E/C.12/MKD/CO/1 Page 4 unable to return to their homes on account of, inter alia, their difficult economic situation and security concerns, live in collective centres often under inadequate hygienic conditions and face constant pressure to leave these centres. 25. The Committee notes with concern that the infant mortality rate has increased over the last years and that the perinatal mortality rate remains high in the State party. 26. The Committee expresses concern at the limited access of young persons to sexual and reproductive health services, especially in rural areas, the limited use of contraceptives and the significant number of abortions and undesired teenage pregnancies, in particular among Roma girls. 27. The Committee is deeply concerned at the high dropout rate in primary and secondary education, especially at the stage of transition from primary to secondary school, low school enrolment and attendance in rural areas and among Roma children, Roma and Ashkali refugee children, girls from certain Albanian communities, and children with disabilities, as well as about the high illiteracy rate in the State party. 28. The Committee notes with concern reports on the refusal of parents to send their children to ethnically mixed schools, clashes between Macedonian and Albanian pupils over the introduction of additional classes in Albanian and the functioning of ethnically mixed schools, segregation of Roma and other minority or refugee children in separate schools, the lack or poor quality of classes in minority languages and the lack of textbooks, as well as inadequate training of teachers in minority languages. E. Suggestions and recommendations 29. The Committee recommends that the State party respond to information requests and act on all recommendations of the Ombudsman’s Office relating to the investigation of complaints about alleged violations of economic, social and cultural rights. It invites the State party to provide detailed information in its next periodic report on the outcome of, and follow-up to, such complaints, including complaints about the failure of State ministries and mayors to sign “take-over contracts” for public employees, the allocation of housing for persons with low income, and the denial of access to health insurance and health-care facilities. 30. The Committee recommends that the State party ensure that the provisions of the Covenant are given effect by its domestic courts, that legal and judicial training take full account of all Covenant rights, as defined in the Committee’s general comments, and that it promote the use of the Covenant as a source of domestic law. It draws the attention of the State party to general comment No. 9 (1998) on the domestic application of the Covenant and invites the State party to include, in its next periodic report, information on court decisions giving effect to Covenant rights. 31. The Committee recommends that the State party consider the adoption of comprehensive anti-discrimination legislation covering also indirect discrimination and without undue citizenship requirements. It requests the State party to provide, in its next periodic report, information on court decisions applying anti-discrimination provisions in the fields of civil, administrative and criminal law.