTER DAYS IN BAN DAWN 19

THE LANGUAGE OF EDUCATION 26

TABLES AND CHARTS

Table-- UNICEF PROGRAMMES FROM

GENERAL RESOURCES 44Chart: UNICEF INCOME BY SOURCE 1992 61Chan: UNICEF INCOME 1991-1993 6J

Chart: UNICEF EXPENDITURES 1991-1991 62

Charts: UN1CEF EXPENDITURES ON

PROGRAMMES BY SECTOR 1988/1992 63

Table: 1992 G O V E R N M E N T A L C O N T R I B U T I O N S . . . 64

Tabk: 1992 NON-GOVERNMENTAL CONTRIBUTIONS . . 67

Ghssary 69

3I9y i 11N1CEF ANNUAL RtroftT

iolentactsof manand nature chal-lenged the con-

science and resources of ourglobal village last year as rarelybefore.

UNTCEF was Involved in 50major humanitarian relief oper-ations caused by events whichranged from drought and floodsto volcanic eruptions and civilwars. Long gone are the dayswhen the world was blind to suf-fering in far-off places. A revo-lution in communications hasmade it impossible to conceallarge-scale famine or violence.Or for our leaders to avoid thequestion: "What are you doingabout it?"

Television and news-hungrymedia have brought these 'loud'emergencies into our homes, ouroffices and our schools. Theworld of CNN reaches out to useven as we wait on line at thesupermarket or the bank. Wecan turn a blind eye but theimprint ot suffering is not easilyerased. At the very least, wehave to ask ourselves: "What arewe going to do about it ?"

In developing countries, tele-vised images of the environmentand lifestyles in the industrial-ized world also have the powerto shock and invire comparison.Awareness of opportunities else-where in the global village hasfuelled democracy movementsand helped to break down bar-riers, overpower authoritarianregimes and transform the con-duct of national and interna-tional affairs.

The graphic repetition ofscenes of violence and sufferinghas a downside. The recent pro-liferation of emergencies .shout-ing for our attention carries withit the risk of'compassion fatigue'-n numbing of the senses. It canalso distort perceptions of thescale of suffering in relation tohuman needs elsewhere.

In 1992, the world wasshocked by the deaths of about500,000 children as a resulr of'loud' emergencies. The an-guished faces of those childrenfrom Somalia, the Sudan, for-mer Yugoslavia and other dis-tant lands were in our livingrooms night after night.

What the cameras missed lastyear were the silent emergencies- the hidden suffering of mil-lions of other child victims ofmalnutrition, disease andendemic poverty. The camerasmissed the 'silent1 trauma ofdeath - death because childrenwere not immunized, becausetheir communities lacked safewarer anil sanitation, andbecause their parents were un-aware of oral rehydration ther-apy (ORT). They also missed rhetens of thousands of otherwisehealthy children who wentblind because their parents didnot know that vitamin A in iheright foods or a capsule couldsave the sight of a son ordaughter.

The deaths of some 5,000children every day from diar-rhoea 1 dehydration passed

largely unnoticed by the media.The needs ot those childrenwere overshadowed by the tele-vised profile of 1,000 childrenwho died each day at the heightot the Somalia emergency.

Such silent emergenciesclaimed the lives of nearly 12million of the 12.5 million chil-dren who died in 1992 and willtake at least as many again thisyear. We cannot allow thosedeaths to remain in the shad-ows. Some 35,000 children aredying every day, the great major-ity from causes which we canprevent at very low cost. Noearthquake, flood or war hastaken the lives o\' 250,000 chil-dren in a single week, and yetthat is what is happening weekafter week in the world's poorestcountries.

The international commu-nity must also come to termswith the fact that increasingdemands are being placed onlimited resources- At the time ofwriting there were 45 civil andethnic conflicts raging aroundthe world, in addition to naturaldisasters and the ongoing silentemergency.

iNTHODlVnON

Every life is precious, and wewelcome the increasing inter-national response to the firessparked hy loud emergencies,but the nations of the worldmust also invest far more thanthey do today in their preven-tion. As the Secretary-Generalof the United Nations stressedin his Agenda tor Peace report,there is a critical link betweendemocracy and the satisfactionof people's basic needs and aspi-rations through development.The alleviation of poverty'sworst manifestations early inchildren's lives can do much tobreak the cycle of want, frustra-tion and social disaffection thatis at the root of so many oftoday's conflicts. There is a crit-ical need as well to educate chil-dren nor only in the 'three Rs'but also in tolerance for ethnic,cultural and other communitydifferences.

This is not Utopian thinking.In Lebanon and the Philip-pines, 'education for peace' pro-

grammes supported by UNICEFhave shown that much can bedone towards teaching childrento get along with their neigh-bours and reduce conflict.

Immunization is perhaps ourbest example of prevention andwhat we can accomplish byextending the reach of anaffordable technology. Thecampaign for universal childimmunization (uc i ) , led byUNlcEh and the World HealthOrganization (WHO), is now-reaching more than 80 per centof the world's children with vac-cines against six child killer dis-eases before their first birthday.Our target is 90 per cent cover-age within seven years, uci issaving over 3 million lives everyyear at a cost of between twoand three dollars per child.

Ambitious but doahle goalswere adopted by the world'sleaders at the historic WorldSummit for Children in 1990.In the great majority of coun-tries, national programmes of

action (Nl'As) to seriously pursuethose goals have been, or arebeing, prepared.

If our goals tor children in the1990s are met, the world fortoday's generation and futuregenerations can be a safer, morepeaceful place. With a restruc-turing of nations' priorities togive children a first call on theirresources, we can reduce infantand child mortality by onethird. We can halve malnutri-tion, illiteracy and maternalmortality rates. We can provideuniversal access to safe watersupplies and sanitation facilitiesand we can meet our immuni-zation target.

We would need very littlenew money to achieve thoseobjectives. We estimate that anadditional US$25 billion a yearwould be sufficient to implementthe goals of the World Summitfor Children and that most of itcould be tound within existinglocal and official developmentassistance (ODA) budgets.

UNICEF has initiated'education for peace'programmes incountries where armedconflict has closedschools and disruptedchildren's lives. Here,children from verydifferent cultural andreligious backgroundslearn to accept thesedifferences, workingand playing togetherat a peace campoutside the war zone.

iyv i i i \ iLcr ANIVL'IL ivti'UKi

UNICEF responds to the needsof women and children not onlythrough its emergencyprogrammes, but also byproviding continuing care forthose caught in 'silent'emergencies, the victims ofmalnutrition, disease andpoverty.

ones where so much can hedone with so little additionalcommitments. Wliat the inter-national community must rec-ognize is that the two travelhand in hand. Poverty, wantand disaffection too often findexpression at the point of a gun.Tragic events of the past yearshould convince nations thatprevention through develop-ment is the least painful andcostly course to pursue.

We can and we must breakthe cycle of poverty, sicknessand violence that squanderschildren's potential and poisonstheir view of the world at large.Given rhc needs and the low-cost solutions at the disposal ofthe international community, itis an increasing obscenity not toact. Morality marches withchanging capacity. The decadeof the 1990s has ushered in anew era of opportunities torcooperation and social progress.We must seize it with bothhands tor our children today andtor a better world tomorrow.

fi

Developing countries aretrying to find two thirds of thatamount by rerouting resourcesfrom less productive areas to thesocial sector. There has been anencouraging shift in attention,in Africa and other developingregions, towards the need todevelop nations' human capital.At the present time, only about10 per cent of governmentspending in the developingworld goes towards basic nutri-tion, health care, water supply,sanitation, primary educationand family planning.

Industrialized countries havebeen asked to find an extraUS$8 billion a year by rearrang-ing their priorities as well. Majordonors currently spend less than10 per cent of their ODA onmeeting priority human needsin the social sector. If budgetsare restructured so that at least20 per cent of local and ODAspending is earmarked for meet-ing priority human needs, thenthe Summit goals for childrenwould fall within our grasp.

Unfortunately, while theworld has become increasinglyresponsive to the 'loud' emer-gencies, it is still lagging in itsefforts to alleviate the 'silent'

•A James P. GrantExecutive Director

199S (JNICHF ANNl AL REPORT

1992 - A REVIEW

Anew wave of emergencies in 1992 servednotice that the world remains a dangerous

place. Many of the dreams of the post-cold war erawere put on hold as rivals in a host of countriespursued ethnic, religious, territorial and politicaldifferences at the point of a gun. Children, asalways, were among the first to surfer. Nature wasalso relentless. Drought, floods and other trau-matic events challenged the resources and logis-tical capacity of development and relief agenciesas never before.

During the year, UNICF.F was involved inhumanitarian responses to children's needs inover 50 countries, most of them very poor, andmany of them riven by factions which complicatedthe delivery of emergency supplies. With otheragencies of the United Nations, notably theUnited Nations High Commissioner for Refugees(UNHCR) and the World Food Programme (WFP),

and under the broad coordination of the newlycreated United Nations Department of Humani-tarian Affairs, UNICEF is involved in 10 'complex'emergencies.

UNICEF expenditures on humanitarian relieftotalled almost US$170 million. This was 22 percent of the total budget expenditures for 1992 -the highest level since the post-World War 11emergency effort - and over three times theamount spent on emergency operations in 1990.

The strife and suffering in Somalia and in for-mer Yugoslavia were emblematic oi political com-plexities which have stretched to the limitUNICEF'S capacity to meet the needs of children soclearly drafted in the Convention on the Rights ofthe Child and the Declaration of the 1990 WorldSummit for Children.

On numerous occasions, UNICEF found that itsability to deliver humanitarian assistance washindered not by difficult terrain or shortages ofresources, but by lack of political will and respectfor human rights. In several instances, protractednegotiations with the parties concerned not onlydelayed relief efforts hut also added to the sufferingand death among civilians engulfed by the crisis.

Frequently, it became exceedingly dangerous todeliver food, water, medicines and other reliefsupplies. In spite of system-wide measures tostrengthen security during relief operations, tourinternational and three locally hired UNICEF staffmembers were killed in Somalia and the Sudan.

With the proliferation of politically complexemergencies, the Secretary-General of the United

Nations established the Department of Humani-tarian Affairs (DHA) to coordinate UnitedNations relief activities. The UNICEF ExecutiveDirector travelled to Somalia with the Under-secretary General for DHA, and to Iraq as leaderof a United Nations humanitarian relief delega-tion. Mr. Grant also made two trips to formerYugoslavia.

The heavy involvement in emergencies raisesbasic issues of UNICEF policy and support forlonger-term development efforts to tackle poverty,hunger, ill health and illiteracy. Most of the 13million children who died during 1992 died as aresult of'silent' and mostly preventable emergen-cies. The eradication of poverty is the key to mostof UNICF.F'S goals ror children in the 1990s.

UNICEF programmes in such chronic emergencycountries as Afghanistan, Angola, Ethiopia,Mozambique and the Sudan recognize this devel-opment-emergency continuum by attempting toensure that emergency activities, in the areas ofhealth, water supply and sanitation, nutrition orhousehold food security, not only relieve immedi-ate suffering but also accelerate rehabilitation anddevelopment. Water tankers can provide relief inthe midst of a drought emergency, bur they are oilittle use when the rains return. Emergencyresources invested in a well and handpump, how-ever, will give a community the foundation for amore secure future.

Warring factions permitthe passage of a reliefconvoy to deliversupplies - blankets,clothing, food, waterand medical supplies -to children in need.

PROtfKAMMLS

UN1CEF efforts to contain the silent emergencieswrought by disease, malnutrition and illiteracycontinued to yield significant gains in child sur-vival, development and protection.

Immunization coverage was sustained andexpanded in a large number of countries,although the price UNlCEF paid for vaccinesincreased by an average of 23 per cent. UNlCEFnegotiated with suppliers in the hope that theywould moderate their increases, and developingcountries were encouraged, wherever possible, tobegin paying tor their own vaccines through thevaccine independence initiative.

The global oral rehydration therapy (ORT) userate reached more than 38 per cent during theyear, more than double the 17 per cent of 1985.But some 3 million children died needlessly in1992 from diarrhoea! diseases. Revitalized pro-grammes are needed at global and national levels,and a series of country-based reviews began toexamine governments' plans of action, goals andtraining, together with nations' capacity to pro-duce and distribute oral rehydration salts (ORS).

UNlCEF expanded the focus and scale of its sup-port to Central and Eastern Europe, the BalticStates and the newly independent States, andwork started on the development of country pro-grammes for Albania, Armenia, Azerbaijan,Kazakhstan, Kyrgy;stan, Tajikistan, Turkmeni-stan and Uzbekistan. A special representativewas appointed for Albania and die LINICEF Rep-

resentative in Kabul served as focal point tor thefour Central Asian Republics and Kazakhstan. InFebruary and March, UNlCEF and World HealthOrganization (WHO) collaborative missions withthe United Nations Development Programme(UNDP), the United Nations Population Fund(UNFPA) and WFP reviewed actions to deal with thelooming crisis of health and other urgent humanneeds in 11 republics of the newly independentStates and the three Baltic countries. The mis-sions recommended that some US$420 million ofinternational support be provided during theremainder of 1992 and 1993 for urgent health andother human needs.

The special needs of Africa's children, drama-tized by several ongoing emergencies, remained aUNlCEF priority. Programme expenditures inAfrica increased from US$210 million or 36 percent of total programme expenditures in 1991, toUS$284 million or 38 per cent of the total in

Total UNlCEF programme expenditures for theyear totalled US$744 million - 26 per cent morethan in 1991.

During the year, the number of countries imple-menting the Bamako Initiative advanced to 25,and the Initiative received increasing support as avaluable alternative to traditional mixes of publicand private health services. Although 22 of thecountries actively implementing the Initiative arein sub-Saharan Africa, several countries outsideAfrica, including My an mar, Peru and Viet Nam,either received UNO* technical support duringthe year or asked about the feasibility of commu-nity-managed and financed health care for theirpeople.

UNlCEF and WHO wrote to all Heads of State orGovernment during the year seeking their per-sonal support for breastfeeding and the baby-friendly hospital initiative (BFHI). By the end of1992, 122 developing countries either had takenaction to end free and low-cost supplies of breast-milk substitutes or had never had them. In total,767 hospitals are committed to achieving or havealready achieved baby-friendly status, havingundertaken the 'Ten Steps to Successful Breast-feeding' to promote and provide optimum supporttor breastfeeding.

The girl child is still a victim of discrimination, butmore countries are committed to improving herchances in life.

1993 IJNICEF ANNUAL REPORT

Humanitarian assist-ance - the delivery ofthe basic essentials oflife to victims of armedconflict - has becomedifficult and dangerous.

More than 100 Heads of State or Governmentattended the Earth Summit in Rio de Janeiro(Brazil). Agenda 21 - the Summit blueprint foraction - embraced the major goals for child sur-vival, development and protection, together withthe concept of primary environmental care {PEC).The voices of the young were also heard at theSummit, which supported global forums for chil-dren and youth.

One ot the most alarming trends in the wors-ening acquired immunodeficiency syndrome(AIDS) pandemic was a rapid global shift in infec-tion rates towards Asia, the most populous region.WHO predicted that by mid-decade, more Asiansthan Africans would he newly infected each year.AIDS is taking a heavy toll on youth, who representan increasingly large proportion of the popula-tions ot developing nations.

During the year national programmes of action{"NPAs) and the Convention on the Rights of theChild have become important guidelines for set-ting priorities and strategies tut children's well-being. By year-end, 127 countries had ratified theConvention, and 9 out of 10 children in the worldlived in countries with NPAs, adopting or adaptingthe goals of the World Summit tor Children to theparticular circumstances of each country. Some137 countries have prepared, or are in the processof preparing, NPAs that effectively translate theirleaders1 commitments to the World Summit Dec-

laration into measurable goals with programmesto implement them, UNKJEK estimates that 98 percent of children in Asia, 97 per cent in LatinAmerica, 90 per cent in suh-Saharan Africa and83 per cent in the Middle East and North Africaare now covered by NPAs.

The NEAs and the Convention were also givenpolitical impetus by four regional meetingsfocused on mobilizing commitments andresources. These meetings were the InternationalConference on Assistance to African Children(ICAAC), held by the Organization of AfricanUnity (OALJ) in Dakar (November); the Confer-ence on Children's Welfare, Protection andDevelopment, held by the League of Arab Statesin Tunis (November); a high-level meeting onNI'As tor Latin America, held in Mexico City(October); and the Conference on Children inSouth Asia by the South Asian Association forRegional Cooperation (SAARC) , held in Colombo(September).

NPAs also reflect the international community'sgrowing acceptance of the need for developmentto have 'a human face'. During the year, UNICEFattempted to involve the World Bank and regionaldevelopment hanks more closely with the NPAprocess .so that they would direct a greater share oftheir resources re the social sector, with specialemphasis on primary health care (put:) and basiceducation.

PfiO(;rUMMES

UNICEF's capacity' to monitor its goals for chil-dren was strengthened during the year hy theadoption of indicators to enable comparisonsbetween countries. A new approach to the esti-mation of infant and under'five mortality rateswas adopted. During 1993, a status report, TheProgress of Nations, will he published, showing theprogress, country by country, towards the majorgoals of the World Summit for Children.

UNICEF cooperated in programmes in 137 coun-tries in 1992. The majority were in sub-SaharanAfrica (45), followed by Latin America and theCaribbean (35), Asia (34), the Middle East andNorth Africa (14), and Eastern Europe and Cen-tral Asia (9). In keeping with UNlCEF's priorityfocus on the needs of the poorest, programmeexpenditures for least developed countries were 43per cent of the total. Q

CONFERENCEPURSUESGOALS FORAFRICA'SCHILDREN

Despite progress made to alleviatepoverty and lower mortality rates,African nations still have far to goto meet international goals forchildren in the 1990s. One thirdof the estimated 13 millionchildren who die from preventablecauses each year are African,although they comprise just over10 per cent of the world's children.

It was against this backgroundthat UNlCfcT supported theOrganization of African Unity(OAU) and the Government ofSenegal in holding a three-dayInternational Conference onAssistance to African Children(ICAAC) in Dakar in November.Forty'Six African Governmentswere represented — most of themat the ministerial level — togetherwith 26 non-African countries,both industrialized anddeveloping, and two liberationmovements. Non-governmentalorganizations (NGOs), whichprovide about 30 per cent of theaid for Africa, were invited for thefirst time to participate in donor-government discussions. EighteenUnited Nations agencies, inaddition to UN1CEF, also joinedthis major endeavour to find waysand means of acceleratingprogress for the continent'schildren.

At the time of the Conference,more than 40 African countrieshad prepared, or were in theprocess of preparing, nationalprogrammes of action (NPAs) inorder to reach the goals for the1990s agreed to at the 1990World Summit for Children.

NPAs address priority needs inhealth, nutrition, education, andwater and environmentalsanitation through luw-costcollaborative efforts with thecommunities and families most atrisk. Conference participantsagreed to incorporate their NPAsin their bilateral and multilateralconsultations and developmentprogrammes.

• TO SAVE I MILLION LIVES:

The medium'term (1995) andlonger-term (2000) goals areambitious. The countriesattending the Conference agreedto accelerate action towards a setof intermediate targets by the endof 1995 to:

» raise Africa's averageimmunization coverage level from75 per cent to 80 per cent againstdiphtheria, pertussis, tetanus,polio and tuberculosis;

» ensure 90 per cent coverageagainst measles and 90 per centcoverage against tetanus forwomen;

» achieve 80 per cent usageof oral rehydration therapy (ORT)against diarrhoea! dehydration;

•• virtually eliminate iodinedeficiency;

» encourage exclusivebreastfeeding.

These goals are achievable forthe most part with only modestincreases in external support,provided there is a strong politicalcommitment and widespreadsocial mobilization. Takentogether these measures couldhelp prevent the deaths of] million children a year.

A conference report preparedby the OAU and UNICEF estimated

that African nations collectivelywould need an additionalUS$12.7 billion a year to achievethe agreed goals. About twothirds of this (US$8.8 billion)would be needed for majorsectoral programmes in the areasof health, education, nutrition,and water supply and sanitation.Some US$4 billion would gocowards programmes for thepoorest households, especiallyin countries that are recoveringfrom war, drought and otherdisasters.

Most of these resources couldbe found through a restructuringof national and officialdevelopment assistance (ODA)priorities. African and otherdeveloping nations devote justover 10 per cent of their budgetsto priority human needs. More isspent on armies and debtservicing than on education andhealth. Donor countries similarlydirect less than 10 per cent of ODA"towards basic needs in the world'spoorest communities. About 1.5per cent of all bilateral aid goes toprimary health care, 1.3 percentto family planning, and 0.5 percent to primary education.

What is needed, in the words ofUN1CEF Executive Director JamesP. Grant, is "20/20 vision" - areassessment of priorities bywhich 20 per cent of nationalbudgets and 20 per cent of ODAare apportioned to the socialsector and the special needs ofchildren.

1W U-NICEF ANNUAL Nj-roRr

CHILD SURVIVAL AND DEVELOPMENT

PRIMARY HEALTH CARE

1 HE past year has seen a movement towardsdeveloping a more comprehensive package ofhealth interventions ar the community level byhuilding on the outreach of the expanded pro-gramme on immunization (EPI) and the spread ofthe Bamako Initiative. Evidence of this is seenmostly in Africa, where there is an urgent need toorganize the PHC delivery system. Examples ofsuch action are found in the Gambia, Guinea-Bissau and several other African countries.

Many countries continued to build on the suc-cesses of universal child immunization (uc:i) todevelop integrated health systems. Immunizationprogrammes provide at least five contacts betweeninfants and health care providers in the first yearof life, and several countries - Bangladesh, Indo-nesia, Iran, Nepal, Nigeria and Uganda- utilizedthese contacts during the year to deliver vitaminA and iodine supplements, promote ORT, giveguidance to mothers on the treatment of acute res-piratory infections, and promote breastfeedingand prenatal care for pregnant women.

At the meeting of the Joint Consultative Groupon Policy (JCGP) in January, WHO and UNiCEh" weredirected to prepare a document on the subject oiorganizing district health systems based on PHC.The paper highlights the importance of systems in

maintaining the health gains made in the 1980s.It also emphasizes ways in which successful pro-grammes such as EPI can reinforce district healthsystems.

THE BAMAKO INITIATIVE

/ A F T E R five years of careful nurturing, theBamako Initiative has reached a critical stage inits evolution. In an extensive evaluation, the Lon-don School of Hygiene and Tropical Medicine hasfound the Initiative to be an appropriate way todevelop PHC services. Thus far, 25 countries areimplementing it as an alternative to traditionalmixes of public and private health services, butunless donors resolve to give a major push finan-cially and otherwise, its contribution to PHC isdestined to remain small. At the present rate ofprogress, it would take 40 years for the BamakoInitiative to revitalize Africa's health infrastruc-ture, and even then, half the population beyondthe range of existing facilities would be left with-out access to adequate health care.

Based on past experience in 22 sub-SaharanAfrican countries, Peru in Latin America, andMyanmar and Viet Nam in Asia, UNICEF esti-mates that 9 countries already have the potentialto accelerate implementation of the Initiative andachieve national coverage by mid-decade if suffi-

The basic healthprotection that is everychild's right is at lastwithin the reach of thedeveloping world.

PHttyRAMMES

YEMESSOA, CAMEROON

Hope restored in Yemessoa

hen he reached the top of the hill, Celestin Ngba cast a weary eye towards thehealth centre and then back downward into his village.

He traced the thin gravel line of the main road as it wound between mud wallsand iron rooftops, burrowed through plantations of cocoa, cassava, groundnuts and

plantains, and then surfaced briefly as if to take in air before disappearing for good beneath awall of equatorial forest.

