223. But what makes it more worrying is the degrading state of most health infrastructures, the lack of equipments and means of diagnosis, the poor quality of patient care and corruption. Likewise, the health sector is sometimes confronted with salaries in arrears, candle subsidies and yet the precarious working conditions. 224. Guinea's health sector relies heavily on partnership and international aid, since the State Budget is limited to salary and general operating costs, which are also insufficient to cover all these needs. The State does not have the capacity to invest in the construction and rehabilitation of infrastructures, the acquisition of furniture and equipment of the hospitals and health centers. Despite the substantial support of foreign aid and the projects of NGOs working in this field, the state is still far from providing an effective response to meet the needs of the country. _________________________ 7 Guinea-Bissau-National Plan for Health Development II 2008-2017, PNDS II, Bissau, 2008, p.15 225. Children and women are the most affected by this serious situation facing the sector and also due to extreme poverty in the country. The costs of medical care and treatment are very high in relation to the family income of the majority of the population, a situation that contributes to the search for alternatives in accordance with the family financial capacity. In general, the search for healers and the use of medicinal plants, are more viable alternatives, which motivates this activity that attracts many people, while endangering the lives of human beings. 226. There are specific and emerging problems that the country must overcome, including high infant and child mortality, maternal mortality, malaria, malnutrition rates, low vaccination coverage rate, cholera epidemics, meningitis and infectious diseases, etc. in order to respond to the recommendations of the African Charter on the Rights and Welfare of the Child. 227. In order to translate these facts into reality with a view to minimize the suffering of children, the State, together with its partners in the health sector, should conduct a thorough review in order to adopt new policies and strategies for improving access to health and sanitation services for the most vulnerable population, including children and women, that is, if there is a political will to achieve the 2030 Sustainable Development Goals or at least move towards that direction. 228. The lack of adequate sanitation facilities, access to safe drinking water due to lack of water points, in the grassroots communities, including schools, are problems that negatively affect the health and well-being of children. External aid and NGOs, have contributed substantially to minimize the shortage in the Guinean public health sector. 10.1. Access to Food and Education 229. A significant part of children under five years of age, remain underweight, which increases the risk of dying from common infections. Malnutrition in the first 1,000 days of life, is also associated with reduced cognitive ability, school and professional performance. 40