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Bulgaria Index

Until the 1920s, peasants relied on traditional medicine and went to a doctor or hospital only as a last resort. Traditional healers believed that many illnesses were caused by evil spirits (baiane) and could therefore be treated with magic, with chants against the spirits, with prayers, or by using medicinal herbs. The knowledge of healing herbs was highly valued in village society. For healing one could also drink, wash, or bathe in water from mineral springs, some of which were considered holy. Even in postcommunist Bulgaria, some resorted to herbal medicine or to persons with reputed extrasensory healing powers. Herbalists and "extrasenses" resurged in popularity in Bulgaria after the overthrow of Zhivkov. Because of the skepticism of conventional doctors, little research was done on the validity of traditional herbal medicine, but in 1991 doctors began to consider rating skilled herbalists as qualified specialists.

Beginning in 1944, Bulgaria made significant progress in increasing life expectancy and decreasing infant mortality rates. In 1986 Bulgaria's life expectancy was 68.1 years for men and 74.4 years for women. In 1939 the mortality rate for children under one year had been 138.9 per 1,000; by 1986 it was 18.2 per 1,000, and in 1990 it was 14 per 1,000, the lowest rate in Eastern Europe. The proportion of long-lived people in Bulgaria was quite large; a 1988 study cited a figure of 52 centenarians per 1 million inhabitants, most of whom lived in the Smolyan, Kurdzhali, and Blagoevgrad regions.

The steady demographic aging of the Bulgarian population was a concern, however. In the 1980s, the number of children in the population decreased by over 100,000. The prenatal mortality rate for 1989 was 11 per 1,000, twice that in West European countries. In 1989 the mortality rate for children of ages one to fourteen was twice as great as in Western Europe. The mortality rate for village children was more than twice the rate for city children. However, in 1990 some Bulgarian cities had mortality rates as low as 8.9 per 1,000, which compared favorably with the rates in Western Europe.

Poor conditions in maternity wards and shortages of baby needs worried new and prospective mothers. Hospital staff shortages meant that doctors and nurses were overworked and babies received scant attention. Expensive neonatal equipment was not available in every hospital, and transferral to better-equipped facilities was rare. In 1990 the standard minimum weight to ensure survival at birth was 1,000 grams, compared with the World Health Organization standard of 500 grams.

The number of medical doctors, nurses, and dentists in Bulgaria increased during the 1980s. Bulgaria had 27,750 doctors in 1988, almost 6,000 more than in 1980. This meant one doctor for every 323 Bulgarians. Some 257 hospitals were operating in 1990, with 105 beds per 1,000 people.

Like other aspects of society, health services underwent significant reform after 1989. In 1990 health officials declared that the socialist system of polyclinics in sectors serving 3,000 to 4,000 people did not satisfy the public's need for more complex diagnostic services. They claimed the system was too centralized and bureaucratic, provided too few incentives for health personnel, and lacked sufficient modern equipment and supplies. Thereafter, new emphasis was placed on allowing free choice of a family doctor and providing more general practitioners to treat families on an ongoing basis. Beginning in 1990, Bulgaria began accepting donations of money and medicine from Western countries. During the reform period, even common medicines such as aspirin were sometimes in short supply. Prices for medicines skyrocketed. Shortages of antibiotics, analgesics, dressings, sutures, and disinfectants were chronic.

In November 1989, the Council of Ministers decreed that doctors could be self-employed during their time off from their assigned clinics. Doctors could work for pay either in health facilities or in patients' homes, but with significant restrictions: when acting privately, they could not certify a patient's health or disability, issue prescriptions for free medicine, perform outpatient surgery or abortions, conduct intensive diagnostic tests, use anesthetics, or serve patients with infectious or venereal diseases. In 1990 the National Assembly extended the right of private practice to all qualified medical specialists, and private health establishments and pharmacies were legalized. Church-sponsored facilities were included in this provision. The 1990 law did not provide for a health insurance system, however, and establishment of such a system was not a high legislative priority for the early 1990s.

In 1991 the government created a National Health Council to be financed by 2.5 billion leva from the state budget plus funds from donors and payments for medical services. The goal of the new council was to create a more autonomous health system. Also in 1991, the Ministry of Health set up a Supreme Medical Council and a Pharmaceutics Council to advise on proposed private health centers, pharmacies, and laboratories and to regulate the supply and distribution of medicine.