The Ngba family seldom travelled beyond the tree line. Motorized transport was infrequent,and it was a three-hour trek to the town of Obala, just 15 kilometres away. Besides, they had mostof what they needed in Yemessoa. Isolated within the forest, the village was modern by ruralstandards, The water supply was pumped from a deep borehole and piped to outlets convenientlylocated along the main road. Electricity was drawn from the national power grid, and now therewas a health centre with a full-time head nurse and one trained assistant,

Mr. Ngba's 17-year-old daughter. Adele-Philomene, had just given birth there, and both motherand child were in excellent health,

Fortunately, the centre had recently reopened under community management and offeredessential drugs and basic health care for very modest fees. "It was unbelievable," said Mr. Ngba."If we had been able to afford transportation to the mission hospital in Efok I can tell you it wouldhave cost 10 times more. Before our community took over the management of the centre, theplace was almost abandoned and there were never enough medicines, The nurse wrote longprescriptions and sent you away."

The health centre in Yemessoa is one of 38 which have been set up in 10 provinces ofCameroon under the Bamako Initiative to replace poorly run government services and to protectcommunities from the overpriced and sometimes dangerous drugs prescribed by street merchants.The Initiative was launched in 1987 in Bamako (Mali) by African Ministers of Health after discussionswith UNICEF and WHO about ways of transforming some 40,000 government health facilities in sub-Saharan Africa Into efficient and affordable community-run operations.

The Yemessoa centre has two buildings which are open day andnight. Vaccinations are given daily. Drugs are always available to treatthe most common ailments: malaria, roundworm, skin infections andacute respiratory Infections. An antenatal clinic Is available to allpregnant women. The chief of the village reports that not one womanhas died from pregnancy or birth-related complications in more than ayear. He said that although falling cocoa prices had hurt local farmers,more than 80 per cent of villagers had been able to afford the drugsand health care provided. Attendance at the facility had more thandoubled from 958 visits in 1991 to 2,190 in 1992.

Yemessoa is in one of three provinces which have introduced theBamako Initiative with UNICEF assistance. USAID and a Germano-Cameroonian primary health care project each support another threeprovinces, while FAO helps one other. NGOs, including Save the Children,CARE and the Association of French Volunteers, are also supporting theInitiative in a number of provinces. In the UNICEF-assisted area, inhabitedby about 4 million people In 41 health districts, the objective is to bring38 per cent of the population under the umbrella of the BamakoInitiative by 1995.

Each centre is supplied with essential drugs from a warehouse in the capital, Yaounde. Thedrugs are procured Internationally through UNICEF channels at extremely favourable bulk rates.Each centre then adds its own margin to cover operating costs and sets fees for other healthservices. Only 10 per cent of the centres have failed to recover their operating costs,

Almost 2,000 government health centres covering some 20 million people In sub-SaharanAfrica have been revitalized by the Bamako Initiative. Cameroon hopes to Increase the number ofits health centres under community management from 38 to 118 In 1993,

IWUWICB" ANNUAL REPURT

cient financial resources are made available. Forthe remainder, including many large countries,resources will have to he found and, in addition,the basic capacity of the health system will requirestrengthening.

• ALLIANCES: A positive development in

1992 was that a World Bank report entitled 'Bet-ter Health for Africa' provides strong support for abroad-based alliance between the Bank, the Afri-can Development Bank, bilateral and multilateralagencies and NGOs to revitalize Africa's healthcare system at the periphery and district level fol-lowing the principles of the Bamako Initiative.

• UNICEF is convinced that this alliance is feasibleand has increased its interaction with WHO, thebanks, bilateral agencies and NUOs which areworking on African health issues.

In Mali, UNICEF is working with the EuropeanCommunity, French and German bilateral assist-ance agencies, the United States Agency forInternational Development (USAID), WHO andthe World Bank. It is expected that by 1996 incor-poration of the basic principles of the BamakoInitiative will have transformed health infrastruc-tures in five regions of Mali into fully functioning,community-based health systems. In the Gam-bia, revitaliiation of PHC based on the BamakoInitiative is in progress. One health division hasbecome operational, and five more will follow inearly 1993. Integration of vertical interventionswith more broadly based health programmes hasbeen supported by UNICEF without sacrificing thesatisfactory results of the EPI programme.

• CHANGING TIMES, Many African countrieshave been cautious so far about instituting thereforms which they helped to frame in the 1980s -especially those leading to greater communityinvolvement in health services management - butthe times are changing rapidly. Democratizationin Africa has helped to generate public demand foraffordable and better-quality services, and bothgovernments and donors will have to adaptaccordingly.

Democratic change has also opened up possi-bilities to apply the principles of the Bamako Ini-tiative in Central and Eastern Europe wheretraditional drug supply lines have collapsed. Manycountries are soliciting loans amounting tohundreds of millions of dollars to finance the pur-chase of essential drugs. If this money could beused to purchase the most cost-effective genericdrugs, competition among international supplierswould invariably drive down prices on the globalmarket, to the benefit of all.

Another new development in 1992 was the

The Bamako Initiativegives families accessto essential drugs atprices they can afford.

appearance of a publication for health workersentitled The Presenter, published by UNICEF ini-tially in cooperation with the us Pharmacopeia!Convention and now with Association MieuxPrescrire, in consultation with WHO. The publi-cation provides technical information on the useof drugs for different pathologies. Four issues werepublished in four languages during the year, cov-ering such subjects as pregnancy, sexually trans-mitted diseases and AIDS-related diseases, acuterespiratory infections (ARI) and the control ofdiarrhoeal diseases (CDD). Some 35,000 copieswere distributed, and circulation is increasingrapidly.

UNIVERSAL CHILD IMMUNIZATION

IMMUNIZATION coverage was sustained and

improved in a large majority of countries. But suc-cess has placed new demands on the vaccine sup-ply pipeline, and the prices UN ICE F pa.ys forvaccines increased by an average of 23 per cent.UNICEF has been working closely with WHO toensure that additional vaccines are available to allwho need them and that the uci goals of devel-oping countries are not jeopardized. Steps havebeen taken to:

» help developing countries which producelarge amounts of vaccine to improve the quality oftheir products and become self-sufficient;

» persuade vaccine suppliers to moderate theirprice increases;

•• encourage developing countries, whereverpossible, to begin to pay for their own vaccinesthrough the vaccine independence initiative.

,

PRtXJRAMMF.S

The immunization effortof the 1980s hasbrought dramaticdeclines in theincidence of diseaseamong children,preventing over3 million child deathsand 400,000 cases ofparalytic polio eachyear. Everything nowdepends on themaintenance of stronghealth systems tosustain and increaseimmunization levels.

This initiative offers high-quality but low-costvaccines through the UNICEF warehouse inCopenhagen, which accepts non-convertible cur-rencies. It also includes a revolving fund to pre-finance vaccine procurement, UNICEF uses localcurrencies for i n-country expenses and reimbursesthe revolving fund in dollars. Morocco has takenadvantage of the initiative and several other coun-tries are negotiating to join the scheme.

A situation analysis of global vaccine produc-tion and demand will be completed in 1993.

• POLIO ERADICATION; The last case of polioin the Americas was reported in Peru in Septem-ber 1991, and polio-free zones are being created inEast and South Asia, the Middle East, NorthAfrica and southern Africa.

Rotary International is an outstanding exampleof popular support tor the eradication campaign.Rotary raised more than US$240 million tor theeffort and provided thousands of volunteers toassist immunization services.

Most countries of Asia and the Middle East andNorth Africa have started to implement plans toeradicate polio, eliminate neonatal tetanus andcontrol measles, and UNICEF is supporting effortsto strengthen their disease-surveillance systems.These systems will provide timely reporting on theonset of any suspected case of polio and the inci-dence of measles and neonatal tetanus. Manycountries have started to map cases of neonataltetanus and polio and to identify high-risk areaswhere immunization coverage is low.

• DELIVERY SYSTEMS: Unfortunately severalcountries - most of them in sub-Saharan Africa -have not been able to maintain the high levels ofcoverage achieved in 1990. Civil unrest, droughtand lack of infrastructure are among the reasonscited. Attempts are currently being made tostrengthen their delivery systems.

in Guinea-Bissau, however, EPl activities arewell implemented across the country through theuse of outreach centres. This decentralizedapproach has had a positive impact on delivery ofPHC: services. While EPl began as a vertical pro-gramme, it is foreseen that in 1993 it will be inte-grated into the Bamako Initiative to revitalize thePHC system all over the country. (See The BamakoInitiative'.)

• VACCINE RESEARCH: UNICEF is actively col-laborating in the children's vaccine initiative(cvi) with UNDP, WHO, the World Bank and theRockefeller Foundation, cvi task forces are analys-ing the global vaccine supply situation and coor-dinating support tor selected countries to improvequality and increase local production. Researchhas commenced on a more heat-stable polio vac-cine, a single-dose tetanus vaccine and animproved measles vaccine, UNICEF does not pro-vide financial support for research activities, butis leading efforts to assure affordable high-qualityvaccines for the global immunization programme.UNICEF is also supporting the development ofstronger disease surveillance capacity in develop-ing countries.

W« J I N1CEF Ansi AI. REPORT

ACUTE RESPIRATORY INFECTIONS

C-ACH year, AR1 and, in particular, pneumoniaaccount for some 3.6 million deaths among chil-dren under five and are the single biggest cause ofchild mortality in the world.

By December, more than 65 developing coun-tries had operational plans of action for the controlof ARl, and another 20 had prepared technicalguidelines tor case management.

Most country programmes rely heavily on com-munity health workers for diagnosis and treat-ment. During the year, UNIOEF and WHO

supported training for more than 1,000 seniorhealth personnel in 25 countries.

UNICEl-'s comprehensive approach for the con-trol of ARl includes: helping develop plans ofaction geared to the needs, infrastructure andresources of each country; decentralizing activi-ties to subnational levels; assisting with the train-ing of health workers; supporting access toessential drugs and appropriate technologicaldevices; and helping with monitoring andcommunication.

• BAMAKO INITIATIVE: Access to antibioticsis essential for effective case management, and theBamako Initiative has helped guarantee commu-nity supplies in a number of countries, particu-larly in sub-Saharan Africa. Cotrimoxazole, thedrug recommended for the home treatment ofpneumonia, is now available in many countries.

In 1992, WHO, with LINJCEF support, took thelead in surveillance of antibiotic resistance.UNlCEF also collaborated with WHO in efforts todevelop equipment tor treatment of children suf-fering from pneumonia. Respiratory-rate timersand oxygen concentrators were introduced in1992 in Africa and Asia, where their use will beclosely monitored.

• CORRECT TREATMENT: Programme re-views in several countries where ARI programmesexist showed a marked reduction in the use ofantibiotics for coughs and colds, and in the use ofx-rays for the detection of pneumonia.

Ethnographic studies have been useful in deter-mining household practices and thereby develop-ing appropriate home-care messages for mothers.The messages help mothers recognize the earlysigns of pneumonia and seek appropriate treat-ment outside the home if needed.

An ARI managers' meeting in Bolivia (February1992) resulted in the formation of a consulta-tive group to provide intercountry support forARI activities. This support covered such ele-ments as general surveys, epidemiology, training

and communication. During the year, severalAsian countries included components of the ARIprogramme in an integrated package of servicesfor child survival. The package was very cost-effective, combining training, programming,management of services, drugs and logistics.

CONTROL OF DIARRHOEALDISEASES

/ALTHOUGH the rate of ORT use, based on thepercentage of cases of diarrhoea treated in chil-dren under five, has more than doubled from 17per cent in 1985 to 38 per cent at present, some 3million children died during the year from diar-rhoeal diseases. These unnecessary deaths were apoignant reminder that a revitalized diarrhoea Idiseases control programme is essential at globaland country levels.

Analyses of globaJ and country-specific datashow that nations must address diarrhoea! diseaseswith greater emphasis and specificity if they are toachieve the goal of halving child deaths from diar-rhoea by the year 2000. An intermediate goal of80 per cent ORT usage has been set for selectedcountries in order to toe us political support andcommitment to achieve the health target. Effortswill he made to ensure proper case management athome and in health facilities as well as to improveaccess to ORS.

International organizations can play a majorrole in these areas. In Mexico, the International A packet of oral

rehydration salts is achild's passport togood health.

I JR(H;I;AMM£:>

Jun ior Chamber of Commerce signed an agree-ment with rhe Minister of Health to support ORTactivities as part of the CDD programme in stateswhere diarrhoea I diseases pose the greatest risk.

• REVISED STRATEGIES: In a number at" coun-tries of Asia, Africa and Latin America, ORT userates and deaths due to diarrhoeal diseases havecome under close political observation. After ananalysis of child mortality in Morocco, King Has-san II declared that deaths due to diarrhoeal dehy-dration must be reduced dramatically. A two-yearinitiative to achieve that objective includes arevised communications strategy directed to thefamily and the marketing of ORS, combined withtraining for health personnel.

Ar the SAARC ministerial meeting on childrenheld in Colombo (16-18 September), senior gov-ernment officials from Bangladesh, Bhutan,India, Maldives, Nepal, Pakistan and Sri Lankacited CDD as a key objective through home-basedinterventions supported by the health system.Country planning includes improved productionand distribution of ORS in Pakistan.

• COMMITMENT TO CDD: At a ministerial

meeting in Mexico in October, 19 Latin Ameri-can countries discussed their NPAS and committedtheir health systems to a revival ofci >n. In Brazil,the Catholic Church and non-governmentalorganizations (NCJOS) aim to carry the ORT mes-sage to every home in states with the highestinfant and child mortality rates.

Child survival and con were also a majorfocus of the countries represented at the Interna-tional Conference on Assistance to African

Children (IC:AAC), convened by the OAU (Dakar,25-27 November).

It is important that countries and agencies inte-grate their activities at the field level. A packagefor programme development and training is beingdeveloped for case management of children withdiarrhoea, pneumonia, measles, malaria andmalnutrition. WHO continues to be a major part-ner with UNICEF in all activities related to pol-icy development, programme design andimplementation.

AIDS AND CHILDREN

D Y end-1992, WHO estimated that, world-wide, 13 million adults had been infected with thehuman immunodeficiency virus (HIV) and that2.5 million of these had progressed to AIDS. Everyday, approximately 5,000 additional people arebecoming infected, HIV infections among womenand children are increasing rapidly, and for chil-dren the results are especially devastating.Approximately one out of every three childrenborn to an Hiv-infected mother dies of A ins, usu-ally before the age of five. Even children who arenot infected suffer the disease's consequenceswhen it develops in their parents. While sub-Saharan Africa remains the most heavily infectedarea, the pandemic continues to spread through-out the world, making the problem truly global,with no country spared.

• MULT1SECTORAL APPROACH: There isincreasing recognition that no single interventionor approach is sufficient to contain the epidemicand that the spread of AIDS is directly linked tosocietal factors, especially to the status of women,with poor women and young girls being the mostvulnerable.

In this context, the UNicEH AIDS preventioneffort focuses on youth and women through amultisectoral approach. In line with the Ains pre-vention and care strategy approved by die Execu-tive Board in 1992, UNICEF supports activitiesaimed at: increasing life skills among youth, bothwithin and outside the school system, throughyouth organizations and peer groups; strengthen-ing health services; and supporting Ainy-infectedfamilies. An important aspect of the work is socialmobilization to spread knowledge through all lev-els of society - particularly among youth andwomen -and to increase the commitment of lead-ers and policy makers.

• CONTRIBUTING FACTORS: The eastern andsouthern Africa region remains the most severely

This young mother issaving her child's lifeBut dehydration fromdiarrhoea still causesover 1.5 million childdeaths a year.

1993 VNKEF ANNVU RLPORTaffected by the AIDS pandemic. As in otherregions, many factors contribute to the rapid•spread of HIV including die low socio-economicstatus of women and girls, the tendency of manymen to have multiple sexual partners, the highpersistence of sexually transmitted infectionsknown to facilitate HIV transmission, seasonalmigration patterns and the consequences of"armed conflict. Recognizing these factors, theUJsriCEF approach has been ro strengthen thecapacities of communities to address the problem.In Uganda, this is being done through allianceswith Nuos working both in prevention efforts andin activities to protect children who have beenorphaned.

• F o c u s ON YOUTH: In nearly all the coun-tries of the region, a large part of UNICEF supportis directed towards preventing HIV transmissionamong young people. In Rwanda, a peer-to-peerproject, with youth choosing their own leadersand developing their own materials, was testedduring 1992 and will now be carried our on alarger scale. This type of approach is proving suc-cessful in a number of other countries. In Zambia,there is a specific focus on women, with UNICEF

supporting the prevention and control of maternal•syphilis, an activity rhac will contribute todecreasing maternal mortality as well as to theprevention of Hiv transmission.

In West and Central Africa, one of the under-lying causes of" the spread of the disease is popula-tion migration, so UNICEF is developing preventionactivities which cover adjacent countries.

UNICEF uses a peer-to-peer approach inAfrica to protect thecontinent's youngpeople.

The most alarming increases in the rate oftransmission are in Asia. After a period of deny-ing the existence of the problem, countries arebeginning to respond with a sense of urgency.This is most evident in Thailand, where the Gov-ernment is engaged in a campaign to liberate girlsforced into prostitution. UNICES is providingassistance for their ^integration in society.

In Latin America and the Caribbean, UNICEFsupport to the Alas prevention effort is buildingon existing activities with children in especiallydifficult circumstances. Again, the focus is onyoung people, particularly those in high-risk sit-uations.

Finally, in the Middle East and North Africa,file region currently least affected by AIDS, UNICEFsupports activities to convince governments of thereality of the problem and is developing pro- •grammes to address the underlying situations-known to contribute to the rapid spread of thevirus. Thus, in Morocco assistance is given to pro-grammes to address the reproductive health needsand overall situation of women and girls.

• I M P R O V E D COORDINATION: During 1992,UNICEF took a number of steps to ensure better col-laboration and coordination with other organiza-tions both within and outside the United Nationssystem. Its closest relationship continues to bewith the WHO Global Programme on AIDS (GPA).

Joint activities organized in 1992 included a con-sultation of experts on HIV transmission andbreastfeeding as well as a number of countryassessments.

SS====

IJN(W;KU1M/:.S

The UNICEF nutrition strategy has been pro-moted in all developing countries and adopted toa large extent by Bangladesh, Bolivia, BurkinaFaso, Ecuador, Malawi, Mali, Namibia, Nigeria,the Philippines, Sri Lanka, Swaziland and theUnited Republic ot Tanzania. Other countries,including Brazil, Chad, Egypt, Ethiopia, India,Indonesia, Nepal, Madagascar, Mozambique,Niger, Peru and Viet Nam, are following suit.

Major constraints on the development of co-herent national nutrition strategies are:

" a lack of national consensus on rhe nature ofthe nutrition problem, in particular on the causesof malnutrition;

» the continued marginalizatton of nutritionissues in governments, agencies and universities;

» a failure to recognize the impact of sectoralpolicies and strategies on nutrition in such areasas agriculture, health, education, water andsanitation;

» inadequate understanding of the key role ofwomen in nutrition.

The tour main elements of the UNICEF nutritionstrategy involve:

» control of the three main forms ol micronu^trient malnutrition (iron, iodine and vitamin A);

» protection, promotion and support of breast-feeding and improved child-feeding practices;

» community participation and empowermentthrough improved assessment, analysis and sus-tainable actions (the triple-A approach);

» improved nutrition information systems.

Exclusive breastfeed-ing from birth is thebest way to ensure ababy is well nourished. NUTRITION

O,'N the global level, protein-energy malnutri-tion (PEM) among children under five years of agedeclined from 42 percent in 1975 to 34 per cent in1990. However, because of population growth,the absolute number of malnourished children hasincreased, from 168 million in 1975 to 184 millionin 1990.

The data contained in the Second World Nutri-tion Situatiim Report (1992), compiled by the Sub-committee on Nutrition of the AdministrativeCommittee on Coordination (A(X7SI.:N), do not

show significant differences among regions andbetween countries. South America shows a 50 percent reduction over the past 15 years, but PEM hasnot decreased in sub-Saharan Africa; and SouthAsia, the region with the largest child popula-tion, has more than 54 percent of the world's mal-nourished children.

During the 1980s, in many countries, includingBrazil, China, Egypt, India, Indonesia, Kenya,Thailand, Venezuela and Zimbabwe, the preva-lence of malnutrition, as measured by the numberof underweight children, showed a slow hut sig-nificant decline (see profile, 'Brighter Days in BanDawn'). The situation in some other countries,including Bangladesh, Colombia, the Philippinesand Rwanda, was static, while the trend in severalAfrican countries worsened. In 1992, wars anddomestic conflicts led to famine in Angola, Ethio-pia, Liberia, Mozambique, Somalia and theSudan, and severe drought affected householdfood security and nutrition in most countries ofeastern and southern Africa.

Not only on adequate food supply but alsohealth and care are essential for nutritional well-

IWJ UNlCEFANNTALRl-nm

B A N D A W N , T H A I L A N D

Brighter days in Ban Dawn

he loose sandy soil of this north-eastern village is dry much of the year, but mostfamilies scrape by on small plots of jute, tapioca and peanuts, which they cultivatealongside a canal which follows the main road. In a good year water stays in thecanal long enough for farmers to plant rice, but good years, like the rains are

infrequent. Rice is the main dietary staple, but in families that cannot grow enough to meet theirmn needs, nee purchases consume about 20 per cent of the household budget

Some 320 people - mostly very young or very old - live In Ban Dawn in thatched woodenhouses. Young people with six or more years of education tend to strike out on their own

More than half of the country's poor live in villages like Ban Dawn, with about one ninth theincome of those employed in the non-agricultural sector.

Malnutrition rates among children in the north-east averaged 25 per cent in 1990 and ranged

by mmonutnent cWdenckxareabo pmvdent Iron defk^ncy anaemia and QoW caused byinadequate iodine in the diet. Deficiencies In vitamins A and B2 are also a concern

In 1989 a survey in Ban Dawn of 44 children aged six years and younger found that 42 percent suffemd from W d e g r e e , ( ^ ^

The project blends modem knowledge of nutrition, health and education with the

oommunfYs percepts of nialrxjfrrHon CTKJtKXJHk,icHn9qpcf*KKL\AaaG,,3<]n)cskGK]v,hottheyGMadoing in a nutritional context and why. The project for Ban Down, and seven other rural villages inthe north and north-east, has analysed the main causes of malnutrition in each community andworks with several government agencies to alleviate the problem

During the action phase (January 1991-December 1992], a day-care centre was set up ine ^ v , , o o e . o n d a m c m u a a n d v W ^ ^village volunteers to use with parents or other caregivers. After training, the 20 to 40 volunteersrecruited from every project village each trained between 5 and 10parents in better child-rearing practices.

At the Ban Dawn day-care centre, preschoolers are now taughtgood health and hygiene habits and are encouraged to expressthemselves verbally. In primary school, fifth and sixth grade girls and boysare shown how to take better core of their siblings and become goodparents. The centre Is run by a committee which gathers contributionsfrom each household and pays a volunteer to care for the childrenduring the day and give them their lunch. The volunteer has been trainedto teach counting and the Thai alphabet. The centre also serves as aninformation and training resource for parents who want to know moreabout child care, health and nutrition. Additional information Is providedover public address systems or by monks and other respectedspokespersons.

Village volunteers also organize feeding stations for children in selectedhomes or at the community centre. Food is provided by the communityand is supplemented with fresh vegetables and other produce fromschool gardens, While the children eat, the parents are shown how tomake playthings with local materials and to stimulate child learning.

The project decentralizes authority - a striking departure from conventional child healthn ^ c ^ e d u c ^ programsofficials who are not necessarily disposed towards community participation

R e t r ^ Assuaged fhaf children^ welanf and height** age n ™ Improved In Ban DownBan Down «the poorer (XtneefghWlages hi the project but has shown He gmoteddegme of 'improvement, particularly in second degree malnutrition. Early Indications are that the approachcan be replicated nationwide for all 6 million of Thailand's under-six-year-olds

PKUUKAMME.S

Of rhe three necessary conditions for nutri-tional well-heing- (bod, health and care - the lasthas received the least attention, although UNICEFhas successfully promoted awarenes.s of improvedfeeding practices, including breastfeeding. Otherimportant components of child care are personalhygiene, the use of basic health services, and pro-tection and stimulation of the child.

