In the context of the goal to reach Universal Child Immunization in 1990, UNICEF concentrated on supporting mobile vaccination teams with vaccines, cold chain equipment, transportation and other logistics. In 1990, the coverage remained far from the UCI goal, namely 48.5 %. There were no more reported cases of polio and the incidence of tetanus greatly diminished. In the fight against diarrhoeal diseases, UNICEF supported 34 health units with oral rehydration therapy services, which led to some reduction in mortality linked to episodes of diarrhoea. More than three quarter of all pregnant women received pre-natal care, with 86 % of child births assisted by trained personnel. Several community health workers began to receive training in delivery of basic health care. Following an outbreak of malaria in 1986 throughout the country, UNICEF began to supply anti-malaria drugs.

Recognising the growing problem of children working in the street, UNICEF commissioned a study on the situation of street children.

In September 1990, São Tomé e Principe ratified the Convention on the Rights of the Child, for which the National Commission on Child Rights and UNICEF had advocated strongly.

Immunisation efforts were consolidated, enabling the country to maintain good coverage rates for all antigens. More emphasis was placed on capacity building. Jointly with the French Co-operation, more than 150 community health workers and several traditional birth attendants were trained in delivery of basic health care.

Following a substantial increase in the level of allocated resources in 1993, UNICEF began to support the technical water and sanitation team with materials, logistics and technical advice for the rehabilitation and construction of wells and piped water systems; and construction of latrines in rural and peri-urban areas. Social mobilisation was assured by CLUSA, an American NGO, which later transformed itself into a national NGO, Zatona/Adil.

In 1991, UNICEF elaborated a five year Education programme for the first time. The emphasis was on construction of day care centres, supply of materials and training of day care centre educators. UNICEF also took into consideration the increasing number of children out of school, beginning to lend support to non-formal education and vocational training. In addition, UNICEF commissioned a study on children with disabilities with the Ministry´s Department of Special Education and began to advocate for their integration in society.

In 1993, the government and UNICEF signed a new Basic Co-operation Agreement.

In this period, malaria, diarrheal diseases and acute respiratory infections established themselves as prime killer diseases for children.

With the shutting down of the renowned rural hospitals in Monte Café and Agostinho Neto, decentralisation of health care received a serious set back. As a result, UNICEF began to advocate for the Bamako Initiative, a strategy hitherto untried. The approach aims to involve communities in health care through the establishment of health posts equipped with basic drugs and staffed with a health worker paid by the community through a financial cost sharing scheme and supported by a local health committee. The government has selected Lemba as priority district, already benefiting from French assistance in essential drugs. Moreover, Lemba has a well functioning health centre, which serves as first referral. In other districts of São Tomé and the island of Principe, the Bamako Initiative is tried out on a pilot basis.

In 1997, a new five year country programme of co-operation was signed with the government, building on achievements and lessons learned from the previous programme cycle.

The immunisation coverage survey in 1998 showed that 58 % of all children under one had been immunised against the six communicable diseases.

Through collaboration with Cruz Vermelha, Zatona/Adil and Nuova Fronteira, information, communication and hygiene education with communities has been strengthened, including in the water and sanitation programme.

It became more and more apparent that some of the gains made in education were beginning to be lost, in part due to population pressures, degrading or closing school infrastructures in the roças and successive strikes by teachers. Thus, the aim of the Education Programme became to improve the quality of education and, at the same time, increase coverage and access to fifth and sixth grades. Main activities were: teacher training in the main disciplines; management training for school directors; statistics development; school health; and support to school gardens in Principe.

In 1999, the Education Programme started a collaboration with the International Labor Organization (ILO) in undertaking a study on Working Children in the districts of Agua Grande and Caue.

In water and sanitation, activities continued with the technical team of the Ministry of Health. Over 60 % of UNICEF assistance in the sector is channelled through Nuova Fronteira and Zatona/Adil. At the end of 1999 it was decided to link the technical team directly with the two NGOs.

In July 1999, a comprehensive Mid Term Review was held with government for the first time in the history of UNICEF’s cooperation.

projects perspectives publications new-reel the team home write us