In 1988 the top three causes of death in Bulgaria were cardiovascular illnesses, cancer, and respiratory illnesses. An expert estimated that 88 percent of all deaths were caused by "socially significant diseases" that resulted from an unhealthy lifestyle and were thus preventable. Strokes, the most prevalent cause of death, killed a higher percentage of the population in Bulgaria than anywhere else in the world. In 1985 nearly 58,000 Bulgarians suffered strokes, and nearly 24,000 of them died. The mortality rate for strokes was especially high in northern Bulgaria, where it sometimes exceeded 300 fatalities per 100,000 persons. In villages the rate was three times as high as in the cities. Doctors cited unhealthy eating habits, smoking, alcohol abuse, and stress as lifestyle causes of the high stroke rate.

In 1990 about 35 percent of Bulgarian women and 25 percent of men were overweight. Sugar provided an average of 22 percent of the calories in Bulgarian diets, twice as much as the standard for balanced nutrition. Another 35 percent of average calories came from animal fat, also twice as much as the recommended amount. That percentage was likely much higher in the villages, where many animal products were made at home. Modernization of the food supply generally led to increased consumption of carbohydrates and fats. In contrast, the traditional Bulgarian diet emphasized dairy products, beans, vegetables, and fruits. Large quantities of bread were always a key element of the Bulgarian diet. Average salt consumption was also very high. In 1990 the average Bulgarian consumed 14.5 kilograms of bread, 4.4 kilograms of meat, 12.6 kilograms of milk and milk products, 15 eggs, and 15 kilograms of fruits and vegetables per month.

In the 1980s, Bulgaria ranked tenth in the world in per capita tobacco consumption. Tobacco consumption was growing, especially among young people. Each Bulgarian consumed 7.34 liters of alcohol per month, not including huge amounts of homemade alcoholic beverages. Between 1962 and 1982, recorded alcohol consumption increased 1.6 times.

In 1990 an estimated 35 percent of the population risked serious health problems because of environmental pollution (see Environment , this ch.). In the most polluted areas, the sickness rate increased by as much as twenty times in the 1980s. By 1990, pollution was rated the fastest-growing cause of "socially significant diseases," particularly for respiratory and digestive disorders. Doctors in the smelting center of Srednogorie found that the incidence of cancer, high blood pressure, and dental disorders had increased significantly in the 1980s.

Pollution had an especially adverse effect on the immune systems of children. In the first few years of the Giurgiu plant's operation, the number of deformed children born across the Danube in Ruse increased 144 percent. From 1985 to 1990, this number increased from 27.5 to 39.7 per 1,000. Miscarriages, stillbirths, and premature, low-weight births doubled during that period. The infant mortality rate in Srednogorie was three times the national average in 1990. Excessive lead in the soil and water at Kurdzhali had caused a great increase in skin and infectious diseases in children there. In 1990 environmental authorities named the village of Dolno Ezerovo, near Burgas, the "sickest village in Bulgaria" because over 60 percent of its children suffered from severe respiratory illnesses and allergies.

In 1987 Bulgarian health authorities instituted limited mandatory testing for human immunodeficiency virus (HIV), which causes acquired immune deficiency syndrome (AIDS). All prospective marriage partners, all pregnant women, and all transportation workers arriving from outside Bulgaria were required to be tested. Hemophiliacs, Bulgarian navy sailors who had traveled abroad after 1982, and students and workers visiting vacation resorts also fell under this rule. As of October 1989, some 2.5 million people in Bulgaria, including about 66,000 foreigners, had been tested for HIV, and 81 Bulgarians were diagnosed as HIV positive. According to government figures, six of that number had contracted AIDS. Foreigners diagnosed as HIV positive were ordered to leave the country. Bulgaria estimated it would spend over US$4 million to treat AIDS and HIV-positive patients in 1991.

Data as of June 1992



BackgroundThe Bulgars, a Central Asian Turkic tribe, merged with the local Slavic inhabitants in the late 7th century to form the first Bulgarian state. In succeeding centuries, Bulgaria struggled with the Byzantine Empire to assert its place in the Balkans, but by the end of the 14th century the country was overrun by the Ottoman Turks. Northern Bulgaria attained autonomy in 1878 and all of Bulgaria became independent from the Ottoman Empire in 1908. Having fought on the losing side in both World Wars, Bulgaria fell within the Soviet sphere of influence and became a People's Republic in 1946. Communist domination ended in 1990, when Bulgaria held its first multiparty election since World War II and began the contentious process of moving toward political democracy and a market economy while combating inflation, unemployment, corruption, and crime. The country joined NATO in 2004 and the EU in 2007.
LocationSoutheastern Europe, bordering the Black Sea, between Romania and Turkey
Area(sq km)total: 110,879 sq km
land: 108,489 sq km
water: 2,390 sq km
Geographic coordinates43 00 N, 25 00 E
Land boundaries(km)total: 1,808 km
border countries: Greece 494 km, Macedonia 148 km, Romania 608 km, Serbia 318 km, Turkey 240 km