UNICEF reviewed the role of care in child nutri-tion in a paper for rhe International Conferenceon Nutrition held in Rome in December.

• HOUSEHOLD FOOD SECURITY: Per capitafood production has stagnated in many nationsand has fallen by as much as 50 per cent in somecountries of eastern and southern Africa. Declin-ing food production has resulted in major priceincreases, making food inaccessible to poorhouseholds and reducing the frequency of mealsand amount of food for many children.

LINICEF support for household food security hasincluded: credit schemes for women producers inCambodia, Malawi, Namibia, rhe Philippines,Rwanda and "Tanzania; seed multiplication proj-ects in Nigeria; training tor agricultural extensionworkers in Namibia; food banks in Chad andNiger; and multiple cropping schemes in Beninand Burkina Faso. The UNlCEh" Eastern andSouthern Africa Regional Office (ESARO) hascoordinated a study of household food securityfocusing on .Angola, Botswana, Burundi, Ethio-pia, Madagascar, Malawi, Mozambique, Nami-bia, Rwanda, Tanzania and Zambia. UNICEF has

also been active in preparations for an Interna-tional Decade tor Food and Nutrition in Africa.

• MICRONUTRIENTS: There were a numberof successful moves during the year to combatmicronutrient malnutrition and increase aware-ness of the consequences of this 'hidden hunger'.Consensus strengthened on the importance ofvitamin A in fighting common infections, and itnow seems feasible that by 1995 iodine deficiencydisorders (IDD) can be eradicared in a number ofhighly populated regions. Clearer evidence alsoemerged on the negative impact of simultaneousdeficiencies of micronutrients, including iron,vitamin A, iodine and zinc, on the body.

• IDD: A Ministerial Conference on Childrenin South Asia (September) accepted a challengeto iodize all salt in SAARC countries by the end of1995. There are preliminary indications that Bhu-tan has virtually eliminated IDD, and importantsreps have been taken towards iodizing all salt inBangladesh. China has developed a comprehen-sive plan with UNICEF, UNDl1 and WHO to tackleIDD, and important steps were also taken to elim-inate the disorders in Mongolia, Myanmar and thePhilippines. In the Americas, Bolivia and Ecua-dor are close to eliminating IDD; Cameroon andNamibia have been among the most successfulAfrican countries in tackling this problem. A sur-vey carried out by the Internarional Council forthe Control of Iodine Deficiency Disorders(ICCIDD) revealed that these disorders remain asignificant problem in Central and EasternEurope.

• VITAMIN A= National vitamin A supple-mentation programmes were implemented inBangladesh and Sri Lanka during the year, and anumber of other countries plan to deliver vitaminA supplements through their EPl programmes, Anational survey in Indonesia is expected to con-firm that xerophthalmia has been virtuallyeliminated.

• IRON: UNICEF supplied iron and folic acidsupplements on a large scale to pregnant womenin _30 countries during the year.

• N U T R I T I O N INFORMATION SYSTEMS: A

review of nutrition information systems in Bo-tswana, China, Costa Rica, Madagascar, Mali,Mexico, Venezuela and Viet Nam was not encour-aging. It showed that while most countries gath-ered substantial data and generated impressivecomputer diagrams, inadequate analysis meantthat little of the information was used by decisionmakers. Surveyors noted a need for stronger advo-cacy to generate understanding of the problemsand demand for solutions.

Lack of vitamin A couldcause this child tobecome blind, but twocapsules - costing fourUS cents - will protecthim for a year.

1993 I WJCEF A\-NI u Rtruin

medium-term plan 1992/1995, WHO providestechnical assistance and UNFPA provides supportfor training, demographic studies and census tak-ing, women in development activities, and thesupply of contraceptives. UN DP gives necessaryinstitutional support.

In addition to saving lives and improving thequality of lite for mothers and children alreadyhorn, family planning would reduce demand forabortions and help prevent the more than 50,000illegal abortions currently performed every day.

During 1992, the Earth Summit (LINCED) pro-vided a major forum for discussion on populationpolicies in the context of sustainable development.

In many developing countries, particularly inAfrica and South Asia, communities depend ontraditional bixth attendants (TBAs) for prenataland del ivery services. UNICEF continues to supporttraining for TBAs in many countries, includingEgypt, Ghana, Iran, Malawi, Mexico and Nepal.UNICEF is now conducting these programmes inaccordance with the guidelines worked out jointlyhy UNICEF, WHO and UNFPA. Special efforts areheing made to upgrade the knowledge and skills ofTBAs in maternal and child health (MCH) activi-ties and to establish closer links between thehealth sector and TRAS.

UNICEF continues to supply iron and folic acidsupplements for antenatal clinics and hospitals,and chloroquine, where appropriate, for malariaprophylaxis in pregnant mothers.

Training of UNICEF staff in safe motherhood was

One of the year 2000 goals is access to prenatalcare for all pregnant women.

SAFE MOTHERHOOD AND FAMILYPLANNING

I\T least 500,000 women died during the yearfrom causes related to pregnancy and childbirth.And tor each of these deaths 15-20 women suf-fered some form of lifelong disability. About 25 percent of maternal deaths are due to abortions andanother 25 per cent to the complications whichare common in ill-timed, high-risk pregnancies.This tragic loss of life would be greatly reduced ifcouples who did not want to have a baby were ableto avoid pregnancy safely and effectively.

• GOALS: The 1990 World Summit set impor-tant goals for safe motherhood and familyplanning, including a 50 per cent reduction inmaternal mortality by the year 2000; access by allpregnant women to prenatal care, trained attend-ants during childbirth and referral facilities forhigh-risk pregnancies and obstetric emergencies;and access by all couples, especially women, tofamily planning information and services to avoidpregnancies which are too early, too late, toomany or too frequent during a woman's reproduc-tive cycle.

Working in partnership with WHO, UNFPA andUNDP, UNlCEF's focus on reaching the goals offamily planning is in the areas of information,education and communication on birth-spacing,responsible parenthood and discouraging earlymarriage and early pregnancies as stressed in the

A health workerexplains differentmethods of familyplanning. Such servicescan change the livesof women in thedeveloping world.

PI«X;RAMMI*

In Iran, UNICEF supports government efforts toreduce maternal mortality rates by training ruralmid wives and monitoring their impact and effi-ciency. By the end of die current training cycle itis expected that 95 per cent of deliveries will behandled by TBAs. A government programme inte-grates family planning with the PHC network,makes extensive use of the media for health edu-cation and provides low-cost contraceptives.UNICEF assisted with health education and advo-cacy and a KAP (knowledge, attitudes and prac*tices) study in 24 provinces.

In Egypt, TBA training is linked to the immu-nization of women against teranus. The mainobjective of the programme is to ensure hygienicdelivery practices and the early referral of patientswho have complications to appropriate healthfacilities.

In Mexico, more than half of the 14 millioncouples practise some method of family planning.UNICEF supports training and communicationsactivities, and some 252,000 community healthpromoters, 24,000 health workers and 3,400 tra-ditional midwives have been trained in MCHactivities.

In Nepal, UNFPA and UNICEF collaborate in pro-grammes to encourage smaller families and childcare. Elements of family planning have beenwoven into every aspect of UNICEF programmeactivities In the areas of MCH, education and pov-erty alleviation.

In the Philippines, UNICEF'S urban basic serv-ices (UBS) programme has integrated family plan-ning and adolescent fertility in 25 poor urbanareas. UNICEF assistance for MCH is supplementedwith funding from the Australian InternationalDevelopment Assistance Bureau.

In Tanzania, UN1CFF supports family planningas part of the safe motherhood initiative.

In Zimbabwe, the AIDS Prevention Programmehas a major focus on education for schoolchildrenabout responsible sexual behaviour, includinginformation about reproduction and family-planning.

• FEMALE CIRCUMCISION: Female genitalmutilation affects more than 80 million womenglobally. Its psychological consequences have notbeen adequately studied but the devastating phys-ical effects are well documented. These rangefrom infertility and pelvic infection to frigidityand difficulties at delivery.

The mutilating effect of female circumcisionvaries widely and is closely tied to cultural prac-tices and beliefs. It is a delicate issue which makesbehavioural change difficult, particularly in those

The family has the firstresponsibility for thecare of children.Happy, healthy familiesare Ihe goal of thesafe motherhoodinitiative.

continued in 1992 with an interregional trainingworkshop in Ouagadougou (Burkina Faso), 26October-3 November. Participants were fromboth the Easr and West African regions and fromthe South Asia Regional Office (ROSA).

In March, UNK:F> participated in a meeting ofPartners for Safe Motherhood, hosted by theWorld Bunk in Washington, D.c. It was acknowl-edged that while much interest had been gener-ated since the launching of the safe motherhoodinitiative in 1987, the number of maternal deathsremained indefensibly high.

A strategy paper on safe motherhood was pre-pared under contract by Columbia University inNew York in consultation with UNU:EF staff.

• GLOBAL ACTIVITIES: In Bangladesh, ac-cess to MCH and family planning information andservices continued to improve, together with sup-port for a government programme to raise theaverage age of marriage and prolong the intervalbetween births.

In Ghana, a safe motherhood project was sup-ported by UN1CEF in three of the country's tenregions. Projects in the remaining seven regionsare supported by UNFPA and USA1D.

In Malawi, UNICEH is helping to increase publicawareness of safe motherhood and improve mater-nal services at health units. Antenatal clinics andtrained TBAs are supplied with essential drugs,including iron folate and chluroquine.

I9y 11TMICKF AIWI AI. Rertwi

countries where the health department does norrecognize it ay a problem.

UNICEF's main role has been in publ ic educationabout the harmful consequences of female cir-cumcision through training programmes for mid-wives and TBAs.

In Guinea, where 80 per cent of all women arecircumcised, UNICES provides advocacy and pro-gramme support for local NGOs concerned withexcision and infibulation.

BREASTFEEDING

lnii effort to accelerate action on the protec-tion, promotion and support of breastfeeding,with BFHl as a key strategy, resulted in a greatresurgence of activities in 1992.

Within 18 months of its launch in June of 1991,BFHI activities had been undertaken in more than120 countries - both developing and industrial-ized. At the end of last year, 97 per cent of all thedeveloping world's children lived in countries thathad either taken action to end free and low-costsupplies of breastmilk substitutes or had never hadthem. Only six developing countries had not yetacted to end the distribution of free supplies;hopefully, all will have done so by April 1995. Thegoal of ending the distribution of free and low-costsupplies in all industrialized countries has been settor mid-1994.

• SAVING LIVES: The goal of RFHI is to mobi-lise health care systems and health workers to pro-vide information and support to women tobreastfeed exclusively from birth. Even in thepoorest or circumstances a mother can conveni-ently provide all the nutrition her child needs torthe first tour to six months by breastfeeding. Butmany hospitals actively discourage this naturaloption by separating infants from their mothers atbirth and using infant formula as a 'modern' feed-ing alternative. In many communities, especiallypoor ones, the results are often disastrous, WHOreports that a bortle-fed baby in a poor commu-nity is 15 times more likely to die from diarrhoealdiseases and 4 times more likely to die from pneu-monia than a baby who is exclusively breastfed.WHO estimates that more than 1.5 million infantlives could be saved from diarrhoea and ARI deathseach year if mothers breastfed exclusively duringthe first four to six months.

• GLOBAL CRITERIA-, UNICES and WHO havesupported the process of the designation of'baby-friendly1 hospitals by developing global criteriabased on the Ten Steps to SuccessfulBreastfeeding'. Guidelines, training manuals andan international assessment instrument providecommon global standards for judging accomplish-ments. Countries were assisted in establishingRFHI national committees and in designatingbaby-friendly hospitals, UNICEF identified a global

A smiling motherwelcomes hernewborn, who is givento her to breastfeedimmediately after birthat a baby-friendlyhospital. UNICEF effortsto promote BFHIworldwide are gainingground.

PROGRAMMES

network of health professionals qualified to help intraining health workers, in transforming hospitalpractices and in supporting countries to plan forlong-term changes.

During 1992, 90 developing countries had tar-geted hospitals to hecome baby-friendly. In morethan half of those countries, 767 hospitals arecommitted to achieving or have already achievedbaby-friendly status, having undertaken the TenSteps to promote and provide optimum support forbreastfeeding. In several developing countries,the Ten Steps were adopted to apply to whole vil-

lages, cities and regions. Breastfeeding promotionorganizations have continued to mobilize the pub-lic to demand baby-friendly hospitals.

• CHANGING HOSPITALS: BFHI is the firstWHO/UNICEF initiative launched with goals forboth developing and industrialized countries.This global initiative set in motion dialogue andactions aimed at re-establishing a breastfeedingculture, as well as the gradual, sustainable trans-formation of the way hospitals treat new parents,newborns and eventually their patients all overthe world. Q

BASIC EDUCATION

THE Executive Board has strongly endorsedthe expansion of basic education activities,

giving priority to primary education, education ofgirls and women, and linkages with early childdevelopment (ECD).

Primary education was a priority theme at rep-resentatives' meetings in all regions during theyear, and at an NCO conference on girls' education(New York, April 1992) the Executive Directorcalled for the full integration of girls into themainstream education system, while recognizingthe importance of using non-formal approaches toprovide learning opportunities to girls in theinterim period until the formal system was ade-quately able to meet the demand.

LJNICEF organized a regional workshop in Bo-tswana on girls' education in order to develop NrAsbased on diagnostic studies prepared for eightcountries in the eastern and southern Africanregion.

UNICEF efforts to support education for girlsincluded training of female teachers in Nepal,Pakistan and Yemen; preparing gender-sensitivecurricula in Bangladesh, Mozambique and Nepal;ensuring that schools were located near commu-nities in Bangladesh, Bhutan and Nepal; and sup-porting day-care centres tor younger siblings inChina. In Pakistan, the new UNICEF country pro-gramme focused on the enrolment and retentionof girls in school. Tn Morocco, a project waslaunched in 1992 to double the enrolment of ruralgirls in primary schools by 1995. (See also profile,'Educate a girl, educate a nation.)

• CREATIVE APPROACHES: Stronger empha-sis was placed on creative ways of bringing basiceducation services to poor and difficult-tivreachcommunities. Determined advocacy generatedmany enquiries for information about successfulinnovations including the Bangladesh RuralAdvancement Committee (RRAC) non-formaleducation project and the Escuela Nueva, a formaleducation project in Colombia. A senior memberof BRAC travelled to Nigeria, Senegal and SierraLeone to provide information about these com-munity-based schools, and educators from Turkeywent to Colombia with UNICEF assistance to learnabout Escuela Nueva.

• EARLY CHILD DEVELOPMENT: UNICEF pol-icy on young child development was updated dur-ing the year in collaboration with agency partnersfrom the Jomrien Conference, NGOs and privatevolunteer organizations in the field. A framework

A basic educationmust equip a child forthe responsibility ofadulthood. Educationof the girl child isincreasingly a UNICEF

1993 UNICEF Amn \L REPORT

for policy development was prepared and sharedwith 20 African countries and Facts for Life mes-sages were expanded to include child develop'ment. Training focused on the young child wasinitiated for UNICEF staff in nine Sahelian coun-tries, and training modules were introduced inAngola, Ghana, Rwanda and several other coun-tries of Africa, Asia and Latin America. TwelveLatin American countries had strong young childdevelopment components in their basic educationprogramme for 1991-1992, and 20 African and 11Asian and Middle Eastern countries are adoptingmore comprehensive strategies in this area.

• ADULT LITERACY: UNICEF participated inseveral meetings and seminars on literacy andadult education, and is preparing policy guidelinesfor further discussion and consensus-building.

A number of countries have new literacy activ-ities. Nepal has an integrated adult and children'sliteracy programme which includes reading, writ-ing, numeracy and basic knowledge on health andnutrition. Namibia launched a national literacyprogramme in September, with the target ofachieving literacy for all by the year 2000. Egyptestablished a National Agency tor Adult Educa-tion and the Eradication of Illiteracy and is in thethird year of a 'Decade for Literacy". The Domin-ican Republic has adapted a new set of literacymaterials from the Facts far Life manual.

A teacher conductsa literacy class forwomen during a breakin their work as carpet-weavers.

A UNESCO/UNICEF regional seminar was held inBogota in May 1992 to develop a new frameworkfor adult education in Latin America, and a num-ber of activities are planned in this area withUNESCO, the International Council for AdultEducation, the Latin American Council for AdultEducation, and the US-based National Center onAdult Literacy.

• MONITORING GOALS: UNICEF continued its

work with UNESCO and other partners to helpcountries improve the quality and timeliness ofdata collection, and a joint UNESCo/uNiCEF proj-ect is developing ways to determine learningachievement, UNESCO and the World Bank areworking on indicators tor selected activities.

• BUILDING PARTNERSHIPS: Existing net-

works were strengthened and extended during theyear, both at headquarters level and in the field.Meetings were held with USA ID, the World Bank,UNDP and UNESCO to share information and toplan joint activities, and strong working relation-ships were initiated in the areas of ECD and girls'education. Both the Bank and USAID have agreedto incorporate ECD in their list of educationalpriorities and have asked for ongoing assistancefrom UNICEF. A UNICEF publication, Strategies mPntmntc Girls' Education, made an important con-tribution in focusing policy discussion at thedonors1 meeting on basic education held in Paris(June 1992).

Promotional activities continued under theUNESCO/UNICEF Cooperative Agreement, andUNICEF participated in the first meeting of theInternational Consultative Forum on Education,

25

A boy sets off for school before sunrise, carryinghis books and his midday meal

PRUtJKAAlMfi

B O L I V I A

The language of education

or Indigenous people in Latin America, education is often a double-edged sword.Delivered only In Spanish, the language of colonial conquest. It has tended todisparage native cultures and make students feel ignorant or ashamed of theirheritage, Drop-out rates for indigenous students are far above national averages,

and for those who enrol In school and stay long enough to graduate, the price can also be high.Very often, education becomes a barrier between children and parents who speak only theirnative tongues and are illiterate.

In a poignant letter to UNICES leaders of the Guarani community In Bolivia wrote: "Many yearsago, when schools arrived In our region, they told us that education would be the way out of ourbackwardness, a way of achieving our development. We thought so as well and struggled to haveschools. We built the buildings with our own scarce resources and fought for the state to sendteachers to our community. Each child we sent to school represented our hopes for a bettertomorrow.

"The years went by, and we did not see the fruits of these schools. Those of us who are parentstoday suffered the frustration at that time of having to leave school after a few years without anyadvantage. The meaning of things was Inverted for us. Strangely, education did not help us toadvance, quite the opposite. It served as a pretext for them to fell us, on top of everything, that wewere stupid, ignorant and backward. The Spanish language, which was supposed to open thedoors to science and knowledge for us and be the vehicle for improvements In our lives, ended upmaking us ashamed of the customs and language of our fathers and our Guarani culture. Schoolbecame an obstacle to our efforts to relate to the rest of society"

There is a total of some 200,000 indigenous Guarani in Argentina, Bolivia, Brazil and Paraguay.In Bolivia, an estimated 80,000 live in the Chaco region close to the borders with Argentina andParaguay

A meeting between the Assembly of the Guarani People. UNiCEF and the Bolivian Ministry ofEducation In 1989 brought the promise of change through a project to Introduce bilingual

education without cultural biases to schools in marginal areas. There are114 indigenous bilingual schools in Bolivia, of which 23 are for Guarani-speaking children. The project is sponsored by Bolivia's Primary EducationProgramme with support from UNICES UNESCO, the Government of theNetherlands, the Catholic Church, and local and international non-governmental organizations [NGOs). The effort was reinforced In January1992 by the presidential launching of a literacy campaign to give everyGuarani girl, boy, woman and man a basic bilingual education. By theend of the year, more than 10,000 Guaranis and 500 communityeducators were involved In the campaign.

A council of Guarani eiders, including women, has been involved Inall phases of the project and has reviewed the writing and illustration oftexts to ensure their relevance to the cultural and daily reality of thestudents. Bartomeu Mella, a Jesuit priest and authority on the Guaranilanguage and culture, said that the elders or Arakuaiya [guardiansof knowledge] have expressed themselves through the new curriculawith an authenticity and precision that anthropologists havefound difficult to achieve.

Early results show that boys and girls In the Guarani bilingual schools are earning higher gradesIn all subjects than their peers in comparable monolingual schools and that the number of drop-outs and students repeating grades has decreased significantly. According to UNESCO, in theGuarani bilingual schools the repetition rate for the first grade was 10.5 per cent after two years ofthe project, while at the national level It was 26.4 per cent,

Although the Bolivian project is still in Its infancy, reports from parents to UNICEF oreencouraging. "Now the children are learning more and better," wrote one parent body. "Theycan express themselves freely without being punished for speaking another language."

1993 IWCEF ANNUAL REPORT

hosted hy UNESCO in Geneva in September. Cnn-

: structive working relations were developed withtwo UNESCO-affiliated institutions - the Interna-tional Institute tor Educational Planning (HEP) inParis - and the UNESCO Institute of Education(UIE) in Hamburg. Collaboration arrangementsalso exist with the Christian Children's Fund, theBernard Van Leer Foundation, the World Orga-nization for Preschool Education and the Child-to-Child Trust.

In 1991 the UNESCO/UNICEF Joint Committeeon Education (ICE) proposed the development of ajoint 'Nine Largest Countries' strategy. Nine ofthe most populous countries-Bangladesh, Brazil,China, Egypt, India, Indonesia, Mexico, Nigeriaand Pakistan - were selected because, since theyhave 75 per cent of the world's illiterates, signifi-cant progress would be made in achieving theJomtien goals if those countries were encouragedto provide universal access to basic education bythe end of the decade. In 1992, plans for a jointstrategy to help the nine reduce illiteracy and pro-vide access to primary education hy the end of thedecade were started, and each Head of State was

invited to participate. UNICEF/UNESCO consulta-tions, advocacy visits to selected countries, coun-try sector analyses and technical support arcplanned for each country during 1993. Theseefforts will culminate in an internationalmeeting, hosted by India and involving Heads ofState and educators from all nine countries, inNovember 1993.

• BuD(iET: Although UNICEF budgetary com-mitments for basic education have gone up inmany countries, actual programme expenditurefor education went down from US$57 million in1990 to US$48 million in 1991 or only 8 per centof the total programme budget. This phenomenonmay have been partly due to the demand forresources created by an unusually high incidenceof emergencies in various regions during 1991. In1992, however, expenditures on basic educationrose to US$72 million or about 10 per cent ofUNICEF total programme budget for that year. Thislatter increase does suggest that there may nowbe a growing commitment on the part of UNICES

field offices to invest more resources in basiceducation. Q

WATER AND ENVIRONMENTAL SANITATION

DROUGHT, civil strife and combinationsof both severely tested the capacity of

UNR;EF and other agencies to meet the demand forsafe water supplies in 1992. Virtually all of south-ern Africa and countries of the Horn, as well asparts of Asia and Latin America, suffered the dis-ruption of regular development programmes asgovernments and relief agencies were forced torespond to emergencies.

In most, if not all, of the emergency countriesthere are both regular and emergency water andsanitation (WATSAN) programmes. To make opti-mum use of emergency funds, these programmesshould be linked as far as practicable. For example,it can be very wasteful in emergency zones to useresources to buy water tankers, which are of verylimited use after the crisis has passed. It can be farmore cost-effective to sink wells in the emergencyzone and sustain them. There should be a judi-cious mix of emergency and regular WATSAN pro-grammes in areas of instability.

