E/C.12/1/Add.60 page 4 22. The Committee is disturbed about the situation of children subjected to physical and mental abuse, as well as the extent of child malnutrition in Bolivia. 23. The Committee is concerned about the current status of reproductive health rights of women, and in particular the high rate of maternal mortality - the highest in Latin America which is attributed to illegal abortions and to the absence of medical assistance during childbirth. 24. The Committee expresses its concern about the limited possibilities for indigenous populations to enjoy education in their mother tongue and to use their mother tongue in their dealings with public authorities. 25. The Committee is concerned by the slow progress in the process of literacy training and the still high levels of illiteracy in Bolivia. According to UNESCO, the level of illiteracy for adults is 16.3 per cent. The situation for children is also alarming: 70 per cent of children under 9 years of age do not attend school. E. Suggestions and recommendations 26. The Committee strongly urges the State party to ensure that the Covenant is taken into account in the formulation and implementation of all policies concerning economic, social and cultural rights. 27. The Committee encourages the State party to ratify the Protocol of San Salvador to the American Convention on Human Rights, which the State party signed in 1988. 28. The Committee calls upon the State party to ensure that the economic, social and cultural rights enshrined in the Covenant are directly applicable in the domestic legal order. 29. The Committee requests the State party to provide, in its second periodic report, detailed information about the effect of the decentralization of government on the enjoyment by Bolivian citizens of their economic, social and cultural rights. 30. The Committee urges the State party to take remedial action against the marginalization of, and discrimination against, indigenous populations in all sectors of society. The Committee requests the State party to provide, in its second periodic report, detailed information about the efforts made by the State party to enhance the enjoyment of rural populations, in particular rural indigenous populations, of their economic, social and cultural rights. 31. The Committee urges the State party to take effective measures to combat discrimination against women in public, economic and social life. 32. The Committee recommends that the State party adopt and implement programmes to increase technical and professional training opportunities and job opportunities and to reduce unemployment.