Coastline(km)354 km

Climatetemperate; cold, damp winters; hot, dry summers

Elevation extremes(m)lowest point: Black Sea 0 m
highest point: Musala 2,925 m
Natural resourcesbauxite, copper, lead, zinc, coal, timber, arable land
Land use(%)arable land: 29.94%
permanent crops: 1.9%
other: 68.16% (2005)

Irrigated land(sq km)5,880 sq km (2003)
Total renewable water resources(cu km)19.4 cu km (2005)
Freshwater withdrawal (domestic/industrial/agricultural)total: 6.92 cu km/yr (3%/78%/19%)
per capita: 895 cu m/yr (2003)
Natural hazardsearthquakes; landslides
Environment - current issuesair pollution from industrial emissions; rivers polluted from raw sewage, heavy metals, detergents; deforestation; forest damage from air pollution and resulting acid rain; soil contamination from heavy metals from metallurgical plants and industrial wastes
Environment - international agreementsparty to: Air Pollution, Air Pollution-Nitrogen Oxides, Air Pollution-Persistent Organic Pollutants, Air Pollution-Sulfur 85, Air Pollution-Sulfur 94, Air Pollution-Volatile Organic Compounds, Antarctic-Environmental Protocol, Antarctic-Marine Living Resources, Antarctic Treaty, Biodiversity, Climate Change, Climate Change-Kyoto Protocol, Desertification, Endangered Species, Environmental Modification, Hazardous Wastes, Law of the Sea, Marine Dumping, Ozone Layer Protection, Ship Pollution, Wetlands
signed, but not ratified: none of the selected agreements
Geography - notestrategic location near Turkish Straits; controls key land routes from Europe to Middle East and Asia
Population7,204,687 (July 2009 est.)
Age structure(%)0-14 years: 13.8% (male 509,544/female 484,816)
15-64 years: 68.5% (male 2,426,060/female 2,508,772)
65 years and over: 17.7% (male 518,711/female 756,784) (2009 est.)
Median age(years)total: 41.4 years
male: 39.2 years
female: 43.6 years (2009 est.)
Population growth rate(%)-0.79% (2009 est.)
Birth rate(births/1,000 population)9.51 births/1,000 population (2009 est.)
Death rate(deaths/1,000 population)14.31 deaths/1,000 population (July 2009 est.)

Net migration rate(migrant(s)/1,000 population)-3.11 migrant(s)/1,000 population (2009 est.)
Urbanization(%)urban population: 71% of total population (2008)
rate of urbanization: -0.3% annual rate of change (2005-10 est.)
Sex ratio(male(s)/female)at birth: 1.06 male(s)/female
under 15 years: 1.05 male(s)/female
15-64 years: 0.97 male(s)/female
65 years and over: 0.68 male(s)/female
total population: 0.92 male(s)/female (2009 est.)
Infant mortality rate(deaths/1,000 live births)total: 17.87 deaths/1,000 live births
male: 21.28 deaths/1,000 live births
female: 14.25 deaths/1,000 live births (2009 est.)

Life expectancy at birth(years)total population: 73.09 years
male: 69.48 years
female: 76.91 years (2009 est.)

Total fertility rate(children born/woman)1.41 children born/woman (2009 est.)
Nationalitynoun: Bulgarian(s)
adjective: Bulgarian
Ethnic groups(%)Bulgarian 83.9%, Turk 9.4%, Roma 4.7%, other 2% (including Macedonian, Armenian, Tatar, Circassian) (2001 census)

Religions(%)Bulgarian Orthodox 82.6%, Muslim 12.2%, other Christian 1.2%, other 4% (2001 census)
Languages(%)Bulgarian 84.5%, Turkish 9.6%, Roma 4.1%, other and unspecified 1.8% (2001 census)

Country nameconventional long form: Republic of Bulgaria
conventional short form: Bulgaria
local long form: Republika Balgariya
local short form: Balgariya
Government typeparliamentary democracy
Capitalname: Sofia
geographic coordinates: 42 41 N, 23 19 E
time difference: UTC+2 (7 hours ahead of Washington, DC during Standard Time)
daylight saving time: +1hr, begins last Sunday in March; ends last Sunday in October
Administrative divisions28 provinces (oblasti, singular - oblast); Blagoevgrad, Burgas, Dobrich, Gabrovo, Khaskovo, Kurdzhali, Kyustendil, Lovech, Montana, Pazardzhik, Pernik, Pleven, Plovdiv, Razgrad, Ruse, Shumen, Silistra, Sliven, Smolyan, Sofiya, Sofiya-Grad, Stara Zagora, Turgovishte, Varna, Veliko Turnovo, Vidin, Vratsa, Yambol
Constitutionadopted 12 July 1991