• MONITORING: Following the World Sum-mit for Children, NPAS have become a rallyingpoinr for sectoral goals, and the Water and Sani-tation Monitoring System (WASAMS), developed

by UNICEF and WHO, has become a useful tool forthose countries wanting to assess and track their

Restoring clean waterto war-torn areasrequires a combinationof emergency andregular measures.

PiKX/KAMMES

own performance, t INICEF and WHO collaborate ingathering national data each year to enhance sec-tor monitoring at the global level, analyse trendsand make regional and global comparisons. Thesedata are published by the Geneva-based GlobalCollaborative Council for Water Supply and San-itation. About 70 developing countries providedbaseline data in 1990, while some 18 countriescarried our some torm of WATSAN review in 1992.These included in-depth evaluations in Angola,Bangladesh, Cambodia, Haiti, Indonesia, Mex-ico, Sri Lanka and Viet Nam.

• NATIONAL PROGRAMMES OF ACTION: The

strength of NRAS for advocacy and follow-up wasmost evident in Mexico where investment in thesector has grown fivefold since WATSAM goals wereinserted in the NPA in 1990. By the end of 1992,coverage had increased from 79 per cent to 84 percent for water supply, and from 63 to 68 per centfor sanitation.

• ENVIRONMENT: Two meetings during the

year highlighted environmental aspects ofWATSAN projects. An International Conferenceon Water and the Environment, held in Dublin(January) submitted a number of substantive pro-posals co the Earth Summit (UNCED) in Rio deJaneiro (June). Both conferences emphasizedintersectotal linkages for sustainable develop-ment, and UNCElVs Agenda 21 gave integratedwater resources management well-deservedprominence.

Women mechanics repair a handpump. Theirteam maintains 50 pumps in good working orderas part of a UNICEF-assisted programme.

• GUINEA WORM DISEASE: Significant prog-ress was made towards the eradication of dra-cunculiasis (guinea worm disease) with the com-pletion of national case searches in all knownendemic countries except Chad and the Sudanwhere political instability hindered .safe access toendemic areas.

A promising sign is that while globally thenumber of known endemic villages has increasedas a result ot stronger surveillance measures, thenumber of cases has declined. About 85 per centof the known cases of dracunculiasis occur in justsix countries - Benin, Burkina Faso, Ghana,Mali, Nigeria and Uganda - and it is believed theSudan also has a large number of victims.

A UNICEF/WHO Inter-agency Technical SupportTeam, created for endemic francophone coun-tries, became operational during the year and isbased in Burkina Faso.

• SUSTAINABILITY: The concept of localmanagement involving women in the operationand maintenance of WATSAN systems has beenadopted by an increasing number of countries,some ot which are broadening the scope of theBamako Initiative from its health focus to includecost-sharing tor water systems. A number of coun-tries have established community WATS AN com-

UNICEF has helped tobuild latrines for thepeople of this remote,mountainous villoqe

1993 UNICEF ANNUAL RtPOHT

U M S H U G A L R A . T H E S U D A N

Child-friendly villages

taring suspiciously, the old man barked, "Why are you asking?""By God! Answer me," said the younger man. "How many children do you have?""Fourteen," said the old man reluctantly, before self-consciously counting again...."Perhaps 15" The crowd roared with laughfer and the Sudanese mobile theatre group

knew it had another hit for its repertoire.The theatre group has had a string of successes In Um Shugaira - a community of former

nomads from the Howozma tribe. The Hawazma have embraced almost every available socialImprovement from hand pumps to oral rehydration. Personal hygiene is better, child nutrition hasImproved, and mortality rates - about 180 per 1,000 live births - are In retreat.

A village committee of five women and five men has been trained to promote health andhygiene, and two members have accepted responsibility for maintaining the community'shandpumps and low-cost pit latrines. UNICEF supports these activities together with income-generating projects for women and a child nursery.

About 20 other villages in the state of Kordofan consider themselves to be equally progressive.There has been some discussion about the possibility of officially designating villages as "child-friendly' once fhey achieve immunization, water, sanitation, education and other development goals.

A UNICEF-supported project backed by creative government financing aims to provide safewater supplies and sanitation for most of the state's 3 million inhabitants. The Sudanese Governmenthas negotiated with donors to write off US$65 million In debt In return for government localcurrency investment in the project,

One of the most successful components of UNICEF assistance in Kordofan has been theinstallation and maintenance of handpumps. About 6,500 wells, dug since 1989 have beencapped with India Mark II handpumps. The combined cost of well digging and pump Installationper unit is about US$3,500, compared with US$8,000 per unit before the project started. Annualmaintenance of each pump is about US$25, and an average village like Um Shugaira has sevenhandpumps. Each handpump serves about 200 people and isaffectionately known as a hayati - 'my life' - appropriate in a landwhere the struggle for safe drinking water is a struggle for life itself.

In villages like Um Shugaira, women have assumed responsibility formaintenance of the pumps to ensure that never again will they have towalk four hours every day to fetch the household water supply.Maintenance money is gathered from a tax on sugar, levies at harvest

..time, or a fixed monthly tariff for each household. Quarterly surveysIndicate that more than 85 per cent of the pumps remain operational•throughout the year.

The child-friendly village project also promotes the construction ofsimple latrines together with hygiene education. A handpumpmaintenance manual carries messages from the UNICEF handbook Factsfor Life, which schoolteachers and religious leaders have been trained tocommunicate to parents and students in Kordofan. Last year, more than 1million school exercise books, 500,000 matchboxes and 250,000 schooltimetables carried immunization messages. Schools are priority sites forthe installation of both handpumps and latrines.

UNICEF project support has also been given to the enrolment ofmore than 7500 women in a literacy programme; mobilization ofinternational, national and local resources for girls' education and earlychildhood development services; and provision of solar refrigerators for safe vaccine storage. Therefrigeration units will extend the reach of mobile Immunization units Into communities isolated byhot desert terrain.

UNICEF has also helped to establish more than 20 oral rehydration 'comers' at health unitsaround fhe state. The health units are the focal point for a trial introduction of the Bamako Initiativewhich UNICEF believes could eventually make Sudan's child-friendly village project self-sustaining.

PROGRAMMES'

To combat disease inshanty towns, UNICEFcombines hygieneeducation with theupgrading of waterpoints. Here, water iscollected at aconservation projectsupported by UNICEF.

vA

\4>j& c*

^ - % .

mittees with financial as well as technical respon-sibilities. UNICEF is supporting these endeavourswith regional workshops to build local capacity incountries including Angola, Mozambique and

• LINKAGES: Several countries are seeking toexpand the most common linkages between watersupply, sanitation and health to include nutrition,education, women in development and the envi-ronment. African Sahelian countries have soughtsectoral linkages with the environment. Omanhas linked WATSAN with a campaign to combattrachoma, and other countries are establishinglinkages with education through school hygiene.

• SANITATION AND HYGIENE: The need tochange human behaviour has made sanitation andhygiene elements more difficult to programmethan water supply. However, a decision by UNlCEh"in 1990 to shift the focus from engineering tohealth and social communications with a prefer-ence for women to handle this task (because oftheir key role in educating the family on die needfor sanitation and as an opportunity to empowerthem to demand better facilities in the commu-nity) has had satisfactory1 results in Bangladesh,Benin and Ethiopia. {See also the profile on theSudan, 'Child-friendly villages'.) In each of thesecountries women with a public health backgroundhead the sanitation and hygiene components ofthe programme.

• TECHNICAL COOPERATION: Highlights oftechnical cooperation among developing coun-tries (TCLX:) during the year included: a visit toGuatemala and Honduras to look at low-costWATSAN projects in marginal areas by Peru'snational WATSAN officer; the secondment of Moz-

ambique's Senior Project Officer to advise on thedrilling and rehabilitation of boreholes in Zambia;assistance to drought-affected areas of Zambia bya WATSAN officer from Sierra Leone; guidance onWATSAN services for refugees in Kenya from aWATSAN officer from Mozambique; an exchange ofinformation between Uganda and Tanzania onthe use of PVC rising mains (pipes) for hand-pumps; a visit by four Nigerian government offi-cials and one WATSAN officer to Tegucigalpa(Honduras) to inspect urban programmes.

• COLLABORATION: Inter-agency collabora-tion needs to be pursued more energetically andsystematically both inside and outside the UnitedNations system. During the year UNICEF wotkedclosely with a number of agencies and organiza-tions including UNDP, WHO, the World Bank,NGOs and several bilateral bodies.

• RESEARCH AND DEVELOPMENT: A Frenchcompany, Rhone-Poulenc, has developed a cylin-der which can be inserted in boreholes to releaseregulated amounts of iodine into drinking watersupplies in areas deficient in this vital micronu-trient. A water source which provides 7,200 litresof water a day can be iodated at a cost of US$150a year. The company claims that the system hasbeen well received during tests in Mali, andIJNICEF staff in the areas of WATSAN and nutritionwill participate in field trials in Benin, Guate-mala, Indonesia, Kenya, Malawi, Nepal, Nigeria,Pakistan, the Sudan, Tanzania and Viet Nam, allof which have iodine deficiency problems.

• GLOBAL ACTIVITIES: During 1992, UNICEF

cooperated with approximately 100 countries inWATSAN projects or activities, with an approxi-mate financial input of US$84 million. •

| ^ H E Earth Summit (UNCED), held in Rio dcX Janeiro in June, provided an extraordinary

opportunity for people of all nations to examinethe sustainability of their natural developmentpattern and their lifestyles.

UNICEH played its part in this process by helpingto mobilize governments, NCOS and citizens fromall walks of life. Its main role was that of an advo-cate for development approaches focused onhuman concerns and the special needs of childrenand women. Many country offices were involvedin studies and situation analyses linking the stateof the environment to the plight of the poor, andin co-sponsoring national seminars and confer-ences on this subject, UNICEF'S role and specialconcerns for children and women were subse-

c-uently reflected in many of the national reportsprepared for UNCED.

Several offices helped initiate puhlic campaignsand children's hearings to increase environmentalawareness among children and involve themactively in the protection and improvement of theenvironment around their school, home andcommunity.

Further efforts were made during the year toinclude environmental dimensions in all countryprogramme areas including me:, household foodand fuel security, water supply and environmentalsanitation, income-generating activities forwomen, UBS and integrated area development.UNCED reinforced the UNICEF argument that chil-dren are the most vulnerable victims of environ-mental degradation, and it allowed their voices tobe heard through Global Children's Hearings andthe Global Youth Forum held in Rio at the time ofthe Conference.

• CHILDREN'S CONCERNS: Children from 21countries spoke passionately about their hopesand fears for the environment and of the need forgovernments to reassess their priorities. Amongthe issues they raised were poverty, human rights,armed conflict and military expenditure, Cher-nobyl and the fear of nuclear war, environmentaleducation, access to information, and the needs ofstreet chi Idren and indigenous peoples (seeprofile,'The language of education').

At the Global Youth Forum, 15-year-oldMelanie Paris of Trinidad and Tobago made thiseloquent plea to adult society tor young people'sinvolvement in decisions affecting their future:

"Tell me, I forget;Show me, I might remember;Involve me and I will understand."

• FRAMEWORK FOR ACTION: In spite of manylimitations, Agenda 21, the operational docu-ment on environment and sustainable develop-ment agreed upon by world leaders gathered atRio, provides a good framework for comprehen-sive and far-reaching action. Three points in par-ticular are relevant in this context;

" Afienda 21 has placed human beings at thecentre of environmental concern, emphasizingthe socio-economic dimensions as much as theconservation of resources.

» It recognizes that, for protection of the envi-ronment, the participation and empowerment ofthe poor are essential, and that so long as one fifthof the world's population continues Co consume

Young people were eloquent in their pleas for asafer planet at the Earth Summit's Global Youth

PROGRAMMES

As part of an emergencyprogramme to restartlocal food productionin a region devastatedby war. farmers receiveseeds, tools and fuel inexchange for part oftheir seed production,which is then passedon to others to plant.

tour fifths of the world's resources and producesmost of the pollution and waste, no lasting solu-tions to the crisis will be possible.

» Agenda 21 has gone further than any otherinternational conference document in emphasiz-ing the importance of collaboration between gov-ernments and NGOS.

• OBJECTIVES; The main challenge pre-sented to UNICEF by Agenda 21 was to: promotePEC activities that address the needs of communi-ties; improve the environment for children athousehold and community level; and encouragelocal participation through women, youth andchildren.

Although PEC was firmly established in thedevelopment lexicon atUNCED, UNICEF countryprogrammes have long pursued its objectivesthrough the provision of safe water and sanitationservices; household food security and nutrition;PHC and the empowetment of communitiesthrough the Bamako Initiative; formal and non-formal education through the 'Third Channel'and 'education for life'; activities to generateincome and reduce the workload of women; thepromotion of conservation and alternative energysources; and small-scale agroforestry.

UNiCEF's partnership in Education for All alsoprovides a channel tor development of school cur-ricula, highlighting aspects of environmental pro-

tection and sustainable development and theopportunities that exist for children, teachers andparents to put into action the lessons learned.

• SUPPORT FOR PEC: UNICEF supported manyenvironmental projects during the year.

•> In Brazil, six UNICEF offices serving eightAmazon Basin countries participated in a Povertyand Environment Project to help indigenous andother poor communities affected by deforestationcaused by logging, agriculture, gold mining andpetroleum extraction.

» In Fenerive (Madagascar), the primaryschool curriculum integrates health, nutritionand environmental awareness with school gar-dening and tree planting.

» In Niger, UNlctK has included an environ-mental component in most of its programme sup-port in the provinces of Zinder, Maradi, TahouaandTillaheri.

» In Bangladesh, a well-digging project, whichthe Government made conditional on each com-munity constructing and using five to ten latrines,has contributed to a 25 per cent reduction inreported diarrhoea cases.

» In the Philippines, UNICEF support for com-munity food production as a follow-up to emer-gency relief has made significant inroads onmalnutrition, particularly in the sugar-producingprovince of Negros Occidental. j j

1993 VNICEF ANNUAL REPOKI _ _

URBAN BASIC SERVICES

ALMOST half of" the developing world'surban dwellers are children whose vulner-

ability over the past decade has increased with therapid growth of towns and cities amid economicand environmental crises and recurring conflicts.

In 1980, there were twice as many poor ruralhouseholds (80 million) as poor urban ones (40million), but by the year 2000 it is estimated thatthere will be more poor urban households (72 mil-lion) than those in rural areas (56 million). Morethan half of the absolute poor will be concen-trated in urban centres, which are growing atannual races of" 5 per cent in Africa, 4 per cent inAsia and .3 percent in Latin America. Some citiesreport growth rates as high as 10 per cent with theinflux of migrants.

Disaggregated data, although limited, indicatethat urhan children fare worse with respect toinfant mortality rates (IMR) than the nationalaverage and are sometimes even worse off thantheir rural counterparts. A survey of 35 countriesfound that average access to safe water was 64 percent in marginal urban areas and 67 per cent innjral areas, and within urban areas there was greatinequity. The poor were spending up ro 40 percent of their earnings on water supply alone -three to ten times more than other urban dwellerswhose supplies were subsidized.

Urban malnutrition is also widespread. Studiesin a number of developing country cities showedthat up to 50 per cent of children in slum areaswere malnourished and that the incidence ofanaemia was twice as high in the slums aselsewhere.

• UNICEF ASSISTANCE: During the year,UNICEF assistance to children and women inurban areas focused on:

» support for national, centrally designed andsectoral services in urban areas;

» support for subnational, participatory andintersectoral IJBS programmes;

» greatly expanded efforts in favour of workingand street children;

» country-specific studies and assessments;» advocacy for economic adjustment policies

'with a human face1.

Heightened global concern about the environ-ments in which the children of the urban poor areforced to Jive their lives, coupled with a trendtowards democratization and the decentralizationof authority, have opened up new opportunitiesfor progress which UNICEF has seized by realigningits LIBS strategy.

• REALIGNED STRATEGY: UNICEF plans atwo-pronged approach comprising an urban childfocus in various sectoral programmes and a revi-

Over half the world'spoor will live in cifiesby fhe year 2000, andUNICEF is realigning itsstrafegy fo help fheirchildren. This child livesin a counfry with anextremely high povertyrate, compounding thesevere urban problemsshe faces every d a y -lack of food, cleanwater and sanitationservices.

PRtXJKAMMES

N E E L A M B H A T A , I N D I A

Devkali's diary: Hope for an urban slum

his congested slum settlement In the industrial town of f arldabad is home to some11.000 of India's urban poor, Living conditions here are squalid. The housing Is makeshift,the water supply limited and sanitation facilities grossly inadequate- Families of six andseven people crowd together in one-room huts of barely two square metres.

Gradually, however, the picture is changing. With help from UNICEF and government and non-governmental organizations, residents are learning that if they organize themselves and worktogether, basic amenities are attainable and the environment can be made safer for their children,

In one small pocket of Neelam Bhata some 50 residents - most of them women - have beenmeeting once a month for almost five years to make plans for a better future. They sit cross-leggedon the floor of a small unfurnished room just bursting for their turn to speak. Devkali, a woman ofabout 55, listens to their discussions intently, carefully recording their observations in her diary toincorporate in a list of needs which she and other community volunteers will present to themunicipal authorities.

Scenes like this are now repeated in similar meeting places throughout Neelam Bhata, wherewomen like Devkali act as a bridge between the residents and local government. Each volunteerrepresents about 25 families. The volunteer makes it her business to know if the children are sick,when they are due for vaccinations, if they attend school and what basic community services areavailable to each household. The accumulated data ore invaluable to planners, who can also callon the volunteers to help mobilize community support for their interventions,

About 400 volunteers In Neelam Bhata interact with community organizers employed by thelocal government under an urban basic services [UBS] project. Between 1986 and 1991. the UBSproject, with UNICEF assistance, provided facilities for 168 cities and towns in India. The state andcentral authorities and UNICEF shared the cost of services for some 2 million people on a 40-20-40per cent basis respectively.

In Neelam Bhata, the project raised the level of immunization coverage, installed handpumpsand trained locals to maintain them. Many open drains and seweragechannels were covered, pathways were paved, some shanties wereupgraded and a community lavatory block was built. Local people alsobuilt a school with Its own water supply and latrines. Most of the primaryschool age children attend school, and adult literacy classes havebecome popular. Over the next 12 months, development committeesplan to help build three dispensaries and two more lavatory blocks,

With the project well established, UNICEF has been able to reduceits financial input and assume the role of a facilitator, providingassistance for the training of project staff and officials, and support forthe development of management and monitoring systems. The centralGovernment has expanded the project to 500 more cities and made afinancial commitment of about US$33 million for the eighth five-year planperiod (1992-1996],

The provision of services remains just one asbect of the programme.The main UNICEF objective is to enable people, and women Inparticular, to take control of their lives.

Devkali was illiterate until she was 50 and seldom set foot outside herhome. She learned to read and write through the project and agreed to

represent her neighbourhood on the development committee. Her work is unpaid but she was ableto take out a loan - about 2,000 rupees [US$70) - through the project and use it to rent and stocka small general store. Business has been good, and she has been repaying about 200 rupees a month.

"It is important for women to have their own money," she says. "For 45 years of my life Itrembled if a man spoke to me. I had lived In this area for 25 years, and my neighbour's husbandnever once spoke to me. Now he greets me In the street and asks about my family. And now that Ihave been chosen to represent my neighbours and negotiate with the local governmentadministration, I don't core if ten thousand men speak to me."

1993 UNICEF ANNI'AL REPORT

talized UBS strategy, which has foux main thrustswithin the framework of NPAS. They are:

» promotion of the decade goals for childrenwhile joining other partners in poverty reduction;

» the application of the UNCED Agenda 21 con-cept of PEC for urhan areas;

» support for rehabilitative and preventiveapproaches to children in especially difficultcircumstances;

» advocacy, technical support and appliedresearch for urban development with a human

The Convention on the Rights of the Child andthe goals set by the World Summit for Childrenprovide the broad policy umbrella for the urbanchild by demanding the elimination of povertyand equal opportunities for all children. •

CHILDHOOD DISABILITY

ABOUT 80 per cent oi the world's disabledpeople live in developing countries and an

estimated 150 million of them are children.According to WHO, less than 3 per cent of disabledadults or children receive rehabilitation servicesof any kind, and various estimates suggest thatonly one in every 100 disabled children in Asiaand Africa attends school.

The statistics were especially troubling as theUnited Nations Decade of Disabled Persons (1983-1992) drew to a close. And in a statement to the17th World Congress of Rehabilitation Interna-tional in Nairobi (7 September), the UNICEF Exec-utive Director said that the world's threshold oftolerance towards disability remained much toohigh. He called for a "global offensive against disa-bility" as powerful as that being waged againstinfanr and child mortality.

• BITTER LEGACY: While the IMR rate in thedeveloping world fell from U6 deaths per 1,000live births in 1950 to 67 deaths per 1,000 in 1991,disability has continued to increase. Armed con-flicts - most tragically visible during the past yearin Afghanistan, Cambodia, Somalia and formerYugoslavia - have greatly swelled the ranks of thedisabled, particularly among children andwomen. More than 1.5 million children in Asia,Africa, Latin America and the Middle East havebeen killed in armed conflicts over the past dec-ade, and for every child killed, it is estimated thatthree others have been injured and/or physicallydisabled. The millions of mines, toy bombs andother booby traps planted by warring parties con-tinue to claim innocent victims years after con-flicts are resolved. The psychological trauma ofwar also endures and is estimated to affect some10 million children globally today.

• TASK FORCE; A United Nations Task Forceto follow up on the Decade oi' Disabled Personsmet in conjunction with the World Congress of

Rehabilitation International and agreed to anadvocacy campaign with the broad objective ofreducing avoidable disability by one third by theyear 2000. UNICEF will maintain the Task Forcesecretariat through its joint Technical SupportProgramme with Rehabilitation International forthe next two years.

During the year, some 51 countries reportedthat they had programmes in the area of child-hood disability prevention, rehabilitation andsupport. Among the activities covered were:

» the early detection of disabilities;» advocacy for protective legislation for the

disabled;» promotion of family- and community-based

rehabilitation; An innocent victim ofwar, this young boywas maimed by aland-mine.

pROIJJUMMEi

» the elimination of vitamin A and iodine defi-ciency disorders;

» the protection of disabled children ininstitutions;

» the training of health workers;» support tor sate motherhood and MCH clinics

to eliminate birth-related accidents.• FUTURE CHALLENGES: Also on the UNICEF

agenda are the need for sustainable immunizationprogrammes; the elimination of water-borne dis-eases such as river blindness; multi-drug therapyfor leprosy; timely rehabilitation; support fornational and local production of low-cost artificiallimbs and other mobility devices; measures tolimit the physical and mental impact of armedconflicts on children; and a ban on the produc-tion, marketing and use of land-mines, which pri-marily target civilians and are a major cause ofdisability and trauma.

Rehabilitation International continued to assistUNk:nF in this work and the Technical SupportProgramme liaised with a number of UnitedNations organizations and NCSOS. Q

1HI

i

#8

1

F

Helped by his father,a boy learns to usecrutches at a hospitalfor war victims.UNICEF helps provideprosthetic andorthopaedic servicesfor children andwomen

CHILDREN IN ESPECIALLY DIFFICULT CIRCUMSTANCES

MEDIA coverage of conflicts in Bosnia andHerzegovina and Somalia highlighted

the brutality inflicted on children as innocent vic-tims of war. It also underscored the pressure onagencies like UNfCtF to respond to new emergen-cies as ongoing conflicts simmered and flaredunpredictably elsewhere. As fighting in Bosniaand Somalia intensified, conflicts in El Salvador,Ethiopia and Mozambique were winding down,but fighting in Afghanistan, Liberia, Sri Lankaand the Sudan challenged UNICEF resourcesthroughout the year.

The main UN ICE* response to these conflictslias been emergency relief coupled with negotia-tion for opening up or maintaining corridors ofpeace in Bosnia, Somalia and the Sudan so thatrelief supplies and workers could reach childrenand women in need. These efforts were mostlyeffective but tile price was high in terms of staffsecurity. (Set! 'Emergency relief ami rehabiliutdtm.)

