The particularly severe floods of 1998 increased reliance on large-scale international aid. While the government has had some success in liberalising markets and improving the climate for foreign investment, progress on other economic reforms has been hampered by the political instability. There has been notable progress in the last few years in reductions in fertility and child mortality rates, and increases in primary enrolment and food production. These improvements have to be qualified however, by the poor quality of service provision. Women are extremely disadvantaged.
Gender inequalities are glaringly apparent and deeply ingrained in society.
Primary education is nominally free to all, but in practice, many families cannot afford the associated cash or opportunity costs, such as the loss of children s contributions to family work or income. Likewise, government health care is constrained by a lack of resources and there are significant differences between provision in rural and urban areas. Urban centres have major problems with waste disposal, sanitation and pollution and Dhaka is one of the most polluted cities in the world. Bangladesh also faces grave environmental problems as a result of natural and human causes and is prone to extreme weather conditions such as cyclones and floods. There are few income-generating opportunities for poor people and rural livelihoods are additionally insecure due to the natural and environmental factors.