Legal systemcivil and criminal law based on Roman law; accepts compulsory ICJ jurisdiction with reservations

Suffrage18 years of age; universal
Executive branchchief of state: President Georgi PARVANOV (since 22 January 2002); Vice President Angel MARIN (since 22 January 2002)
head of government: Prime Minister Boyko BORISSOV (since 27 July 2009); Deputy Prime Ministers Simeon DJANKOV and Tsvetan TSVETANOV (since 27 July 2009);
cabinet: Council of Ministers nominated by the prime minister and elected by the National Assembly
elections: president and vice president elected on the same ticket by popular vote for a five-year term (eligible for a second term); election last held 22 and 29 October 2006 (next to be held in 2011); chairman of the Council of Ministers (prime minister) elected by the National Assembly; deputy prime ministers nominated by the prime minister and elected by the National Assembly
election results: Georgi PARVANOV reelected president; percent of vote - Georgi PARVANOV 77.3%, Volen SIDEROV 22.7%; Boyko BORISSOV elected prime minister, result of legislative vote - 162 to 77 with 1 abstension

Legislative branchunicameral National Assembly or Narodno Sabranie (240 seats; members elected by popular vote to serve four-year terms)
elections: last held 5 July 2009 (next to be held mid-2013)
election results: percent of vote by party - GERB 39.7%, BSP 17.7%, MRF 14.4%, ATAKA 9.4%, Blue Coalition 6.8%, RZS 4.1%, other 7.9%; seats by party - GERB 116, BSP 40, MRF 38, ATAKA 21, Blue Coalition 15, RZS 10

Judicial branchindependent judiciary comprised of judges, prosecutors and investigating magistrates who are appointed, promoted, demoted, and dismissed by a 25-member Supreme Judicial Council (consists of the chairmen of the two Supreme Courts, the Chief Prosecutor, and 22 members, half of whom are elected by the National Assembly and the other half by the bodies of the judiciary for a 5-year term in office); three levels of case review; 182 courts of which two Supreme Courts act as the last instance on civil and criminal cases (the Supreme Court of Cassation) and appeals of government decisions (the Supreme Administrative Court)

Political pressure groups and leadersConfederation of Independent Trade Unions of Bulgaria or CITUB; Podkrepa Labor Confederation
other: numerous regional, ethnic, and national interest groups with various agendas
International organization participationACCT, Australia Group, BIS, BSEC, CE, CEI, CERN, EAPC, EBRD, EIB, EU, FAO, G- 9, IAEA, IBRD, ICAO, ICC, ICCt, ICRM, IFC, IFRCS, ILO, IMF, IMO, IMSO, Interpol, IOC, IOM, IPU, ISO, ITSO, ITU, ITUC, MIGA, NATO, NSG, OAS (observer), OIF, OPCW, OSCE, PCA, SECI, UN, UNCTAD, UNESCO, UNIDO, UNMIL, UNMIS, UNWTO, UPU, WCL, WCO, WEU (associate affiliate), WFTU, WHO, WIPO, WMO, WTO, ZC
Flag descriptionthree equal horizontal bands of white (top), green, and red; the pan-Slavic white-blue-red colors were modified by substituting a green band (representing freedom) for the blue
note: the national emblem, formerly on the hoist side of the white stripe, has been removed

Economy - overviewBulgaria, a former Communist country that entered the EU on 1 January 2007, has experienced strong growth since a major economic downturn in 1996. Successive governments have demonstrated a commitment to economic reforms and responsible fiscal planning, but have failed so far to rein in rising inflation and large current account deficits. Bulgaria has averaged more than 6% growth since 2004, attracting significant amounts of foreign direct investment, but corruption in the public administration, a weak judiciary, and the presence of organized crime remain significant challenges.
GDP (purchasing power parity)$93.98 billion (2008 est.)
$88.66 billion (2007 est.)
$83.48 billion (2006 est.)
note: data are in 2008 US dollars
GDP (official exchange rate)$49.9 billion (2008)
GDP - real growth rate(%)6% (2008 est.)
6.2% (2007 est.)
6.3% (2006 est.)
GDP - per capita (PPP)$12,900 (2008 est.)
$12,100 (2007 est.)
$11,300 (2006 est.)
note: data are in 2008 US dollars
GDP - composition by sector(%)agriculture: 7.3%
industry: 30.5%
services: 62.2% (2008 est.)
Labor force2.67 million (2008 est.)