In armed conflict situations, the rehabilitationof children has increasingly been incorporated inemergency programmes. Special emphasis hasbeen placed on means of dealing with psycho-social stress and trauma on a large scale throughschools, health care systems, community organi-

zations and mass media, UNICEF is now assistingprogrammes for psychosociaI rehabilitation in 1.3countries including Croatia, Iraq and Liberia.

Internal guidelines for providing more effectiveassistance for children in armed conflict situationshave been published in the form of country expe-riences entitled Survivors: Rehabilitation of Chil-dren in Armed Conflict and, as a guide for action,Children m Armed Conflict: A Guide for the Provi-sion of Services.

• PREVENTIONANDREHABILITATION: UNICEF

continued its support, for prevention, early detecttion and community-based rehabilitation of phys-ically disabled children, but its capacity torespond is dwarfed by the scale of the problems inarmed conflict situations. Unfortunately, mostnational responses have been designed for adults,particularly ex-combatants. A major UNICEF

objective is the reintegration of disabled childreninto their families, communities and schools. Inseveral countries, the media has been used to edu-cate the public on the need to 'mainstream' dis-abled children in the public schools.

• EDUCATION FOR PEACE: The concept ofpeace education as a means oi' breaking cycles ofprejudice and conflict between rival groups in

many societies continued to expand during the

*"d * radvc oooilkt, peacefully have been **Ureceived ,n Lebanon andSh Lanka, andeAbrtsare heinB made to replicate them elsewhereUNK2F b c^tinuing R, develop n sehe, of educait*™l,mm*i« and activity 6* exploring i ^ sot peace and teaching conflict-resolution skills toyoung people.

• ABUSE AND NEGLECT. There is as yet onlyl-m.ted national .cknovvledgement of child abuseand neglect in many developing countries. Only afew country programme, nuke reference to ther ^ m e m n * , dWicant pruWem, and twerst.ll have programmes to monitor, prevent orrespond co it. Concern for thne children, ho*,(n«,L,incre,sbiglyreaected in thegmwing mem,henh,p of dc,^k)pmg country In mtematk^land regional nenvorks for the prevention of childabuac and neglect. Devuk^ing countries ure beingencouraged to i n v ^ r e ^ b«ie, and manyhave beBun to address ,t publicly. In the i n d jrnalned world, ongoing country studies indicate

• EXPLOITATIONOFCHILDREN: The traffick-ing of children in South Asia and child prostku-uon related m tuuriam in S o u t h ^ t Asia andWm America are ,,f growing concern and werethe object of rrgiunal meeting, during the

'WJLWJCEF Awn,*. REPORT

In many parts ofthe world, childrencontinue to be forcedinto dangerous worksuch as mining.

Year- A number of regional WX) network hav?ken organized m combat the sexual exploitationutchuyren. and UN^EF is assWng their efforts

inAshri TbTrPaiKn tU E n d C m P r o s t i t u t™Cacholk Child Bureau (Kxml, C h l l Z ^ ! ^owners. Some bcW Noo, have devekyed ef&ctiv?

educanor. programmes to prevent children from

Z k 1 n % d i r e J 7 ^ ^ ^ " ' ^ile others are

children and provide themw^Zd^^

tmnaJ and other rehabilitation services

resulted. Situation analy^ZZtre^t dlildZ^ initiated in Cambodia and Viet Nam, godalmost every country in Latin America has a pro-gramme to protect and assist these children

Increasing ct&m K, identify and protect chil_

Dwcmko, aK ako under « y with che Imrmai"on»l Lak,ur Organisation regarding cuncry.level cooperation in the- ,LO International Pro-gtamme tor Eliminating Ch ilj Labour. Q

37

s%zr^'^'°«^

PROGRAMS^

WOMEN IN DEVELOPMENT

ENCOURAGING efforts are being made tochange attitudes and beliefs that discrimi-

nate against women and girl children and todismantle the structures that impede theiradvancement. But massive work is required toclose the gender gap. Government policy makersand community leaders are learning much tooslowly that nations cannot afford to squander halftheir human resources by denying women oppor-tunities to develop to their full potential.

While many speak the language of equality, thetranslation of commitment to concrete resultsdemands skill in gender analysis based on sex-disaggregated data and the development of gen-der-responsive strategies, plans and programmes.

UNKJEF accelerated training for its staff in 'gen-der analysis' (analysis of the role oi, and divisionof labour among, men and women to help addressissues of inequality) during the year to improvethe capacity of its staff as well as that of govern-mental and NGO counterparts. Country offices inBangladesh, Chad, Ethiopia, Kenya, Morocco,Mozambique, Namibia, Pakistan and Rwandaconducted gender analysis workshops for most oftheir staff. Colombia, Mexico, Peru, Syria, Tan-zania, Venezuela and the counrries of the Carib-bean planned training courses, while Bolivia,

Swaziland, Thailand, Tunisia, Zimbabwe and thePacific Islands countries had between 50 and 80per cent of their staff trained in gender analysisfollowing regional or country-based workshops. InAngola, Bangladesh, Ethiopia, India, Indonesia,Kenya and Tanzania, country offices extendedtheir training to cover high-level government pol-icy makers and planners, local extension workers,NGO activists and community leaders.

Many countries made efforts to improve theirstatistical database and provide sex-disaggregatedinformation for analysis. The resulting indicatorshave shown gains for women in areas such asschool enrolment and literacy, although the poor-est and most disadvantaged households in manycountries are headed by women, and the majorityof school drop-outs remain girl children. In Ban-gladesh, half the female-headed households are inthe extremely poor category, earning 40 per centless income than male-headed households. Thenutritional intake of women in Bangladesh wasalso found to be just 88 per cent of that of men.

• POLITICAL PARTICIPATION: The year alsobrought marked changes in the political partici-pation of women, especially in countries wheregovernments are forging towards democracy. InEthiopia, Niger and Rwanda, transitional govern-ments appointed women to ministerial posts forthe first time. The Indonesian Ministry of Womenestablished machinery for women's advancementat the provincial level. Women have also takenadvantage of die new political climate to run forelected office and to advocate that political partiesinclude gender issues in their platforms. In Kenya,UNK>;F supported a workshop tor media on gender,and democratization.

• LEGISLATIVE CHANGE: Gains were alsomade on the legislative front. In the Philippines,a Women in Nation Building law (1992) is a majormilestone in the country's commitment to pro-mote the role of women in development andimprove their status. The new law recognizes therights of women to enter into contracts, be admit-ted to military schools, apply for loans from thenational housing fund and qualify for social secu-rity. In Namibia, a bill was passed establishingminimum representation levels for women onmunicipal councils. Zimbabwe ratified and Nami-bia acceded to the Convention on the Eliminationof All Forms of Discrimination Against Women,UNK :EF advocacy has had a catalytic effect in eachof these countries. In Syria, UNICEF supported

Literacy classes forwomen can help toclose the gender gap

J99J tTVJfEFANNIVU REPORT

C H E F C H A O U E N P R O V I N C E , M O R O C C O

Educate a girl, educate a nation

"Teach a boy and you will train one Individual. Teach a girl and you will train the whole nation."- A Ibn Badis, Algerian reformer (1889-1940}

ine-year-old Najat Benkacem became a schoolgirl In 1992, Defying national statisticsand the poverty of her home and village, she was enrolled at the nearby Hassan AbiJamaa school and took the first step towards her dream of becoming a teacher.

That first step for Najat and for many other Moroccan girls is due in large measureJo a government decision in 1985 to restructure the nation's primary and secondary educationsystem; a 1989 project to support basic education In rural areas; and a recent decision by KingHassan II to give priority in the 1993-1996 National Plan of Social Action and EconomicDevelopment to basic education for girls like Najat who are especially disadvantaged byconditions in rural areas.

In 1992, the Government and UNICEF reinforced these measures with a school enrolmentcampaign for girls in Chefchaouen and four other provinces noted for their low female literacyrotes, high Infant mortality and heavy workload for women and children. One objective of thecampaign, beyond the moral imperative of providing equal opportunities for girls and women,is to improve the living conditions dramatically.

Ufe is harsh In Chefchaouen. Winters are bitterly cold and summers are dry and hot. Womenand girls are mostly captive to domestic duties which include the time-consuming burden ofcarrying water and collecting firewood. There are few, If any, employment prospects for womenoutside the home, so fathers see little point in educating their daughters. The sons are sent toschool, and if their sisters do follow, they tend to drop out early to help their mothers.

A recent national study estimated that, while 62.5 per cent of boys in rural areas enrolled andcontinued attending school, only 28.5 per cent of girls had the same opportunity, In Chefchaouenthe rate for girls Is thought to be even lower.

Until Morocco's education system changed course, Najat's futurewould have been little different from that of her mother. She lives in thevillage of Bab El Aln with her parents, three brothers and two sisters. Theirhouse is small and has neither a kitchen nor a lavatory. The nearest waterwell Is 500m away and there Is more than enough work for everyone.Najat's father is a farm labourer with barely sufficient income to feed hisfamily, let alone pay for school fees and books for all his children. Likemost fathers, his first choice was to educate the boys, Besides, he couldnot be assured that his daughters would be safe either on the rood toschool or In the schoolyard. The teachers were male and there were notoilet facilities for girls, He was also concerned that an education might'complicate' his daughters' outlook on life, particularly on early marriage.

Fortunately for Najat, many of those hurdles were lowered by officialrecognition of the need for equal education opportunities for girls, thetraining and placement of female teachers in schools, the provision oftoilet facilities for females, the development of school curricula relevantto rural communities, the removal of sexism from school texts, andspecial incentives for parents to send both their girls and boys to school.

In Chefchaouen, UNICEF worked with the provincial Governor to convince parents of the valueof education for their daughters. About 60 traditional birth attendants were trained to persuademothers to push for an education for their daughters, while religious leaders assumed a similar rolewith the fathers. Campaign messages were broadcast, and school uniforms, coats, boots, schoolbags and books were provided for 500 girls. UNICEF also offered to pay the girls' tuition.

Although It is too early to evaluate the returns to Najat and her peers, these and othermeasures nationwide have already led to higher enrolment growth rates for girls than for boys. TheMinistry of National Education has set enrolment targets for rural girls at 50 per cent by 1994 65 percent by 1995 and 80 per cent by 1996.

J

PROGRAMMES

efforts hy the Women's General Union to advo-cate new laws related to women's welfare.

• ECONOMIC OPPORTUNITY: UNICILF contin-ued to support income-generating activities forwomen in a number of countries including Nami-bia, Pakistan and Tanzania. Support also contin-ued for credit schemes for poor rural and urbanwomen in countries including Kenya and the Phil-ippines, replicating the Grameen Bank approachto give women in Bangladesh access ro credit.

• T H E GIRL CHILD: The value of UNICEF

advocacy on behalf of the girl child was evidentduring the year in the increased attention given bygovernments, NGOs and individual communitiesto child gender issues. Plans were made for a GirlChild Decade in Bangladesh. Tanzania's Ministryof Community Development, Women's Affairsand Children commissioned a review of lawsaffecting the girl child. Morocco hosted the firstgirl child symposium in the Maghreb. Iran had aUNlctF booklet, The Girl Child: An Investment inthe Future, translated into Farsi, and Tanzaniatranslated the Convention on the Rights of theChild into Swahili. India also dratted plans tor aDecade of the Girl Child and introduced specialsponsorship schemes and .scholarships for girls.Kenya and Morocco carried out situation analyseson conditions affecting the girl child in theircountries. Textbooks were reviewed for gendersensitivity in Ethiopia, and the Government of

A Muslim woman trains to be a peace counsellorto help prevent ethnic conflict.

Pakistan promoted a gender-awareness curriculumat universities and among NGOs.

UN1CEF programmes also addressed the issues ofchild abuse and violence against women in a num-ber of countries including Chile, Namibia andPapua New Guinea. rj

EMERGENCY RELIEF AND REHABILITATION

AS crisis situations multiplied in 1992, so didUNlC£F's involvement, particularly in

response to the needs of children and womenaffected by large-scale and politically complexemergencies.

UNICEF provided support in nine major flash-points - Afghanistan, Angola, Haiti, Iraq, Lib-eria, Mozambique, Somalia, the Sudan andformer Yugoslavia - while continuing to assistchildren caught in 'silent' emergencies through itsregular country programmes. It also provided sup-port for the drought-affected countries in south-ern Africa - Angola, Botswana, Lesotho,Madagascar, Malawi, Mozambique, Namibia,Swaziland, Tanzania, Zambia and Zimbabwe.

Other emergency events in 1992 included: theconflict situation in Zaire; floods in Ecuador,Lebanon, Pakistan and Paraguay; earthquakes inEgypt, Indonesia, Pakistan and Turkey; outbreaks

of cerebrospinal meningitis in Cameroon andcholera in El Salvador and Peru; volcanic erup-tions in the Philippines as well as in Nicaragua,where the damage was compounded by a tidal

UNtcEF also responded to the immediate needsof refugees from Myanmar entering Bangladesh;displaced persons and returnees in Sri Lanka;Malian refugees in Mauritania; and Liberian ref-ugees in C6te d'lvoire, Guinea and Sierra Leone.It also provided assistance to meet urgent healthneeds in the 11 republics of the CIS and three Bal-tic States, and health and other child survivalneeds in Albania.

In all, the organization responded to emer-gency situations in 54 countries with an expendi-ture of US$167 million in 1992, compared with 26countries {US$49 million) in 1990, and 50(US$111 million) in 1991.

•DIFFICULT AND DANGEROUS, A ho« of

po meal arid operational factors made effectivedel.very of humanitarian assistance difficult and° ^ " ^ m u » . F . u r international anj threeocally hired UNICEF staff members were killed

J"nng relief operations in Somalia and the-ouuan.

negotiations before relief could"be deliveretUo« m , civilian victim, ufcunmct; d« coUar«e cf

pubhc admmiso-ations in a number of countries-

others ' m P ° S i t i O n o f e c o n u m « "nction, on

hwseholJ """d *="Ht*'lLI*^!sI,iIlioZ!'^l%'^[;^™k^W"ad"n"fnaumatizeJchi|.

&™lia,r*ibm^yu^CrrZ%l%organization's advocacy activities for children andwomen in emergency situations.

' co» r J inntu,n and team leadership a r thecountry level;

" Prutecrktiiorrelkf worker, ,u*j humanitar-ian relief;

* the media tor resource mobilization

Durmg the year, UNICEF allocated US$242 3

largest share, totalling US$ 129.8 million or 54per cenr. The EWwaawcd % cower Wdaj emer-e n n - ^ m 32 cuunme, of Africa, rheAmcr.^ ^ ^ Carihbeao, A.sia, Middle Ea,r andCentral and Eastern Europe.

welcome Jcvck*mKTK. i*,KT3=i,,Z^%*h^^^.[;^,*

mj UNICEF ANNUAL REPORT

The psychologicaldamage caused bywar can be even moredevastating thanphysical injuries.

guidelines and operational directives * ̂ " ^ '

Although UNfCEF responds have A=twed pri-"«nly,« the provi,lon of supply to ̂ ^ ^ _fcri^g, it is recognized that there is a close linkbetween emergency activities and long-term

Rehabilitation isa permanentcomponent of UNICEFemergency reliefprogrammes. Afterimmediafe provision ofsupplies, the focusfurns to helpingchildren regain theconfidence to rebuildpeace in theircountries.

PROGRAMMES

• CAPACITY STRENGTHENED: Steps havebeen taken to enhance UNIt;EF's emergencyresponse capacity at headquarters in New Yorkand Geneva and in the field with additional staffand the secondment of experienced officers fromgovernments and external agencies includingSwedRelief and the Norwegian Refugee Council.In Somalia, 12 Indonesian doctors worked withthe measles vaccination programme, and a usCenters tor Disease Control and Prevention teamalso helped with health surveillance efforts.

• TRAINING AND MANAGEMENT: An emer-gency roster was established at headquarters tofacilitate the rapid deployment of staff to the field.

Training in emergency management was alsostrengthened, with the objective of providing atleast two staff members in each country officewith the necessary skills to handle emergencies.In 1991/1992 regional emergency training work-shops were organized tor 85 staff in Abidjan andNairobi. Staff members from Djibouti, Ethiopia,Haiti and Iraq were also included, and country-level briefings followed during the year. A briefingand training package developed fur staff inSomalia was shared with UNICEF offices in Iraqand former Yugoslavia. Ten staff members alsoattended DHA/UNDP Emergency ManagementWorkshops during the year. |_j

SOCIAL MOBILIZATION/FACTS FOR LIFE

THE achievement of the World Summit goalsfor children in the 1990s will require sus-

tained change in the way individuals, communi-ties and societies think and act in important areasof life, TJNICEF is accordingly examining nationalexperiences of social mobilization to derive les-sons tor broader application.

Studies under way show that 'sustainable mobi-lisation1 emphasizes the importance of individualsand their community acquiring the relevantknowledge and skills to help them take decisionsand actions that give them more control of theirown lives and thus enable them to participateactively in the broader development process.

Examples of such an approach are EducationPopular, developed in Latin America for literacyand other community-oriented purposes, andeducation tor development, which is beginning togain ground in formal school systems initially inthe industrialized world, but with stirrings o(interest also in the South. The skills fosteredby both these initiatives, because they help themaking of decisions and the taking of consistentaction, are sometimes known as 'life skills'. (Seealso 'AIDSand children'.)

• DECENTRALIZATION: Sustainable mobili-zation, being based on broadening participation,draws strength from the trend towards decentral-ized responsibility for services. In the Philippines,mobilization efforts have deepened the involve-ment in service delivery at various levels - pro-vincial, municipal and neighbourhood - and inparticular, increased the interaction betweenthem. In Tanzania, the Government has createda powerful institutional framework and, in many

instances, community-based efforts have beenmade to tackle pervasive child malnutrition.Some villages report startling reductions in mal-nutrition and death among young children, andbroad-scale improvements in nutritional statushave also been impressive.

• NEEO FOR CHANGE; Studies also show thatchange, and support for change, is needed at thenational and political levels as well as at the oftenneglected intervening administrative and tech-nocratic levels. Reciprocal interaction betweenall layers of government and community is essen-tial, with responsibilities and accountabilityclearly established. Communication is the life-blood of this interaction, and a steady and depend-able exchange of information for action has proveda reliable catalyst.

Facts for Life

While action for social change on the scalerequired to realize the World Summit goals forchildren depends critically on empowering andenabling processes, the basis for action is knowl-edge, and in priority areas of child health, FactsftrrLife continued to provide a succinct compilationof the most vital aspects of this knowledge.

As the total number of copies in circulationafter three years swelled to some 6 million, inmore than 170 languages, work began on a newedition with an added chapter on early childhooddevelopment and an additional co-publisher,UNI-PA, which will promote further disseminationthrough the global network of planned parent-hood organizations. Q

I!W3 UNICEF ANNUAL RJ-PCJRT

EVALUATION AND RESEARCH

EMPHASIS is now being placed on goingbeyond increasing the numbers, die quality

and use of evaluation, to focusing on managingthe evaluation process more systematically andeffectively at all levels. A review of evaluations;md the it use, as well as a summary of the evalua-tion plan and structure for each programme area,will now be included in all UNICEF country pro-grammes submitted to the Executive Board.

• SHARING LESSONS LEARNED: The evalua-tion database was expanded to provide qualitativeinformation and serve as a management tool forcountry and regional offices. It currently containsinformation on some 4,000 evaluations and stud-ies completed by UNICEF since 1987. A test editionof the database was completed for distribution toregional offices and selected country offices. Fol-lowing this test phase, a full-fledged version willbe shared organisation-wide.

Checklists have been developed for grading thequality of evaluations, and the methodology forreviewing evaluations has also been improved.The Evaluation Newsletter continued to serve as aninformation exchange.

• THEMATIC PLAN: A thematic rolling evalu-ation plan is being developed as a guide to policyand programme development. Critical factorsassessed will include the sustainability of pro-gramme action, impact on the poorest groups,development and empowerment benefits forwomen, stimulation of community participation,social mobilization and cost-effectiveness.

A thematic evaluation process involving aseven-country case-study of UNICEF support togrowth monitoring and promotion was carried outto review and share experiences, identify techni-cal and operational improvements and examinesustainability. Priority areas for further opera-tional research were identified and an attempt isbeing made to build national capacity to conductrapid anthropological assessments. A set of globalfindings, lessons learned and recommendationswas agreed upon in a workshop in Nairobi in May.A workshop held at headquarters in Octoberexamined implications of the evaluation tor nutri-tion policy development and a new UNICEF strat-egy for nutrition-oriented information systems. Asummary report was made available at the end of1992 to guide country offices in the implementa-tion of the new strategy in existing and newprogrammes.

An evaluation of IJNICEF'S emergency response

led to the formation of a senior-level task force tomodify l 'NICEF policy in the operations area. Oneof the findings was that very few evaluations ofUNICEF's emergency activities exist. Since there isno standard methodology on how to evaluateemergency programmes, a special methodologywas developed. It was first applied in Liberia andincluded interviews with key actors involved inthe emergency response, together with a review ofexisting documents and the linkages betweenUNICEF inputs and programme outputs. Theimpact, coverage and costs were assessed througha process of sentinel community surveillance(scs), carried out by teams of community mem-bers, NGOs and government officials.

• CAPACITY-BUILDING: Intensive training on

low-cost essential research and evaluation meth-odologies was conducted in Angola, Burundi,Chad, Honduras, Liberia, Malawi, Mexico, Mon-golia, Nicaragua, Niger, Rwanda, Thailand andZimbabwe. In addition, two regional workshopsfor the East Asia and Pacific Regional Office(EAPRO) and ESARO, and a seminar at headquar-ters, were also held on the subject. Over 100UNICEF staff from 50 countries have been involvedin the training, which aims at enhancing theUNICEF country office evaluation function andmonitoring of goals tor the 1990s.

Evaluation can helpassess the impact ofprogrammes on thepoorest groups,especially women.

PROGRAMMES

UNICEF PROGRAMMES FROM GENERAL RESOURCES

UNlCEF cooperates in programmes in 137 countries:45 in sub-Saharan Africa; 35 in Latin America; 34 in Asia; 14 in the Middle East

and North Africa; and 9 in Eastern Europe and Central Asia.

UNK w programmes areapproved lor tnulri-yearperiods. Programmereeommendalions heinyprop* tsed en the 1993Executive Board sessionare indicated in colour andshould be regarded astenrativc until dpprn\cvl.

Thi* i.tNiriTF programmebudKei in each country isa,llocarcd accurdin^ Mthree criteria: under-fivetnortalityrate(uyMK)-die annual number of'deaths of children underfive per 1,000 live births;income level (ux I'percapita); anj the size of thechild population.

$16,500,000$3,000,000$3.750 000

jll.,000,000$3,750,000$2,000,000.

52,000,000$52,800,000$100,000$3,750,000$5,404,000

$5,000,000$6,875,000$4,605,000$9,552,000

$5,500,000W. 150,00059,000,000$4,900,000$3,008,000

$0,000,000$7,500,000$3,750,000$36,000,000$6,050,000

$3,181,000$5,000,000H750,000

$7,700,000$5,000,000$2,704,000

.1992^4

.1991-95;

.IW.V94;

.1993-94:

.1993-95:

.1992-96;

.1990-94:

.1992-96:

. 1993-97:

. 1990-94:

. 1990-95:

1992-96: $3,750,0001991-95: $11,625,000

.,1992-96; $5,000,0001991-95: $9,250,000

. . . . . . . 1990-94= $10,195,0001991-95: $65,000,0001991-95: $3,750,000

...1992-96: $7,150,000'....1992-96: $71,500,000

1992-96; $3,750,000

....1993-97: $5,260,000Paraguay . . . . 1993-94: $1,171,000

1992-96-. $7,450,000Philippines - .1994-98: $22,500,000Rwanda . . . . . 1W-97: $9,900,000

..A991-95: $2,500,000, ,..,,1992-96; $8,800,000

,. 1992t $50,00B_

1991.95-$6,250,0001992-44: $6,325,000

.,1992-94, $5,000,000...1992-96: $6,875,000

1991-95: $25,000,000.1992: . $100,000

...1991-95; $2,500,0001991-95: $4,500,000

....1992-96: $38,500,000Tajikistan .. .IW-94: $2,000,000

. . . , NS9-93; $14,000,0001990-94: $4,250,000

,.1989-93: $2,715,000.J990-94: $3,168,000-.mid-1990-mid-95;

$7,305,000.1991-95, $3,750,000.1991-95: $175,000,000,1990-95: $62,450,000

Armenia ,.AzerbaijanBangladesh

Iran, IslamicRep. of . . .

