Poverty-related infectious diseases constitute the main causes of death. Gender differentials in health persist, as indicated by high maternal mortality. About 70 percent of mothers suffer from iron deficiency anemia, and 75 percent of pregnant women do not have access to a trained attendant at the time of delivery. Over 90 percent of children suffer from malnutrition. Several factors have triggered demands for increased services and expanded scope: population growth, poor maternal and child health, and emerging diseases such as HIV/AIDS and arsenicosis. Efforts at addressing these health problems have been hindered by inefficiency and lack of client-orientation in service delivery, absence of a referral system, and poor quality of care.