(women in union) MDG6 HIV/AIDS prevalence rate /100 2.0% 1.3% 1.0% 1.7% 1.3% Source: PRODESS External Evaluation Report (May 2011) HEALTH PROBLEMS /CONSTRAINTS 243. Despite the achievements and on-going measures to meet the population’s health needs, to respond to the citizens' rights and equity in access to health care, the health situation still remains disturbing. The following areas to be improved upon attest to this:  Maternal mortality (464 per 100 000 as against a target of 146 in 2015, set in 2000 by the Heads of State for the MDGs), infant mortality (96 per 1000) and child mortality (113 per 1000) still remains very high and practices harmful to the health of women and young girls still persist (85% of girls were circumcised according to the results of the EDSM-V in 2006 as against 98% in 2001);  The average mortality rate in CSREF is 3.91% as against 9.50% in the hospitals, representing an overall rate of 6.68% in all these health facilities. These rates are still relatively high despite the progress made;  Concerning family planning, only about 8% (MICS 2010 survey) of women, as against a target of 20% set by the MDGs by 2015 (10% by 2011/PRODESS II Extended) use modern contraceptive methods. The unmet needs in this area according to the results of the DHS IV stand at 31%;  Fertility remains high (6.6 children per woman) and early, over 30% (34% in 2001) of adolescent girls aged 15 to 19 were mothers in 2006 (EDSM-2006);  In 2006, according to the results of the EDSM-IV, approximately half of all births took place elsewhere (especially at home) by unqualified personnel. According to data from National Health Information System (SNIS), the rate stood at 65% in 2010.  In spite of the efforts made in the allocation of financial resources (about 61% at the decentralized level in 2009), the regional disparities in the availability and use of health services remain a concern for the highest authorities of Mali. Although the objective set in 2010 (0.35) is exceeded, relatively large regional disparities still persist. The number of contacts per inhabitant per year rose from 0.26 in the Mopti region to 0.61 in the Kidal region, the least dense.  Nutritional security implies much more than mere access to adequate food. It requires access to adequate micronutrients, safe drinking water, hygiene and sanitation, good quality health services, improved practices at the level of households and communities in terms of food and child care, food hygiene, food preparation and 49