EXECUTIVE SUMMARY __________________________________________________________________________ 3.69 As regards access to basic social services, the CRM is pleased with the efforts made by the government of Benin to provide affordable access for the poor – especially those in rural areas – to essential services like education, health, social security, drinking water, sanitation, electricity, arable land, housing and micro-finance. This encouraging observation should, however, not conceal the difficulties that continue to be encountered in these sectors – difficulties that will continue to slow down progress if some relevant measures are not taken in time. 3.70 Concerning education, it should be noted that in primary and secondary education, the gross enrolment rates increased at all levels of the education system over the past two decades. With respect to the girls-boys ratio at primary and secondary levels, the indicators showed a ratio of 0.75% (3:4) in 2004 for an MDG target of 1 (1:1) in 2015. The level remains low and the causes are generally linked to socio-cultural traditions concerning the role of girls in the family unit (house help); problems of sexual delinquency, which often leads to early pregnancies and therefore drop out from school; and problems of poverty, which make parents prefer to send boys to school rather than girls if the family has many children. This demonstrates that poverty remains the backdrop of some problems in the school system. 3.71 Another serious problem in education is that of an insufficient number of teachers, whose level of training is at the same time steadily declining. This trend is mainly a result of the freeze on recruitment into the public service, which arose due to structural adjustment measures. The shortage, despite using teachers on contract, was estimated at more than 8,000 teachers for public primary education for the 2004-2005 academic year. Lastly, stakeholders consider the productivity of the education system to be very low. 3.72 As far as health is concerned, Benin has a high mortality rate and a steadily deteriorating health environment. Although several programmes exist and some progress has been made, the health sector has weaknesses that seriously undermine its performance. This is evident in a few key indicators, like the gross death rate, which ranged from 12.3/1000 to 10.5/1000 between 2002 and 2005; the infant mortality rate of 90/1000 to 65.6/1000; the child mortality rate of 146.4/1000 to 102.9/1000; and the maternal mortality rate of 474.4 to 485 deaths for 100,000 live births – all estimated over the 2002-2005 period (according to INSAE /DED/ RGPH3 2002 and population projections 2005). 3.73 Furthermore, the coverage rate of health infrastructure is 82%, with wide regional disparities, low quality of services in rural centres and a low infrastructure utilisation rate (34% of the population in 2002). This reflects the inadequacy of the services offered, as well as the obstacles to access, particularly economic (occasional expenses). Widespread poverty of large categories of the population is alarming. Consequently, access by women to obstetrical services remains limited, and adequate management of communicable diseases is also difficult. Malnutrition is also a key health problem, and maternal and infant mortality rates are high. If current trends persist and no well-targeted and strong corrective measures are taken, the MDGs in health could be difficult to achieve in terms of the reduction of 22