Jordan1" .. ,Kazakhstan .

Bolivia$6,000,000

$4,000,000$3,043,000$5,000,000

$2,000,000$19,551,000$2,000,000

$5,000,000

.1993-97:

.1995-94;

.1990-94:

.199PJ4-

.199 MM:People's.1994-%

Burkina

Burundi,1993-94:. 1993-97:

..,1992-94:

...1991-95:..1990-94:

Central AfricanRepublic ...1993-97:

. . . . . . . . 1990-94;1991-95:

China 1044-95=.,,.1993-97:..,.1990-94:

1992-96:1992-96:

Kyrgyzstan •Korea, Dem.

Rep. of , . .

. . , . 1990-% $1,800,000

.1992-96: $6,600,000^99296: $5,000,000.1992-96: $5,000,000.1992-94: $3,000,000.1990-94: $12,500,000.1992-96: $16,500,000.1994-96: $2,250,000.1990-94: $2,846,000.1993.97: $20,625,000.1994-98: $5,000,000

...1990-94:. $3,000,000....mid-1990-95;

*,OS0.OO0.... '1991-95: $2,500,000

...... 1992-9& $13,200,000

.1990-95: $27,900,000.,,.1991-95; $25,000,000...1992-96: $5,000,000

.....1992,9b: $25,000,000...1992-96: $5,000,000

Malaysia ,

MaliMauritania

1992-96:......1991-95:

Turkmenistan1993.94;1990-95:

. . . . 1992-96:Uzbekistan ..1993-94:

...1991-95:

...I" 991,95:Yemen ......1994-98:Zaire 1993-95;

1991-95:

$50,000$3,750,000$10,000,000

$2,000,000$22,800,000$3,750,000$2,000,000$3,750,000$40,000,000$L2.500,000$20,460,000

$7,360,000

$6,000,000

.1992-9(x

.........1992-96:Djibouti....-1989-94:

...1992-96; $5,000,000

...1993-97; $5,100,000Ecuador I994-0& 55.000.000*

.......1990-94: $21,450,000: $5,000,000 '

1991-95: $2,500,0001992-94- $49,500,0001993-95: $2,250,000Gabon ...

(1) UNIPEF is prnvidiny assistant fur Palestinian wurnen and cbildrenln: West fr.nk ,,nJ CMZH - $2.175,000 (1992-94)fJurJitu - SaOO,000 (1W-93) itnJ $800,000 pnipoxd fur 1994-97; Lebanon - $1,050.000 (1992-94);Syria-$800,000 (1991-94).

(2) Includes Amijju.i ..ml Bjrf-nd.i. PIIII-JII Viri;in IskmJh, Pimiinica. Grenada. Monrserrat, Saint Kirts-ahdNovis. SaintLi^a."Sauil Vii\LL-iiL jnd tln.'Ciri-n.idino. ;inj Turks ;ind Caiaw Lslands.

(3) indudwCtxik Islands, R ^ t e J Storesuf Mictuntthi, Fiji, Kirihnti, MaretullUlands. Nluc, Pykm, SamifflvSolc8nuciWand»,Tokclau, Tonga, Tuvalu and Vanuatu.

(4) Financed frym inwrreHinrsal funding only m 1992; Barbados. Stychelles, Sunrmme, and Trinidad andTohagn.

199J VN1CEF ANNI AI. RHPOR r

UNICEF conducted training in scs , whichincludes the direct and active involvement of thecommunities where the research or the evaluationtakes place, the immediate action-oriented feed-back to those communities, combined with astructured feedback to the district and national-level management information processes. As adirect result of this training, 17 countries are now

using the yes method with an emphasis on impactmeasurement.

• EVALUATION: A multi-donor evaluation ofUNICES programmes and operations was carriedout in 1991 -1992 by the Governments of Aus-tralia, Canada, Denmark and Switzerland. Anexecutive summary of the evaluation reports willbe presented to the Executive Board in 1993. •

INTER-AGENCY COOPERATION

DURING the year, UNICEF maintained closecollaboration with a wide range of partners

including:

» the Centre for Human Rights on implemen-tation and monitoring of the Convention on theRights of the Child;

» WHO on a series of health measures includingimmunization, the children's vaccine initiative,ARI. CD!\ AIDS, BFHl, the Bamako Initiative,malaria control, MCH, essential drugs, healthylifestyles for youth, safe motherhood and healtheducation;

» UNESCO on basic education, literacy andearly child development;

•> UNFPA and WHO to strengthen MCH and fam-ily planning activities at the country level;

» UNDP, WHO and the Carter Center on guineaworm eradication;

« FAO and WHO on nutrition surveillance;» UNESCO, UNFPA and WHO on Facts for life;» UNDP, UNESCO and the World Bank on fol-

low-up to the World Conference on Education for

» DHA, UNHCR, WFP, WHO and others on emer-gency and rehabilitation;

» UNDP, UNFPA, the United Nations Develop-ment Fund for Women (UN If EM) and WFP onwomen in development;

» UNEP on environment.

UNICEF also worked closely on a range of issueswith the Consultative Committee on Adminis-trative Questions, the Department of Economicand Social Development, the United NationsSudano-Sahclian Office and the United NationsOffice at Vienna.

UNICEF has been advocating that common goalsand strategies are the fundamental starting-pointfor integrating cooperation. It offered a detailedproposal for a common United Nations countrysttategy which was accepted by ACC and adoptedby the General Assembly in resolution 47/199.

UNICEF believes this landmark resolution willgreatly strengthen collaboration in operationalactivities tor development.

• JCCP: The Joint ConsultativeGroup on Pol-icy (JCOP), comprising IFAD, UNDP, UNFPA, WFP

and UNICEF, met regularly under the chairman-ship oi" UNFPA. UNICEF continued to chair thesubgroup on harmonization to synchronize pro-gramme cycles so that the United Nations systemcould respond more effectively to national devel-opment plans. UNICEF has also worked to promotecommon understanding in the areas o( pro-gramme terminology and accounting proceduresfor national programme execution as well as onthe establishment of common United Nationspremises in the field.

• DEVELOPMENT WITH A HUMAN FACE:

UNICEF continued to pursue its concerns about theimpact of adjustment programmes on children. Itstressed the need for focusing more attention oninvestment in basic services to meet human needsin the World Bank's consultative groups and atUNDP round tables. It also continued a fruitful dia-logue with the International Monetary Fund(IMF), the World Bank and regional developmentbanks.

• AFRICA: Based on the experiences of theBamako Initiative, UNICEF has become an activepartner in the World Bank's health policy dia-logue with governments in Africa. It also contin-ued to cooperate with the World Bank and theAfrican Development Bank in the fields of edu-cation, WATSAN, UBS, women in development andsafe motherhood.

Close working relations with UNDr continuedat headquarters and in the field. Regional direc-tors consult and exchange information with theirUNDP counterparts during visits to New York, andcountry representatives visit each others' head-quarters when taking up new assignments.

PROGRAMMES

• CHILD SURVIVAL: UNUP, UNICES, WHO and

the Rockefeller Foundation are partners in theTask Force for Child Survival and Development.

This Task Force is providing important technicaland advocacy support tor national follow-up to thegoals of the World Summit. fj

DEVELOPMENT WITH A HUMAN FACE

Aseries of initiatives during the year placedthe concept of 'development with a human

face' on a new and more active footing.Nearly 80 countries produced NPAs to imple-

ment the goals for children agreed upon at theWorld Summit for Children, and 60 others werein the process of preparing them, NPAS effectivelytransform the spoken commitments of nationalleaders into social and economic policies tor theremainder of the decade.

Other developments which consolidated thisrecognition of human needs included:

» Recommendations in the World Bank's Pov-erty Reduction Handbook and Operational Directive(Washington, D.c, 1992) that social sector tar-gets for the year 2000 should he in line with thoseof the NPAs. The Handbook notes that UNIOEF'S

'on-the-ground-presence1 and 'in-depth involve-ment1 in Bank-funded projects gives it a special

edge in the field. (See 'World Bank' panel.) Refer-ring to recent projects in Guinea, Mali andVenezuela, the Bank states: "UNICEF'S in-depthinvolvement means that grass-roots issues can bedealt with more thoroughly than they might oth-erwise be. Examples include staff motivation incommunity centres, or transition from one orga-nizational and financial model to another. In addi-tion, because UNICEF operations are moredecentralized and flexible than the Bank's,UNICEF is able to fill unforeseen needs as theyemerge during government-donor reviews ofimplementation."

» Completion of human development countrystrategies for Bangladesh, Colombia, Ghana andPakistan. UNICEF was particularly active in thepreparation of Ghana's country programme whichdovetailed with its Ni'A and UNDp's Human Develropment Report, UNICEF also collaborated with

WORLDBANK-UNICEFCOOPERATIONIN INDIA

through warm personalrelationships between the Bank'sand UNlCBF's Delhi-based staff.The personal factor in buildingmutual confidence strengthenedagency policies about cooperation.The relationship betweenfield staff, given UNlCEF'sdecentralized decision-making!was rewarding. Third, it wasimportant that the relationshipin the field was cemented atheadquarters with expressions ofcommitment from management inboth agencies. Fourth, the Bank -at headquarters and in the field -recognized the lead role of UNICEFin this major intervention.

Following India's adoption ofuniversal immunization as anational priority, coverage rosefrom about 15 per cent to about70 per cent by 1990. UNICEF

assistance played a very major rolein this achievement. Two yearsago, the Indian Governmentdecided to build on Us successwith immunization by attemptingto boost the coverage of severalother key mother and child healthinterventions. It approached theBank for assistance, since theprogramme costs would be greaterthan it - or UNICEF and UNlCEF'straditional bilateral co-financiers— could easily provide.Negotiations were successfullyconcluded in August 1991 foramother and child health project ofmore than US$600 million,financed by the Indian Govern-ment, the Bank and UNIGEF.

The cooperative relationshipbetween the Bank and UNICEFwas extremely good during projectidentification and preparation.There were probably four reasonsfor this. First, both agencies couldset benefits from an enhancedpartnership. The Bank benefitedduring preparation from thetechnical expertise of UNlCEF'slarge Delhi staff and their closeworking relationship with theGovernment, UNICEF'S fieldpresence will also be importantduring project supervision.UNICEF saw the Bank's financialcommitment as necessary for theprogramme to take off — and assome guarantee that governmentfunding for the programme wouldhe sustained during difficultfinancial times. Second,cooperation between the Bankand UNICEF was forged initially

From the World Bank's PwertyReduction Handbook and Oj>cr«tionalDirective, Washington, o.c, 1992.

1993l7NlCEFANtn-ALRHP<m

Development with ahuman face is theUNICEF strategytowards theachievement of realsocial progress - andthe good health andwell-being of mothersand children.

UNDP on human development reports for Argen-tina and Botswana.

» Completion of a UNICEF study, Africa's Recov-ery in the 1990s, setting out policy alternativesfocused on human development. A similar studyof eight Latin American countries was also com-pleted in 1992.

* A joint review of NPAS in Ghana, Guinea,Uganda and Zimhahwe by the World Bank andUNICEF prior to the OAU International Conferenceon Assistance to African Children (Dakar, 25-27November). UNICEF has been trying to involve theWorld Bank in the Nl% process in sub-SaharanAfrica in particular. There are plans to extend thejoint review process to other countries in 1993.

UNICEF worked with UNM' and rhe Develop-ment Assistance Committee of the Organizationfor Economic Co-operation and Development(oEcn) on methodology for the analysis of devel-opment aid allocations tor human needs. It alsoworked with other members oi the Joint Consult-ative Group on Policy (IFAD, UNDP, UNFPA andWFP) on a proposal to monitor poverty and theimpact of adjustment policies on vulnerablegroups.

• COMMONWEALTH OF INDEPENDENT

STATES: UNICEF with WHO conducted collabora-tive missions to all but one of the Commonwealthof Independent States (as ) in February/March,followed by second visits to Armenia, Azerbaijan,Kazakhstan and the Central Asian States in

October/November. The country reports that fol-lowed argued that the social gains from independ-ence had been jeopardized by hyper-inflation, thecollapse oi trade and the termination of subven-tions from the budget of the former Soviet Union.UNICEF appealed for assistance from the donor com-munity at international conferences in Geneva,Lisbon and Tokyo, to ensure that the transition tomarket economies had safety nets tor the poorestfamilies. The response, however, was inadequate.UNICEF provided modest emergency assistance toseven qualifying countries of the CIS and helpedwith the preparation of country programmes ofassistance.

• AFRICA: The regional network dealing withadjustment in East and West Africa remainedactive during the year, and a cost and economicsunit was created to strengthen in-house capacityto deal with macroeconomic issues and pro-gramme costing. Two economic advisers were alsoadded to the regional office in sub-Saharan

• DEBT SWAPS: Jamaica, Madagascar and thePhilippines joined the Sudan as countries inwhich UNictF has carried out debt conversions forchild development. UNICEF has now arrangedswaps of commercial bank debt with a face valueof over US$68 million into local currencies valuedat more than US$11 million. Negotiations to con-vert debt for an additional 11 countries, primarilyin Africa and Larin America, were continuing. Q

1993 UNICEF ANNUAL REPORT

MOBILIZING FOR CHILDREN

EFFORTS to integrate the goals of the WorldSummit for Children into the Earth Sum-

mit's Agenda 21, an explosive increase in thenumber of emergencies affecting children and thesituation of children in Africa dominated theinformation and media work of UNICEH in 1992.

International media attention grew in directproportion to the deteriorating situation of chil-dren in a score of countries including Afghani-stan, Angola, Iraq, Liheria, Somalia andsouthern Sudan, 10 drought-stricken countries ofsouthern Africa, and the former Soviet Union.The volume and complexity of emergency situa-tions during the year involved information staff inemergency assessment missions, media held tripsand almost daily reports on relief efforts. As win-ter approached in former Yugoslavia, a 'week oftranquillity1 was negotiated tor the safe passage ofblankets and winter clothing tor tens of thousandsof vulnerable children, and journalists travelledwith the Executive Director in a relief convoy intoSarajevo. In Somalia, UNICEF information staffdefied escalating violence to become a mainsource of facts and figures quoted regularly byinternational news agencies, newspapers andmajor television newscasts.

WHO/UNICEF collaborative missions to the

Commonwealth of Independent States (cis) inFebruary and March also generated strong presscoverage. Special support was provided toNational Committees and UNICEF offices in Cen-tral and Eastern Europe through the publicationof an intormation kit and an analysis of opportun-ities for advocacy.

The first annual World Breastfeeding Week(August) succeeded in drawing considerable pub-lic and media attention to the ha by-friendly hos-pital initiative (BFHl). It was initiated by theWorld Alliance for Breastfeeding Action (WABA)

with UNICEH support and had the backing ofnational non-governmental organizations(NGOs). Wellstart and La Leche League Interna-tional reinforced these endeavours with trainingin breastfeeding promotion for hospital staff.UNICEF spokesperson Eartha Kitt promoted theevent in New York with a press conference at St.Vincent's Hospital and delivered a keynotespeech on behalf of UNICEF at the ninth AnnualInternational Congress on Child Abuse andNeglect (Chicago, September).

A media meeting of 20 leading British, Frenchand other European journalists and experts on

African affairs was held in London in Novemberprior to the Organization of African Unity <OAU)International Conference on Assistance to Afri-can Children (ICAAC). The Conference, and themeeting that preceded it, generated widespreadcoverage of the continent's debt problems andeconomic crisis as well as the challenges posed byAIDS, poverty and urbanization. UNICEF arrangedseveral media trips for international and Africanjournalists, who later travelled to Dakar for theConference. Other related events in Dakarincluded an international meeting of mayors (24November). {See 'Publicparticipatkm'.)

• AGENDA I\-. Political commitments to theUNICEF goals for children in the 1990s werestrengthened by the United Nations Conferenceon Environment and Development (UNCED) heldin Rio de Janeiro in June. Agenda 21 - the I INC :EDmanifesto for environmental and developmentstrategies into the next century- incorporated theWorld Summit goals, encouraged ratification ofthe Convention on the Rights of the Child andsupported the alleviation of poverty. The Confer-ence generated massive media attention and trig-gered events with important messages for childsurvival and development. The successful integra-tion of issues affecting children into Agenda 21should have a number of ongoing benefits forUNICEF external relations including fund-raising,work with NGps and the development of newpartnerships.

Smiling faces bearwitness to the fact thatthe essential humanneeds - enough food,clean water, healthcore and a basiceducation - are nowwithin reach

ExmnNM. REuaioxi

• THE STATE OF THE WORLD'S CHILDREN:

The 1993 report argued that it should be possibleto end child malnutrition, preventable diseasesand widespread illiteracy within R decade. Thereport was launched on 17 December 1992 inMexico, and the press conference was transmittedin association with Visnews via six satellites to arecord number of countries. A video news releaseon the launch was transmitted to all of North andSouth America, Europe and the Middle East,Asia, Australia, New Zealand and parts of Africa.National Committees and country officesreceived an advance video package of storieswhich provided background for news conferencesand briefings. News conferences were held in T6cities of the United States alone where extensivereports were covered by ABC, CBS, CNN, PBS andscores of television stations. Major newspapers,such as Trie New York Times, T/if Washington Post,Los Angeks Times, The Miami Herald, The BostonGlobe and The Baltimore Sun, devoted columnsand editorials to the event. Elsewhere, the launchgenerated impressive coverage on major networksworldwide, including the RBC World Service<UK), CBC (Canada), French TV 2, NHK (Japan),NRK (Norway), KAI (Italy), Televisa (Mexico) andTV Globo (Brazil). Major newspapers which car-ried reports were Curriere ddla Sera (Italy), theDaily Telegraph and Financial Times (IJK). TheGlobe and Mail (Canada), La Repubblica (Italy),Yrnniuri Shi?nbtm and Asahi Shimbun (Japan).

For the first time, l iNICEF also issued a regionalreport - Children of the Americas - in both English,and Spanish, which was preceded by a radio co-production in Spanish with the BBC World Serv-ice. A satellite radio programme was broadcastlive from Bogota and other Latin American loca-tions as well as from London, and UN1CEF staffassisted the US Committee for UNICF.F with aMiami-based news conference which targetedSpanish-speak ing residents in the United States.The activities in Miami were broadcast by televi-sion satellite services throughout the Americas.

• BROADCASTING AND VIDEO: Support for

UNfCEF in the broadcast industry was expandedthrough a new initiative - the International Chil-dren's Day of Broadcasting - observed in morethan 70 countries in mid-December. An infor-mation kit and specially recorded television spotswere distributed with the support of broadcastexecutives from The International Council of theNational Academy of Television Arts and Sci-ences. This will be an annual event with consid-erable fund-raising and advocacy potential.

Demand for UNICEF video footage on emer-gency and other situations grew by 25 per centwith the distribution of more than 8,000 videos.The overwhelmingly positive reception given toUNICEF coverage and co-productions suggests thiswork will become increasingly imporranr. l INICEF

television coverage of emergencies in Afghani-stan, Haiti, Somalia and former Yugoslavia wereaired on television networks worldwide. Informa-tion/Communication Training workshops arebeing developed to further this capacity to useaudiovisual media and to strengthen partnershipswith international broadcasters, national agenciesand mass media.

Among the co-productions initiated in 1992was the Growing Up series, which records thebirth of a number of children around the worldand plans to track the way in which environmen-tal conditions shape their lives over the next L0years. Growing Up will be the official him of WorldEnvironment Day in 1993. The co-productionpartners are Television Trust for the Environmentand Central Television in the United Kingdom.

Other video co-productions included:» The Oilier Side of Africa with NCRV-TV of the

Netherlands;» a prime-time television special on primary

environmental care (PEt;) and children with Nor-wegian Broadcasting;

» environment spots with Television Trust forthe Environment and the Saarchi & 5a ate hiadvertising agency;

A regional report,Children of theAmericas, points oufthat projects for Indiansmust respect theirculture and traditions.

IW.HWICEFANM'AL REPORT

» a three-parr production on the environmentwith the German National Committee andTrans tel;

» a simulation game about international tradeand responsibility aired by BBCTV;

» a series with French television on the girlchild in Pakistan, AIDS in Burundi and Rwanda,and water in Niger;

» the first part of a series on micronutrients,Ending Hidden Hunger, which was shown at theInternational Conference on Nutrition in Rome(in December), sponsored by the United NationsFood and Agricultural Organization (FAO) aridthe World Health Organization (WHO);

» daily news reports and a 10-minute news spoton the OAU conference on children in Dakar torviewers in Europe, the Pacific Rim and NorthAmerica.

Headquarters helped field offices with televisionpost-product ion and the distribution of a numberof special video productions. Work starred on afunding project to help individuals from develop-ing countries product: 10-minute films or videosabout children and development.

UNICEF productions included: The Bamako Ini-tiative in Action; two videos on BFHI; spots on theConvention on the Rights of the Child whichwere aired on CNN International; Images on edu-

While the worldstruggles towardspeace, childrendeserve immediateprotection from thehorrors of war.

cation tor development; and a compilation ofvideos for the Ninth World Food Day SatelliteConference that was seen throughout North andSouth America.

A clearing-house was established at the TulaneUniversity School of Public Health and TropicalMedicine in New Orleans to share informationabout video productions by country offices, andthe first issue of a clearing-house newsletter wasdistributed.

A 'Tape Forum Award '92' was initiated withthe BASF company tor the best broadcast-qualityvideo documentary on children's issues. Over 75productions were submitted globally, and a Britishentry won the award.

• EDUCATION FOR DEVELOPMENT! The yearmarked a turning-point for UNlCEF activities ineducation for development, which broadenedboth in concept and outreach. The programmehas become a forum for social action and hasexpanded to include educators in developingcountries through UNICEF regional offices.

Training workshops were held during the yeartor National Committee education officers atOxford (UK) and for curriculum planners and sen-ior educators from the eastern and southernAfrica regions in Nairobi. The Standing Group ofthe National Committees recommended thatfrom 1993 onwards education for developmentshould have its own National Committee work-shop separate from that on information.

A manual of practical education for develop-ment learning strategies for teachers and youthfacilitators was compiled and tested in 22 coun-

Using the concept of a week of tranquillity' toachieve a lull in fighting, UNICEF is able to deliversupplies to children caught in war zones.

EXTERNAL RELATION;*

their local media. A regular monthly newsletterhas given a further boost Co BFHl. Publication ofthe newsletter BFHl News is expected to continuethrough 1993.

Major policy statements by the ExecutiveDirector were widely disseminated through aseries of booklets that were sent to National Com-mittees, field offices, and organizations concernedwith the particular issues covered.

All UNIUEF headquarters information materialsand core publications are now printed on recycled

• PHOTOGRAPHS: In addition to meetingongoing media, NtiO and other publishers'requests for photographs, more than 45 series ofblack-and-white prints and colour slides were dis-tributed to National Committees and UN ICE Fheadquarters and field offices. Representingalmost 1,000 new images, subjects included BFHl,African children and women, the girl child, theenvironment, and emergencies in Afghanistan,Somalia and former Yugoslavia. Photographs werea major component of UNICEF publications as wellas exhibitions on Africa and UNCED. Technicalsupport to field offices was also increased duringthe year, including the distribution of photoacquisition and treatment guidelines.

