text: -64-Initiative anoverly strongorientation towards essential drugs. Thelackofuse ofUNICEF general resources alsotended tocreate a"mixed message" regarding the position ofUNICEF ontheInitiative. 68.Thesecretariat notedwithappreciation themanysupportive remarks expressed ontheInitiative. Italsonotedthepotential oftheInitiative forlong-term sustainability infinancial, technical, political andmanagerial terms, agreeing thatitprovided thebestprospect forimplementing andsustaining PHC.The commitments ofcommunities, Governments anddonors werecritical tosuccess, however, withthelatterinparticular playing acrucial roleinfacilitating start-up actions. Whilerecognizing theneedforcaution inthespeedof implementation, thechallenge wastoreachasufficient levelofimplementation in ordertoidentify andsolveproblems suchastheimpact ofuserfees,equity, foreign exchange andtherational useofdrugs. Inallofthoseareas, continuous monitoring, analysis andoperations research wereusefultools. 69.Onaquestion ofthedominance ofsupplementary funding fortheInitiative, thesecretariat responded thatthissituation wasalready changing. Ascountries adopted theInitiative asthecentral national strategy forenhancing MCHwithin theframework ofPHC,country programmes wouldreflect thisfact. General resources, however, wouldclearly beinsufficient tomeettheneedsofthe countries, anditwasimportant thatsupplementary fundsbemadeavailable, as indicated inthe1990progress report. Closecollaboration wouldcontinue between UNICEF andWHOinthedevelopment andimplementation phases oftheInitiative. (Seedecision 1990/15 fortherecommendation oftheCommittee asadopted bythe Executive Board.) VIII. SAFEMOTHERHOOD 70.Delegations expressed theirsatisfaction withthereport onsafemotherhood (E/ICEF/1990/L.13), whichpresented awell-balanced andinformative review ofthe nature, magnitude andcausesofmaternal mortality. UNICEF wascommended for givingpriority attention totheissueofsafemotherhood, withparticular emphasis onreducing maternal mortality byonehalfbytheyear2000. 71.Onedelegation stressed theimportance oftheroleofmeninthereduction of maternal mortality, notingthatthisareawasnotdealtwithinthereport. The viewwasexpressed thatthehighmortality rateswereareflection ofthepoor status ofwomeninsociety. Activities intheareaofsafemotherhood, therefore, werecrucial tooverall efforts toimprove thecondition ofwomen. 72.TheneedforUNICEF toactively support family planning wasstressed bymany delegations. Readily accessible family planning services andcounselling would provide bothwomenandmenwithinformation aboutresponsible parenthood. Asnoted byseveral delegations, family planning activities wouldhelptoprevent unwanted pregnancies, reduce thehighprevalence ofillegal abortions andlowerthebirth rate,thereby contributing toimproved maternal health. Themajorconcern wasto ensure thatwomenhadsafepregnancies anddeliveries. 73.Theimportant roleoftraditional birthattendants (TBAs) wasunderscored by several delegations. Whileonedelegation mentioned theirsuccess inthefieldof safemotherhood, another delegation stressed thedifficulties ofmaintaining the services oftrained TBAs,including thelackofproper remuneration, adequate -65-equipment facilities andtransport. UNICEF wasurgedtostrengthen andupgrade TBA training. Thesecretariat concurred withthecomments onTBAs,explaining that UNICEF wastheprincipal provider ofsupport forTBAtraining andwasplanning to extendthatsupport toauxiliary nurse/midwives because oftheirhigherbasic qualifications, aswellastoprovide thenecessary supervision. Itwasalso mentioned thatTBAswereinthebestposition toadvise onfamilyplanning and childspacing matters. 74.Several delegations stressed thenecessity ofhavingwell-trained paramedical personnel. Another delegation mentioned theneedforadequate transport atall
analysis: The text discusses the United Nations Children's Fund (UNICEF) and its efforts to implement the Primary Health Care (PHC) initiative, focusing on maternal and child health, and the importance of family planning, traditional birth attendants, and paramedical personnel. The text also touches on the need for supplementary funding and international cooperation. Given the focus on health and humanitarian aid, it is likely that the text falls under the categories related to these themes.