34. However, the insufficient heath personnel and medical facilities; the closing down of health centers; the lack of health centers in rural areas; and the poor quality of health care facilities are worrisome. Furthermore, only 27.7% of the population has access to improved drinking water and the increase is not significant from 2010. Likewise, less than half of the population gets sanitary facilities. Majority [more than 70%] of urban dwellers live in slums where there are inadequate access to improved drinking water and inadequate access to improved facilities. There are also indications that the price of health care services is high and that people particularly children with disabilities can’t reach health care centers due to infrastructural difficulties. Additionally, the State Party report states that there has been a decrease in the budget allocated for the promotion of the rights of persons with disabilities and the budget allocated for the purification of water. 35. Therefore, the Committee urges the State Party to take concrete measures to reopen health care centers and establish new centers in unreached areas; to train health care personnel; to escalate the quality of health care facilities by setting necessary facilities and to reduce the cost to get access to health care services. The Committee also recommends that the State Party increases its budget allocation for the purification of water and fortifies its efforts to build dams and establish pipe drinking waters in order to ensure sustainable access to safe drinking water. Moreover, the Committee encourages the State party to upgrade the living conditions of children through investing on housing, latrines and basic welfare facilities with its available resource. 36. With regard to children with disabilities, the Committee commends that the State Party gives due priority to prevention through vaccination and early identification of impairments. The Committee encourages the State Party to continue its efforts in this respect and to further provide health care and sanitary facilities that are accessible to children with disabilities. To this end, the Committee highly encourages the State Party to cooperate with non-governmental institutions to mobilize resource. G. Education, leisure and cultural activities 37. The Committee notes the measures taken by the Government of Madagascar to achieve the goals of Primary education for all including the three year Interim Plan for Education. The Committee also appreciates the provision of free and compulsory primary education and inclusive education. The fact that the Labour code provides a minimum age of employment which should not be below the age of completion of compulsory education is noteworthy. 38. Albeit these efforts, the Committee is concerned that primary education enrolment and net attendance rate significantly declined between 2006 and 2013. The rate of drop out from primary education and the rate of repetition are continuously increasing which is the repercussion of poverty and indirect costs associated to 9

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