• INFORMATION CAPACITY-BUILDINC: Work-ing through the Global Communication SupportFund, UNICEF stepped up its support for creativecommunications. Emphasis was put on projects todevelop the capacity or media professionals - radioproducers, journalists and creators of animatedfilms. Among the projects approved in 1992 were:a joint UNICEF/FAO rural radio training project forfrancophone West and Central Africa; a socialmobilisation ttaining project in the Philippines; aglobal communication training project with theRadio Netherlands Training Centre and the Aus-tralian Broadcasting Corporation; a seminar andworkshop for producers of children's televisionprogrammes in Central America; and a multi-media package to mobilize public opinion on theproblems of children in the Americas.

After a year of curriculum development, a con-tract was signed in November 1992 with the Chil-dren's Television Workshop and Mexico's Televisator the production of 130 Spanish-language epi-sodes of Sesame Street (Plaza Sesamu) for use inLatin America and the Caribbean. The series willcontain educational material based on i 'NICEFobjectives in the region.

UNlcE!- Bangladesh finalized a pilot episode ofthe animated film Meerui with Hanna-Barbera'sstudios in the Philippines and began field surveys

UNICEF will helpprovide a safety net forthe children of EasternEurope and Central tries. Images, a video about how stereotypical

views of life in developing countries can be proj-ected by the media, was also produced. It isaccompanied by suggestions for group workactivities.

• INFORMATION MATERIALS: Mobilization

for Africa was an important focus of headquarterspublications in 1992. The tange of materials pro-duced to coincide with the OAU Conference(iCAAC) in November included: Africa's Children,Africa's Future: Priorities for Human Investment inthe 1990s; a bibliography of UNK.'EF publicationsand videos on Africa; and an information kit. Thematerials are intended for use beyond the Confer'ence and have a shelf-life of several years.

Areas of concern highlighted in the quarterlyFirst Call for Children included reports on nationalprogrammes of action (NB\S) and activities in sup-port of the Convention on the Rights of theChild, children and the environment, mobiliza-tion for Africa, and children in war.

A number of booklets were produced coveringsuch subjects as the UNICEF policy on nutrition,UNICEF assistance in Romania, the mayors' initi-ative and UNICEF issues in Agenda 21. Also pro-duced were thematic kits on the environment, theDay of the African Child, and children in Centraland Eastern Europe.

A new initiative was the establishment of theUNICEF Features Service. Human-interest featurearticles on development issues and programmesare being transmitted to National Committees foradvocacy and fund-raising or for placement in

1993 UNICEF ANNUAL REPORT

to assess its impact on the target audience. Theoffice also produced a poster, comic book, leafletand prototype models of Meena products tor pos-sible sale in South Asia. Supplementary fundingtor the Meena project was provided by the Nor-wegian Government.

The movement towards democracy in Africaand elsewhere opened a number of doors forUNICEF advocacy through privately owned com-mercial radio stations and newspapers. Amongthe initiatives taken by UNICEF regional and coun-try offices in Africa was the development of a part-nership with FAQ to train radio producers andother communicators in cooperation with uni-versities and institutes.

The first meeting of the Working Group onImages was convened to examine ways in whichUNICEF interacts with the media, as well as thecontradictions that may arise in the course of itsinformation/education work and fund-raisingendeavours. Further research was commissionedin both of these areas.

A series of regional consultation/training ses-

sions was held for information and communica^tions officers in Abidjan, Beijing, Caracas, Kath-mandu, Nairobi and Rio de Janeiro. Newrepresentatives received training in media andpresentation skills.

In Nice (France), a training session on the sub-ject of media and emergencies was held from 30November to 1 December. The participants wereinformation officers from National Committees aswell as regional information officers and field stafffrom emergency countries. The training sessioncoincided with the annual National CommitteeInformation Workshop.

• POLLS: After a year of preparation, opinionpolling was initiated to gauge public awareness ofUNICEF and its image, as well as perceptions ofdevelopment issues. The first poll was conductedby the us Committee for UNICEF, and it is hopedthat other National Committees will follow suit.On behalf of the Danish, German and SpanishNational Committees, UNICEF also carried out asecondary analysis of opinion poll data held by theEuropean Commission. •

CONVENTION ON THE RIGHTS OF THE CHILD

EFFORTS to accelerate implementation ofthe Convention on the Rights of the Child

focused mainly on training, research and encour-agement for NCOS and other external partners.

UNICEF developed a comprehensive trainingpackage for representatives and senior programmeofficers. The training package was field-testedduring the year, and a training workshop was heldin Addis Ababa from 20 September to 2 October.The workshops will be extended to all regions bythe end of 1993.

At rhe request of the Executive Board, theInternational Child Development Centre (ICDC)

carried out a study analysing the compatibilityand complementarity between the Convention onthe Elimination of All Forms of Discriminationagainst Women and die Convention on the Rightsof the Child.

• INFORMATION BASE: ICDC also proposedthe development of an effective, user-orientedinformation base on children's rights. As a pre-liminary step, the Centre commissioned a surveyto determine the capacity of UNICEF and selectedintergovernmental organizations to handle infor-mation relating (directly or indirectly) to chil-dren's rights. As a second step, ICDC is proposingto undertake a survey of NGOs and other groups.The information gathered could form the basis ofan organizational database on children's rights,which would be the beginning of a process of

One consequence of war is rhe ever-growingnumber of child workers, whose homes andschools are in ruins.

EXTERNAL RELATIONS

information sharing. Special efforts will heneeded to ensure that key institutions in the'South' as well as the 'North' are included both inthe initial surveys and in subsequent informationmanagement and networking activities for chil-dren's rights.

UN ICE F documentation in the area of childrights was improved and key guidelines for thepreparation of country programmes wereamended to include standards set by the Conven-tion. All future situation analyses will address thefull range of needs and interests necessary to fulfilthe Convention's objectives.

• COMMITTEE ON TI ii- RIGHTS OF THE CHILD:

UNICEF arranged an inter-agency consultation inQuito (Ecuador) so that the Committee on theRights of the Child could learn what other agen-cies are doing to promote child rights. The meet-ing was also attended by government officials andNGOs. The Committee had an opportunity totravel within the country, visiting project sites inmountain, coastal and urban areas, UNICEK alsoprovided the Committee with supplementaryinformation on the situation of children in coun-tries that have submitted their first reports onimplementation.

• C H I L D RIGHTS* PARTNERS: Cooperationwith external partners has focused on support foractivities to promote public awareness of childrights and to educate the constituencies of theseorganizations about the Convention and its impli-cations for their work. UNICEF supported an inter-national conference on discrimination against thegirl child in education (New York, 21-22 April); aregional seminar on the implementation of theConvention in terms of preventing child abandon-ment (Sofia, 28 September-2 October) (see 'Non-governmental organisations'); and is helpingnational and international NGOs to develop a sys-tem to share information.

UNICEF is also supporting the efforts of the NGOGroup on the Convention to facilitate creating orstrengthening existing national NGO coalitions forchildren's rights. The main objective of thesenational coalitions is to promote implementationof the Convention and to provide informationabout the situation of children in their countriesto the Committee on the Rights of the Child.UNICES offices worked directly with children aswell as with parliamentarians, mayors and profes-sional groups to promote compliance with theConvention's ideals. •

*

PUBLIC PARTICIPATION

UNiCEK continued its advocacy for childrenthrough collaboration with intergovern-

mental organizations as well as community, reli-gious and political leaders.

• INTERGOVERNMENTAL ORGANIZATIONS;

UNICEF advocacy for children in general, and theOAU Dakar Conference (ICAAC) in particular,resulted in declarations and action from manyquarters including: the tenth Summit of Heads ofState or Government o( the Non-Aligned Move-ment in Jakarta (September); the MinisterialConference on Children of the South AsianAssociation for Regional Cooperation (SA ARC) inColombo (September); the Summit of FirstLadies of Latin America and the Caribbean inCartagena, Colombia (September); the France-AfriLjue Summit in Libreville, Gabon (October);the Ministerial Meeting of the League of ArabStates in Tunis (November); and the SummitLevel Group for South-South Consultation andCooperation, known as the 'Group of Fifteen', inDakar (November). All reaffirmed their commit-ment to implement the goals for children in the

• PARLIAMENTARIANS: About 500 parlia-mentarians from 101 countries attended the 88thInter-Parliamentary Union Conference in Stock-

A major internationalconference held bythe OAU in Dakar inNovember called onthe world to make a'human investment' inAfrica's children.

1993 tWICEF ANNUAL REPORT

holm (7-12 September). They reaffirmed theircommitment to the World Summit goals for chil-dren in the 1990s and joined UNICEF in placingspecial emphasis on needs in Africa.

At a Parliamentary Earth Summit in Rio deJaneiro (5-7 June), they joined religious leaders,scientists and artists in adopting the Rio Consen-sus, which stated that societies unable to care fortheir children could not consider their develop-ment to be sustainable. Parliamentarians also fig-ured prominently in UNICEF advocacy forimplementation of the Convention on the Rightsof the Child.

• RELIGIOUS LEADERS: An interfaith servicein New York on the Day of the African Child (16June) reflected growing international concern forchildren in the region. A task force of religiousleaders was formed to help link UNICEF activitieswith African communities, and a regional meet-ing of religious leaders in Harare (June) discusseda broad range of children's issues.

The importance of advocacy through religiousleaders was again demonstrated when PatriarchPavle of the Orthodox Church of Serbia appealedto citizens of all faiths in former Yugoslavia torespect the 'week of tranquillity' so that food,clothing, medicines, vaccines and vitamins couldbe delivered to children in their communities.

• MAYORS: An International Colloquium ofMayors in Dakar (8-9 January 1992), hosted bythe Mayor of Dakar and UN1CEH, launched theglobal initiative 'Mayors as Defenders of Chil-dren'. The initiative encourages mayors todevelop municipal plans of action in line withNPAs and the goals of the World Summit for Chil-

A carefree childhoodshould be the right ofchildren everywhere.dren. Twenty mayors and municipal leaders from

16 countries and 36 of Senegal's 48 mayorsadopted a Dakar Declaration and Plan of Action.On the eve of ICAAC (24 November), some 40mayors from Canada, Italy, Nigeria and Senegalmet again in Dakar to review their plans andexpress solidarity with the goals for Africanchildren.

In addition, tor the Day of the African Child(16 June), mayors of numerous cities around theworld issued proclamations drawing attention tothe needs of African children. •

NATIONAL COMMITTEES

NATIONAL Committees for UNICEF, asprincipal partners in the industrialized

countries, continued to promote a deeper under-standing of the needs and rights of childrenthrough their ongoing work in support ot theorganization's objectives. They contributed morethan 20 per cent of UNICEF resources, mainlythrough sales of greeting cards and private sectorfund-raising. They also responded quickly toemergency appeals by providing additional funds,especially tor Africa and former Yugoslavia. Theyworked with national and international NGOs,professional groups and local authorities to pro-mote BFHi, and they expanded activities related to

the Convention on the Rights of the Child andWorld Summit follow-up.

• EXCHANGE OF VIEWS: Consultation be-tween the UNICEF secretariat and National Com-mittees was refined and strengthened by tourmeetings between UNICEF staff members and therepresentative Standing Group. Special consul-tations were also held with a broader group ofNational Committee chief executive officers todiscuss such issues as the crises in Somalia andformer Yugoslavia, and the restructuring processat the United Nations. The National Commit-tees also continued to meet with secretariatstaff at workshops in the areas of information,

iixTh'HNAL RELATIONS

The broader community of Committees soughtmeans to assist in establishing new NationalCommittees, or to sustain existing Committeesduring the period of transition. Means were alsoexplored to help create Committees in the newlyindustrialized countries in Asia. •

fund-raising, greeting cards and education fordevelopment.

Special attention continued to be paid to thechanging circumstances faced by National Com-mittees in several Central and Eastern Europeancountries. For example, a planning and coordi-nation meeting was held in Sofia in December.

NON-GOVERNMENTAL ORGANIZATIONS

NGOs played a major role in ensuring thatgoals for children in the 1990s figured

prominently on rhe agendas of major internationalconferences held during the year. They made sub-stantive contributions to LTNCED'S Agenda 21, theInternational Conference on Nutrition and

UNICEF also worked closely with NCO groupsand coalitions to reduce gender disparities in edu-cation; promote healthy lifestyles among youth;involve young people in health and developmentprogrammes; and protect children caught inarmed conflict situations.

• CENTRAL AND EASTERN E U R O P E : The

NGO/UNICEF Coordinating Committee on Activ-ities for Children in Eastern and Central Europewas created in 1991 and has become an effectivemeans of coordinating responses to the needs ofchildren in this region as well as support for theformation of new indigenous NGOs. A capacity-building seminar for NGOs from the three BalticStates was organized by the International Federa-tion oi University Women (Tartu, Estonia, 4-12October). Participants from 17 Central and East-ern European countries attended a regional semi-nar on family-based alternatives to prevent childabandonment (Sofia, 28 September-2 October).The seminar in Bulgaria was jointly organized byDefense for Children International, the Interna-tional Catholic Child Bureau, the InternationalSocial Service and UNICEF.

• AFRICA: International and African NGOsgenerate some 30 per cent of the aid to Africancountries. They were well-represented at ICAAC inDakar, where they restated their desire to workwith governments on NPAS in order to fulfil thegoals of the World Summit for Children.

• GLOBAL: As mentioned, UNlCfcF continuedits work with the NCO Group on the Conventionon the Rights of the Child, helping to createnational coalitions for children's rights and devel-oping ;in information network linking organiza-

tions which work on behalf of children. UNICEF

expanded its long-term collaboration with theRotary International Polio Plus programme to thefield of education. It also continued to work withthe Junior Chamber International on control ofdiarrhoea! diseases (CDP), especially in LatinAmerica. •

Rotary Infemotional has raised more than US$240million for polio eradication worldwide - anoutstanding example of dedication to the causeof children.

1993 UNJCEF ANNUAL REPORT

FUND-RAISING

FUND-RAISING efforts concentrated onreaching targets commensurate with the

UNICEF medium-term plan 1992-1995. Effortswere also made during the year to encourage ageneral mobilization of international resources forNPAs, in particular for African countries.

Special efforts were made to encourage multi-lateral agencies, international financial institu-tions, the European Community and NnOs tochannel funding through UNICEF in support of

• CoST-SHARlNG: A joint project agreementwas signed with the African Development Fundand Bank in an effort to broaden the funding basefor NPAs. The agreement includes joint projectidentification, project preparation, appraisal,implementation, supervision and post-evaluationin member States. It also includes cost-sharing inall hut the implementation phase. Collaboration

with other development banks was alsostrengthened.

In 1992, contributions to general resourcesamounted to some US$545 million. Adding thecontributions from supplementary funded pro-grammes and emergencies, the total exceededUS$900 million for the first time in UNICEFhistory.

• B U D G E T CONCERNS; While donors re-sponded generously to a large number of com-plex emergencies and did not reduce their supportfor supplementary programmes, it is of some con-cern to UNICEF that supplementary funding didnot keep pace with the medium-term plan'sprojections.

UNlCEf-'s debt relief initiative expanded duringthe year to bring the total funds generated in localcurrencies to US$9.4 million. This compares witha US$2 million total in 1991. Q

PUBLIC ADVOCACY

UNICKF Goodwill Ambassadors, SpecialRepresentatives and other celebrity

spokespersons continued to generate major publicsupport for children in need through print andbroadcast interviews, speeches and appearancesat special events.

• AUDREY HEPBURN: The sad news of thedeath of Goodwill Ambassador Audrey Hepburnon 20 January 1993 was deeply felt around theworld. An Audrey Hepburn Memorial Fund hasbeen established to benefit specific projects forchildren in especially difficult circumstances in

In a television tributeto Audrey Hepburn'stireless work forUNICEF, her son citedher unshakabledetermination to bringto all children,everywhere, the gifts ot"health, hope,tenderness and life"

EXTERNAL RELATIONS

Africa. Ms. Hepburn's last overseas visit forUN ICE H was her trip to Somalia in late September,which generated very extensive press coveragefrom interviews and press conferences in Londonand Nairobi.

• GOODWILL AMBASSADORS WORLDWIDE:

Tetsuko Kuroyanagi's visit to Ethiopia in Julyraised more than US$ I million for projects there.

Roger Moore attended several National Com-mittee events, including the UNICEF partnershipcampaign with the city of Kiel in Germany, fund-raisers in the United Kingdom and the UnitedStates, and the Global Forum at UNCED in Rio deJaneiro.

Sir Peter Ustinov, Liv Ullmann, YoussouN'Dour, Sir Edmund Hillary, Immn Khun andJulio Igiesias appeared as advocates tor UNICEF atNational Committee events, and Cicely Tysonspoke at the September dinner of the BusinessCouncil tor the United Nations Ambassadors.

• TELEVISION APPEALS: Other personalitiessupporting UNICEF with television appealsincluded Renato Aragao, Juan Luis Guerra,Edward James Olmos, Franco de Vita and Xuxa.Mexican television host Raul Velasco producedextensive reports on UNICEF in Central Americafor his weekly Sunday show, and US newsmanBryant Gumbel hosted a ground-breaking week ofAfrica-based Today shows prior to ICAAC.

• T H E DAY OI THE AFRICAN C H I L D :

Celebrated annually on 16 June, the Day inspireda range of activities in 14 countries outside Africa.It also gave a push to the finalization of MPAs and

Goodwill Ambassador Tetsuko Kuroyanagi waswelcomed by children when she visited Eihiopiafor UNICEF.

implementation of the Convention on the Rightsof the Child within Africa. Heads of State, firstladies, foreign ministers, religious leaders, associ-ations of artists and intellectuals, the media andthousands of children in 42 African countrieswere involved in advocacy.

Mrs. Boutros Boutros-Ghali, Mrs. MarioCuomo and Mrs. David Din kins chaired a week-long programme of activities for the Day of theAfrican Child in New York City and at the UnitedNations. These activities included an interfaithreligious service, a series of film screenings byAfrican directors, a photographic exhibit, and aneducational-cultural event for 650 schoolchildrenand teachers.

John Johnson, publisher of Ebony and Jet, waspresented with the Africa's Future award by theUS Committee for UNICEF at a diplomatic recep-tion hosted by Chemical Bank.

• 'WEEK OF TRANQUILLITY1; The effort toestablish 1-7 November as a week of tranquillityin rormer Yugoslavia involved extensive use of themedia to galvanize public opinion and advocacyby Goodwill Ambassadors Liv Ullman, AudreyHepburn and Sir Peter Ustinov. Liv Ullman wrotea special appeal letter tor National Committees,encouraging international assistance. AudreyHepburn taped television and radio spots callingfor active support lot the week throughout theconflict area, and Sir Peter did a series of radio andtelevision appeals in five languages for useinternationally. Q

At a ceremony in NewYork to honour pub-lisher John Johnson(left] were Mrs. MarioCuomo (centre) andthe late Lawrence E.Bruce, former Presidentof the US Committeefor UNICEF.

1993 UNICEFANNVAL REPORT

( ^ 2 contributed US$82.2 million to LTNICEHVJgenera l resources during the 1991 season -«Ub$5.6mUlk%i (7.3 per cent) increase over the

' P ^ ^ T « a r , and the strongest return in ocu

history.

The result was especially significant against the

^ g r o u n d oragloWrece«ion,apostal strike inCanada, and difficult economic and political cir-cumstanceain Central and EaArm Europe, eachof which had a negative impact on sales volumeOross proceed, in dollar terms also suffered fromthe strengthening of the United States dollar.

The consolidated net income of US$82 2 mil-,on,or I99j included ,snet operating income:

US$61 million from the sale of greeting cards and

% ^ = ^ ^mena, transfer of a special operating accountaccounts receivable write-offs and prior years'adjustments.

Based on provisional results for the 1992 seasun, the consolidated net income is expected to heUttfrb/ m,l|,on - an increase of US$4.8 million or^percenfoverl99L This increase isatrihutemthe efforts of many thousands of volunteers andstart of National Committees, UNICEF field officesand other sales partners in 145 countries.

• INTERNAL MANAGEMENT REVIEW- GCO

conducted a year-long internal managementrev,cw and adapted its organizational structure tobetter assist National Committees and field offices•n raising money from the private sector. In addi-non to its work in the industrialized countries itKbnci W 31 developing countries with privatesector fund-raising potential.

•D.RFCTMAM, With oco support, NationalCommittees and field offices were able to expandor initiate direct mail programmes. New appeakwere launched in Australia, Belgium, Brazil, Ger-many, Hong Kong, Japan, Mexico, the Nether-knek New Zealand and the Republic of KoreaDirect-mail materials included the publications^ ' e w of the %ar'and "Chance InraChlld'. andfunJ-raismg kits on country programme, inBohvia, China, Ethiopia and Mali. Anotherkn&rsbin* kit, "Children: Innocent Victims ofWar was distributed for emergency appeals.

• F U N D _ R A , S I N ( J DEVELOPMENT PUO

GRAMME- The aim of the Programme is to helpNational Committees and field offices boost their

pnvate sector fund-raising and build donor con-stituencies. During the year, the Programmeacquired 125,000 new donors, including 27 000with monthly pledges. Ten National Committeesand three beW oAces in 15 countries have so 6rbenefited. For a total Investment of US$.3 4 mil-' ^ ^ 1991, t k Programme has already gen-emted returns of US$8.4 million.

A Central and Eastern European NationalCommutes Development Programme was initi-ated ,n 1992 to help those countries develop theircapacity in advocacy, information dominationales network expansion and donor constituencybuilding. '

•WORKSHOPS: Six regional greeting cardworkshops were held during the year, togetherwith a fund-raising workshop for National Com-mittees in Torremolinos (Spain).

•SPECIAL EVENTS, A special events manualwas prepared and distributed to more than JONational Committees and field offices, GCOreviewed mure than 100 proposal, for specialevents directed projects with fund-raising poten-tial to National Committees and field offices andprovided implementation support. The 1992Danny Kaye International Children's Awards tel-evisran broadcast in the Netherlands (September)was hosted by UNKOF Goodwill Ambassador,Roger Moore and Audrey Hepburn. Childrenfrom 23 countries participated in the recordedprogramme, which was broadcast in more than 20countries for advocacy and fund-raising. Danny'sdaughter, Dena Kaye, introduced 61m segmentsfrom her trip to UNlCEF-assisted projects in LatinAmerica.

•EXHIBITS AND PROMOTIONS, Over 20 dif-

tlw A e X h l b i t i O m Were p l a n n e d a n d developed in '

Z^nlrf™ ^ R^^r%talW «Child's Right', for ICAAC inDakariZd J v t l t lof other thematic displays for international confer-ence, on children, water and the environmentacute respiratory infections and AIDS. Q

1993 VNICEF ANNUAL REPORT

UNICEF FINANCES, 1991-1993

INCOME

L J N I C E F derives its income from voluntarycontributions from governmental and non-governmental sources.

Total income for 1992 was US$938 million{compared to US$807 million for 1991). Thisincludes US$204 million in contributions foremergencies (US$136 million in 1991).

The 1992 income was divided between contri-but ions for general resources (58 per cent), sup-plementary funds (20 per cent) and emergencies(22 per cent). General resources are available forcooperation in country programmes approved bythe Executive Board, as well as programme sup-port and administrative expenditures.

General resources income includes contribu-tions from 117 Governments; net income from thesale of greeting cards; funds contributed by thepublic (mainly through National Committees);and other income.

UNICEF also seeks supplementary funds fromgovernments and intergovernmental organiza-tions to support projects for which generalresources are insufficient, or for relief and rehabil-itation programmes in emergency situations,which, by their nature, are difficult to predict.

