pregnant womenwithtetanus toxoid wassolow.Efforts shouldalsobemadeto reverse thedecline inbreast-feeding indeveloping countries inviewofits serious implications forchildhealth, survival andnutrition. Itwasnotedthat simple andcost-effective interventions forreducing maternal deaths wereavailable andmustbeintroduced inallcountries. Inthisconnection, thesafemotherhood initiative waswelcomed andUNICEF wasencouraged toplaceincreased emphasis on thefamilyplanning component. 20.Somedelegations expressed concern aboutthesustainability oftheseefforts andemphasized theimportance ofnational capacity-building andrealistic commitments onthepartofrecipient Governments. ItwasfeltthatCSDshouldbe theprimary objective ofeachcountry andthatinternational support waseffective onlyasacomplement tosoundnational policies. UNICEFactivities inAfrica 21.Manydelegations reiterated theestablished Boardpolicythatthemajorshare ofUNICEF resources shouldbeinvested inthosecountries wherechildren werein greatest need,andtherewasagreement thatAfrica mustcontinue tobethenumber onepriority fortheorganization. Recalling thedeclaration oftheOrganization ofAfrican Unityof1990astheYearoftheAfrican Child,itwasnotedthatAfrica wastheonlycontinent wherethenumberofchilddeaths wasrisingratherthan decreasing owingtotheinability ofcountries tobreakthecycleofpoverty. 22.Mention wasmadeofthemanyproblems afflicting southern Africa -natural disasters, suchasdroughts andfloods, theeffects ofthesystemofapartheid and theexistence ofmillions ofrefugees anddisplaced persons -whichexacerbated the already serious situation ofchildren. UNICEF wascommended forits result-oriented advocacy onbehalfofchildren insouthern Africa, including those living underthesystemofapartheid, anddelegations commented favourably onthe operational activities thatUNICEF andotherUnited Nations agencies were supporting inthisregion. 23.WithregardtothepaperbeforetheBoardonUNICEFsupport forchildren and womeninSouthAfrica (E/ICEF/1990/P/L.42), UNICEF wasurgedtointensify its efforts, buttoproceed cautiously andtoallowitsactions tobeguided bythe experiences andpriorities ofthepeopleofsouthern Africa. TheneedforUNICEF toco-ordinate itsactions withotherUnitedNations agencies wasalsostressed. 24.Several delegations spokeinfavouroftheUNICEFproposal toco-operate with selected non-govermental organizations (NGOs)inSouthAfricatopromote awareness -8-ofthesituation ofblackchildren andwomenthereandtodevelop appropriate interventions foraddressing theirneeds. Onedelegation stressed thatthis co-operation should notleadtodialogue withtheapartheid regime. (Seechap.IV, decision 199019 andannexI,paras. 15-23.) TheBamakoInitiative 25.Several delegations underlined theimportance oftheBamakoInitiative asa meansofrevitalizing thehealth careinfrastructure inAfrica andestablishing sustainable PHCsystems. However, theneedforvigilance inimplementing cost-recovery schemes toensurethatallgroups insociety hadaccess tohealth services, irrespective oftheireconomic means, wasstressed. Onedelegation expressed concern aboutapossible decrease intheutilization ofhealth services andapossible over-prescription ofdrugsresulting fromtheintroduction ofuser feesanddrugcharges. 26.Delegations ofthecountries implementing theBamakoInitiative spokeof positive experiences inestablishing community-level management unitsandof renewed enthusiasm within communities forMCHcareasaresultofgreater community involvement inmanaging health services atthefirstreferral level. One delegation notedthattheInitiative, whichalsoserved asanefficient meansof disseminating knowledge, should beexpanded tocoverotherareasessential to socialwelfare suchassafemotherhood, improved nutrition, drinking watersupply, etc.Thetraining ofcommunity health workers involved intheInitiative servedto strengthen thelinkage between MCHandchildsurvival, protection anddevelopment programmes. Manyofthesedelegations underscored theimportance ofinternational support fortheirefforts andappealed todonorcountries tosupport Africa's
**Analysis**
The text appears to be focused on development issues, particularly in the context of Africa, with a strong emphasis on healthcare and humanitarian aid. The discussion of the Bamako Initiative, safe motherhood, and UNICEF's activities in Africa suggests that the document is concerned with improving the well-being of children and women. The text also touches on the importance of international cooperation and support for development efforts.

**Category**
Health, Humanitarian aid and relief