As a result of pledges at the United NationsPledging Conference for Development Activitiesin November 1992, and pledges made subse-quently, l INICEF income for general resources in1993 is expected to total US$545 million, whichwould represents decrease of less than 1 per centfrom 1992.

UNICEF INCOME BY SOURCE 1992

Total income: $938 million

GOVERNMENTALINCOME

$707 million

GOVERNMENTALINCOME

$231 millionUNICEF INCOME 1991-1993

General resources

Supplementary funds

Emergencies

$1,200 (in millions of US dollars)

Contributions from governments and intergov-ernmental organizations accounted for 75 per centof total income (73 per cent in 1991), and the restcame from non-governmental sources (see piechart on this page). (For estimated individualgovernmental contributions hy country, see pages64 and 65. A list of estimated non-governmentalcontributions by country appears on page 67.)

CONTRIBUTIONS TO SUPPLEMENTARY FUNDSFROM INTERGOVERNMENTAL ORGANIZATIONS

(in thiiusandsafdulkeni)

AGFUND 400.Q

EEC 4,729.51DB 3,075.0OPEC Fund 1,000.0

Total 9,204.5

$ % * $16$

EmergenciesSupplementary fundsGeneral resources

uRESOUHCES

EXPENDITURES

1 HE Executive Director authorizes expend*.wnam niecr recommendation, approved by dieboard tor programme assistance. The pace ofexpenditure depend on Ac .peed of implementcation m any country. •Cash assistanceferprojectpersannel 99

Training costs and local expensesSupply assistance

Subtotal programme expenditure

Programme supportAdministrative servicesWrite-offs and other chargesTotal expenditures

BUDGET ESTIMATES591 744

rheorganizadon', o r d i n a l capacity a, achievethe prigmmmc goals and ArakRks6r the 199&Tie P"J*x«ab result from extensive review, and

^ ^ held k*h in the Held and at hcadquar-The bar chart on this pa* show, expenditure,(c*cuJ,n% wnr^W% and other charges) br 199,and 1992, and estimated 1993. The bar and pie

portion respectively.

FINANCIAL PLAN AND PROSPECTS

OASED on pledges made at the 1992 PledgingConference and recent trends. UN,i;BF exnect%« ™ «ductkn in government contrihutiooa toWm™, mwuncc; 6* ]993. % * ,s due m severaln^jor government donor, reducing their contri-

upon ,ts current level of contributions from gov-emment,. In addition 0) income generated fromthe «Je of pn^uctBbyGn^dng Card and RelatedOpemtkm, (uco), UNK,3F i, encoqmging thenongovernmental sector, through NationalCommittees and NGos, to farther expand their.mportant contrihutDns. The bendt, Motherfbrmg ̂ mndruismK are ako king examined.

UMCEF currently .supports programmes in 137county. Ar the 1 9 0 3 ^ ^ ^ . ^ ^ ^ ^

utive Board, proposals (UT new or extended multi-

$1,200 (in millions of USddla^T

g Administrative servicesProgramme supportCash assistanceSupply assistance

7993IMCEF ANNUAL REPORT

%0m $40m * & , $Wm *C0m ,%0m 1140m ,Wb

Water supply T& sanitation ™w'

nutrition

Community/family-basedservices forchildren & women

Formal &non-formaleducation

Planning& projectsupport

1988• REVISED BUDGET FOR 1992-1993.- UNICEF is

requesting a supplementary budget of US$3.9million in the current biennium. Of this, US$3.4million \s tor additional funds approved by the1992 Executive Board for activities in Central andEastern Europe. The remaining US$0.5 million isfor other miscellaneous mandatory increases.This supplementary budget is proposed within thecontext of a comprehensive financial plan thatdemonstrates that not only is the additionalbudget affordable within the latest income esti-mates but also that the budget overhead ratio forthe hiennium has actually decreased, from 10.1percent to 9.8 per cent.

• P R O P O S E D BUDGET FOR 1994-1995= In1991, the Executive Board requested UNICEF, inconsultation with a reference group comprised ofBoard members, to carry out an in-depth analysisof the structure and format of budget documents;the cri reria for determining core and project posts;and the criteria for determining the grade levels ofUNICEF representatives and other senior-levelposts. Various proposals from this study, approvedby the Board at its 1992 session, were consideredin preparing these budget estimates. The BudgetPlanning and Review Committee found the cri-

+ &&1992

4 * *

SMSOUHUIA

Contributions to UNlCEFgcneral resources are shown at right; additit

Indonesia Lao People'sDemocraticRepublic

Philippinestianistan

Bangladesh

Bhutan

Brunei Darussalam100.0 . . . . . . . . . .-.,,

, . . , . . . 1 h - , i - * I |UO"T- ?

7,300.-0 24.40.0

DemocraticRople'sRepublic of

Singapore

Sri Lanka

Malaysia

Maldives

Thailand< r T . . . &#/7), D

VicrNam

Myanmar

PakistanRepublic of

Australia New Zealand4.7 161.7 464.5

Albania

Austria2,667.9 I.B98.&

Belarus

Belgium454.5 1,969.7

ButgarU

Czechoslovakia

Denmark

17,285.6 . . . ' . . 23.316.8Finland1,897.5 , 29.6BZ,!

France *

Germany1,0489 11.445.8

Greece200.0

Ho1v See

Hungary

Iceland,

Ireland"

428.9 , ,400.0

I \B4O7 . . . . . 47,008".i

Liechtenstein

LuxembourgH%.V 75.S

Monaco

Netherlands2(\Wl.-\ 19,926.6

NorWay

11.ms...,. %%z.i

Poland

Porcugal

Romania

San Marino

. - 2.6J6.9

Sweden*S1,86S.7 . . . . ! 72,437.5

Switzerland

7,534.9 . . , . . 13,521 0

United Kingdom:,7t i4.n .. \I,:M.\

fin _p ...... *

Canada , United States of America22,875.1 11,813.0 ' • 42.S1H.O 83,744-0 +

teria for determining core versus project posts veryhelpful in streamlining the categorization of these

As desired by the Executive Board, this budgetreflects an attempt to 'downsize' New York head-quarters. On the other hand, modest growth, pri-marily of project posts, is being recommended forfield offices-

With the objective at promoting the develop-ment, utilization and building of national capac-ity, as well as enhancing sociocultural sensitivityin UNlCEF-assisted programmes, UNICES continuesto strengthen its national capacity in field offices.Among the new professional posts proposed in thebudget, approximately 95 per cent are for nationalprofessionals.

1993 IWICEFANNLW. REPORT

C O N T R I B U T I O N S (hi thousands of t <s dollars)

contributions for supplementary funds and'emergencies are shown in colour, at (eft.

Bahamas

Barbados

Bolivia

Algeria

Djibouti

* • * . - , * • i . , * I U *t

Iran, Islamic Rep. of

Botswana

BurunJi - •'. _^B_

Central AfricanRepublic

Coloml Saint Lucia

Jamaica

Mexica

- Nicaragua

Panama

Paraguay

Saint VincHitand theGrenadinesDominican

Republic

SurnameEcuador

El Salvador

Guatemala

Trinidad andTobago

Venezuela

Turkey

United ArabEmirate*.

Taniania

Zambia

Zimbabwe

A number ot staff continue to work ar sub-national levels, away from the capital cities ofdeveloping countries. Some 882 staff members,including 346 professionals, work in 128 offices atthe district and provincial levels of developingcountries. This has been noted, particularly by amulti-donor evaluation ream of independentexternal evaluators, as UNICEF'S strong advantage,

compared to other United Nations organizations,tor delivering basic social services at the grass-roots level.

This budget is being proposed at a time of muchdebate concerning the restructuring of the UnitedNations, particularly its operational activities.The multi-donor evaluation group argues for thepreservation of UNICEF'S decentralized programme

RfcSOTRCES

cenr from the 1992-1993 revised budget. How-ever, as a global inflation rate in US dollars ofapproximately 4 percent has been included in thebudget, the annual rate in real terms is 2 per cent.The overhead ratio is 11.7 per cent.

LIQUIDITY PROVISION

LJ NICEF works with countries to prepare pro-grammes so recommendations can be approved bythe Executive Board in advance of major expend-itures on these programmes. LINICH1: does not holdresources to cover fully the costs of these recom-mendations in advance, but depends on futureincome from general resources to cover expendi-tures. The organization does, however, maintaina liquidity provision to cover temporary imbal-ances between cash received and disbursed, aswell as to absorb differences her ween income andexpenditure estimates.

UNICEF maximizes planned general resourcesprogramme expenditures based on the require-ments of the liquidity provision and on the level ofprojected general resources contributions. •

Non-governmentalcontributions providemoney and volunteersfor both regular UNICEFprogrammes and reliefefforts for child victimsof armed conflict.Besides ensuringdelivery of food,medicines and warmclothing, UNICEFsupports immunizationin warring areas toprotect young children.

planning and implementation structures, and forcontrol and accountability of its financialresources.

The proposed budget of US$445.6 million rep-resents an annual growth in real terms of 2 per

INFORMATION RESOURCES MANAGEMENT

SPECIFICATIONS were prepared for the'next generation' standard computerized field

office system in order ro support programme man-agement more specifically and improve synchro-nization with headquarters systems.

The central financial and accounting systemsproject is nearing completion, and systems to beimplemented in early 1993 include: administra-tive budget management on minicomputer, spe-

cial services agreement registration, personaladvances and recovery, electronic payments andgeneral ledger registration. Work has started onevaluating the United Nations integrated man-agement information system with a view to itstuture adoption.

Some 30 field offices installed local area net-works (LANS) to share text and data-processingapplications through personal computers. •

HUMAN RESOURCES MANAGEMENT

AT the end of 1992, UNICEF had 6,288 start"members assigned to 207 locations in 115

countries worldwide. The staff comprised 1,257international professionals (563 core, 694 non-core); 54 government-sponsored; 799 nationalprofessional officers (204 core, 595 non-core); and4,178 general service staff (1,391 core, 2,787 non-core). Of this total, 35 percent of the interna-tional professionals are women, and 65 per centare professionals from developing countries. Atpresent 82 per cent serve in field locations.

• PLANNING: A revised structure for humanresources planning was announced during theyear, and the organization should soon have thecapacity to:

>•> forecast medium- to long-term humanresources requirements;

» prepare existing staff to meet those needsthrough training and redeployment;

» proactively search global labour markets forexpertise, where necessary.

1993 UNIQEF ANNUAL REPORT

1992 NON-GOVERNMENTAL CONTRIBUTIONS(m thousands of US doHars)

Hungary . . . . J ^ ^ ^ g p . 148.8Iceland 30.8

India 1.046.9Indonesia 164.0Iran, Islamic Rep. of 0S2.Q

I™q 20.5Inland 695.8kmct 10.7Ita'y i9An,9Jamaica 22,3Japan 20,486.0Jordan 46J

Kenya 119.2Korea, Republic of }57,<jLebanon 101,3

Libya 8I:4Luxembourg 8^9.6Madagascar 14.9Malawi JO, 1Malaysia ggj

Mali 19.SMalta 10.9Mauritania 17,8Mauritius 71.0Mexico -i21.4Monaco 41. iMorocco 25T.2Mozambique 49,3Myanmar 108.8Netherlands 27,172.1New Zealand 404.7N'ger 214

Nigeria 229.7Norway 1,677.3Oman 477Pakistan s'8.4Panama 22, iParaguay 612Peru ?jo.3

Philippines j g j j

Poland i l l .y

Portugal l.syo.t

Qatar 40.0

Algeria 188,4Angola 236.7Argentina 768.0Australia 3,954.1Austria 2,449.2Bahrain \tib.9Bangladesh 34,0Barbados 27.7Belgium 6,750.6Benin 1 4 . 7

Bolivia 9Q, 2

Bmnl 3,624.1Bulgaria 50.2Burkina Faso 16,7Cameroon 25.1Canada 12,781.5Central African Republic . . 25.0Chad U.4Chile 102.2China 60.6Colombia 4'i'J.7C o n 8o 14.3Costa Rica 30,9Cfited'Ivoire 55.6Cuba 72.2Cyprus 224.9Czechoslovakia 70.2Denmark 1,682.4Djibouti 17 yDominican Republic 76.0Ecuador 281,2ESTPl 73.2El Salvador |i;,yEthiopia 127.1Finland 4.79'?. 7

Fmnce 24,2018Germany 42,395.7Ghana 35.t,Gibraltar 20.5Greece 2,389.5Guatemala 46, gGuinea 199Guinea-Bissau H IHonduras 21.2

Romania 249. S

Russian Federation 225.1Rwanda ] & |San Marino . 34.2Saudi Arabia Qj.gSenegal 126-2

Sierra Leone ujSingapore 374.4Spain 17,635.5Sri Lanka 34.6Sudan 436.0

Sweden . . . . 2,404.2

Switzerland 15,149.3

SY™ 234-7Tanzania 10&|Thailand 533T °S° 10.9Trinidad and Tobago 25.8Tunisia I GO. 5Turkey 1,575.7Uganda ]g- j

United Arab Emirates 74.OUnited Kingdom 4,509.6

United States of America ..32,063.8Uruguay 173.7Venezuela . go jYemen 23.0

Yugoslavia (former) 562.0Z«re I84.2

Zamb™ 33.8Zimbabwe 46,2Contributions

from UN Staff 95.3Contributions

under $10,000 Hh.'J

TOTAL .279,10^8

CfCXi fiscal period

adjustment 12,974-0

Less: Costs of GCO* (61,473.9)

Net available for

UNICEF assistance 230,605.0

*Gwts of producing aiTds utui bfockum,freirfu, overhead, adjustments.

• DffiECTORY: Professional staff profiles wereplaced in a computerized directory to give a moreaccurate picture of available talents and skillsand to establish a relatively objective basis forforward-looking strategies in career develop-ment, training and rotation. The directory willfacilitate talent searches and recruitment andwill help staff members plan their career paths.

• RECRUITMENT: There were more externalappointments of women than men during theyear. Women led men 55.i per cent to 44.9 percent in external recruitments, while men took57- 7 per cent of the internal placements to wom-en's 42. i percent.

• EMERGENCIES AND STAFF SAFETY: An

unprecedented number of emergencies placed

Rfc'SCX'HCES

security. The officer would be stationed at head-quarters to advise offices on security issues, mon-itor conditions worldwide, and coordinateevacuations or other precautions in rapid responseto threatening situations.

• TRAINING: Some 36,000 person/days oftraining were completed during 1992. This rep-resented an average of six training days per staffmember - the most for any United Nationsagency. •

enormous demands on UNICEF staff in 1992. Theeffectiveness of the organization's response was inpart due to the rapid deployment of existing staffand consultants, and the aggressive recruitmentof specialists to cope with the particular needs ofeach situation.

As the safety of staff members and their familiesis of paramount concern to the organization, theExecutive Director proposed the appointment of aSecurity Coordination Officer to oversee their

SUPPLY MANAGEMENT

US$32 million in 1991. Although the majority ofthese purchases are still made in industrializedcountries, efforts to buy indigenous products fromdeveloping countries showed continuing improve-ment, and purchases from those countriesincreased to more than US$100 million, com-pared to US$89 million in 1991.

UNtCEF Supply Division also offers a purchasingservice to governments, NGOs and other UnitedNations agencies. The most significant action inthis area was the conclusion of an agreement withthe Government of Romania to purchase andarrange for the delivery of all the drug require-ments of that country. The drugs and other med-ical supplies are financed from a World Bank loanto the Romanian Government for supporting andimproving the country's health infrastructure.This Procurement Services programme isexpected to continue tor at least the next twoyears. Procurement Services agreements to supplythe essential drug needs of rural Tanzania,financed by the Danish International Develop-ment Agency, continued for the seventh succes-sive year. A number of other countries alsocontinued to benefit from UNICEF purchasing serv-ices complementary to the UNiCEF-assistedprogrammes.

The extended office premises in Copenhagenwere officially opened last year by the Prime Min-ister of Denmark in the presence of UNICEF Exec-utive Director James P. Grant and UNDPAdministrator William H. Draper III. The largerpremises are shared with the Inter-Agency Pro-curement Services Office of UNDP, and this marksa major step towards coordinated purchasingwithin the United Nations system. The complexhouses L50 UNICEF and 56 UNDP staff members,with the UNICEF warehouse and packing facilitysupported by approximately 80 contractedworkers, Q

FOR the Supply Division, 1992 was the mostchallenging year yet. The man-made emer-

gencies in Iraq, especially in the Kurdish north,and in Somalia, die Sudan and former Yugoslaviademanded immediate and repeated deliveries oflarge quantities of medical supplies from theCopenhagen warehouse. These demands, whensuperimposed on the regular programme suppliesto the more than 120 countries where UNICEF isworking, meant that on many occasions the ware-house was required to work evenings and week-ends. The procurement staff rose to the challengeof keeping the warehouse stocked, in addition topurchasing for direct delivery to UNiCEF-assistedprogrammes.

The total value of purchases made in 1992 roseto more than US$370 million, from US$304 mil-lion in 1991. The value of essential drugs pur-chased jumped by US$8 million to US$61million, largely to meet emergency demands.UNICEF continued to fully support the expandedprogramme on immunization, with the value otvaccines purchased rising to US$62 million from

GLOSSARYAdminisrrative Committee on Coordination

acure respiratory infections

baby-friendly hospital initiative

Bangladesh Rural Advancement Committeecontrol of diarrhoea! diseases

Commonwealth of Independent grateschild survival and development

Department of Humaniranan Affairs (United Nations)East Asia and Pacific Regional Office (UNK.:H-)European Economic Communityexpanded programme on immunization

Eastern and Southern Africa Regional Office (UNICEF)Fmd and Agriculture Organization of the United NationsGreeting card and related operations (UNICEF)human immunodeficiency virusInter-American Development Rinkiodine deficiency disorders

International Fund b r Agricultural DevelopmentInternational Labour OrganisationInternational Monetary Fundinfant mortality rntematernal and child health

Middle East and North Africa Regional Office (LINICEF)non-governmental organizationnational programme of action

OrKani:ationoJ'AiTican Unity

Organisation for Economic Co-operation and DevelopmentOrganization of Petroleum Exporting Countriesoral rehydrntion saltsoral rehydrarion therapy

primary-environmental careproteln-(uierB>' malnutritionprimary health care

South Asia Reborn! Office (LINICCT)

South Asian Association for Regional Cooperation

The Americas and Carihliean Regional Office (UMCts)rradititmal birth attendanturban basic service*universal child Immunizationunder-Ave mortalir>- raio

Umred Nations Educanunal, Scientific and Cultural Organizationunited Natntrm Ptjpnlatitm Fund

United Nations High Commisskmer for RefiigeesUnited Nations Children's Fund

United Nations Development Fund for Women

United States Agency for International Developmentwater and sanitation

West and Central Africa Regional Office (uNliT*)World Food Programme

World Health Organization

Netherlands: Stichting NederlandsCamite UNICEF

St. Barbaraweg4Postbus 30603NL-25O0-GP The Hague

New Zealand: New ZealandNational Committee for UN [CEF

Room 534, 5ch floorHarbour Ciry Tower29 Brandon St.P,O, Box 347NZ-Wellington

Norway: UNICEF-Komi teen I NorgeP.O. Box 6877St. Olavspl.N-0130 Oslo I

Poland: Polski Komitet UNtCEFul. Mokoruwska, 39PL-00551 Warsaw

Portugal: ComirfPortugufiapara a UNICEF

Av. Ant. Augusto Aguiar, 56-3EP - 1000 Lisbon

Romania: Comitetut RomanPenrru UNICEF

Strada Stirbei Voda, 37R - 70732 Buclmrest

Sran Marino: Commissions NaiionaleSammarinese per I'UMCEF

do Segreraria di Stato.per.gliAffari Esteri

Pala^nBegniI-47031 San Marino

Spain: Comite Espanol del UNICEFMauricio Legendre, 36E-28046 Madrid

Sweden: Sven^UNICE&KbmmiccenBox Ul 14(AaSgatan 149)S-1Q0 61 Stockholm

Switzerland: ScKweizerischesKomi tee for UNICEF

PostfiachCH-8O21Zilrich

Turkey: UNlCEFTttrtoyeMilliKomitesi

Abdullah CevdetSokak No. 20/10TR - 00680 Cankaya - Ankara

United Kingdom: United KingdomCommittee lor UN [CEF

55 Lincoln's Inn FieldsGB-London WC2A3NB

United States of America:United States Committeefor UNICEF

333 East 38th StreetUSA-New York, N.Y. 10016

Belgium: Comlte beige pour 1'UNICEFAvenue des Arts 20B-1040 Brussels

Bulgaria: Bulgarian NationalCommittee for UNICEF

Oborfste 17BG-1504 Sofia

Canada: Canadian UNICEFCommittee/Comite" UNICEF Canada

443, Mount Pleasant RoadCDN - Toronto, Ontario M4S 2L8

Denmark: Dansk UNICEFKomLteBilled ve) 8, FrihavncnDK-2100 Copenhagen 0

Finland: Suomen L^NICEF - yhdisrys r.y.Pmtulantie 6SF- 00210 Helsinki

France: Comlte: francaW pour 1'UNICEFJ5, rueFelicien-DavidF-75210 Paris Cedex 16

Germany: Deucsches Komi teeAir UNICEF

Haningerweg 104Postfach 52 0419D-5000 Cologne 51

Greece: Hellenic National Committeefor UNICEF

XeniasStreer 1GR-115 27 Athens

Hong Kong: Hong Kong Committeefor UNICEF

60, Blue Pool Road 3/FHappy ValleyHong Kong

Hungary: UNICEF Magyar NemietiBizottsaga

Varsanyi Iren U. 26-34II. LH VI. 1H-1027 Budapest

Ireland; Irish National Committeefor UNICEF

4, St. Andrew StreetIRL-Dublin 2

Israel: Israel National Committeefor UNICEF

do International Cultural Centrefor Youth

12 Emek Rephaim RoadIL-93105 Jerusalem

Italy: Comiiato Italiano per 1'UNTCEFVialppotitoNievo, 611-00153 Rome

Japan: Japan Committee for UNICEFDaiichi Daifcyo-chu BWg.31-10 Daikyo-choShinjuku-kuTokyo 160

Luxembourg: Cornice luxembourgeoispour 1'UNICEF

99, Route d'ArlonL-1140 Luxembourg

F u r t h e r in fo rmat ion a b o u tU N I C E F a n d its work m a y be

ob ta ined from

UNICEF Headquarter*UNICEF House3 UN PlazaNew York, N.Y. 10017, U.S.A.

UNICEF Geneva OfficePalais des NationsC H - 1211 Geneva 10, Switzerland

UNICEF Eastern and Southern AfricaRegional Office

P.O. Box 44145Nairobi, Kenya

UNICEF West and Central AfricaRegional Office

Abidjan 04, Cfite d'lvoire

UN ICEF The Americas and CaribbeanRegional Office

Apartado Aereo 75 55Bogota, Colombia

UNICEF East -Asia and die PacificRegional Office

P.O. Box 2-154Bangkok 10200, Thailand

UNICEF Middle East and North AfricaRegional Office

P.O. Box 811721Amman, Jordan

UNICEF South Asia Regional OfficeP.O. Box 5815, Lekhnath MargKathmandu, Nepal

UNICEF Office for Australiaand New Zealand

P.O. Box Q143, Queen Victoria BuildingSydney, N.S.W. 2000, Australia

UNICEF Office for JapanShin-Aoyama Building N tshikan,

22nd floor1-1, Minami-Aoyama 1-ChomeMinato-KuTokyo 107. Japan

In fo rma t ion m a y also beob ta ined from the followingC o m m i t t e e s for U N I C E F

Australia: Australian Committeetor UNICEF

377 Sussex Street, Suite 4, 2nd floorSydney 2000

Austria: OsterreichischesKomiteeftir UNICEF

Vienna International Centre (UNO-City)22 Wagramer Strasse 5A -1400 Vienna