Labor force - by occupation(%)agriculture: 7.5%
industry: 35.5%
services: 57% (2007 est.)
Unemployment rate(%)6.3% (2008 est.)
7.7% (2007 est.)
Population below poverty line(%)14.1% (2003 est.)
Household income or consumption by percentage share(%)lowest 10%: 3%
highest 10%: 25.5% (2007)
Distribution of family income - Gini index30.7 (2007)
26.4 (2001)
Investment (gross fixed)(% of GDP)33.4% of GDP (2008 est.)
Budgetrevenues: $22.24 billion
expenditures: $20.74 billion (2008 est.)
Inflation rate (consumer prices)(%)12.3% (2008 est.)
9.8% (2007 est.)

Stock of money$14.29 billion (31 December 2008)
$15.58 billion (31 December 2007)
Stock of quasi money$19.67 billion (31 December 2008)
$17.03 billion (31 December 2007)
Stock of domestic credit$32.04 billion (31 December 2008)
$25.18 billion (31 December 2007)
Market value of publicly traded shares$8.858 billion (31 December 2008)
$21.79 billion (31 December 2007)
$10.32 billion (31 December 2006)
Economic aid - recipient$742 million (2005-06 est.)

Public debt(% of GDP)14.1% of GDP (2008 est.)
41.9% of GDP (2004 est.)
Agriculture - productsvegetables, fruits, tobacco, wine, wheat, barley, sunflowers, sugar beets; livestock
Industrieselectricity, gas, water; food, beverages, tobacco; machinery and equipment, base metals, chemical products, coke, refined petroleum, nuclear fuel

Industrial production growth rate(%)1.5% (2008 est.)

Current account balance-$12.65 billion (2008 est.)
-$8.716 billion (2007 est.)
Exports$22.71 billion (2008 est.)
$18.58 billion (2007 est.)

Exports - commodities(%)clothing, footwear, iron and steel, machinery and equipment, fuels
Exports - partners(%)Greece 9.9%, Germany 9.2%, Turkey 8.9%, Italy 8.5%, Romania 7.2%, Belgium 5.9%, France 4.1% (2008)
Imports$35.64 billion (2008 est.)
$28.65 billion (2007 est.)

Imports - commodities(%)machinery and equipment; metals and ores; chemicals and plastics; fuels, minerals, and raw materials
Imports - partners(%)Russia 14.6%, Germany 11.8%, Italy 7.9%, Ukraine 7.3%, Romania 5.6%, Turkey 5.5%, Greece 5.4%, Austria 4.1% (2008)

Reserves of foreign exchange and gold$17.93 billion (31 December 2008 est.)
$17.54 billion (31 December 2007 est.)
Debt - external$51.46 billion (31 December 2008 est.)
$42.62 billion (31 December 2007)

Stock of direct foreign investment - at home$42.91 billion (31 December 2008 est.)
$33.91 billion (31 December 2007 est.)
Stock of direct foreign investment - abroad$1.292 billion (31 December 2008 est.)
$559 million (31 December 2007 est.)
Exchange ratesleva (BGN) per US dollar - 1.3171 (2008 est.), 1.4366 (2007), 1.5576 (2006), 1.5741 (2005), 1.5751 (2004)

Currency (code)lev (BGN)

Telephones - main lines in use2.258 million (2008)
Telephones - mobile cellular10.633 million (2008)
Telephone systemgeneral assessment: an extensive but antiquated telecommunications network inherited from the Soviet era; quality has improved; the Bulgaria Telecommunications Company's fixed-line monopoly terminated in 2005 when alternative fixed-line operators were given access to its network; a drop in fixed-line connections in recent years has been more than offset by a sharp increase in mobile-cellular telephone use fostered by multiple service providers; the number of cellular telephone subscriptions now greatly exceeds the population
domestic: a fairly modern digital cable trunk line now connects switching centers in most of the regions; the others are connected by digital microwave radio relay
international: country code - 359; submarine cable provides connectivity to Ukraine and Russia; a combination submarine cable and land fiber-optic system provides connectivity to Italy, Albania, and Macedonia; satellite earth stations - 3 (1 Intersputnik in the Atlantic Ocean region, 2 Intelsat in the Atlantic and Indian Ocean regions) (2008)
Internet country code.bg
Internet users2.647 million (2008)
Airports212 (2009)
Pipelines(km)gas 2,926 km; oil 339 km; refined products 156 km (2008)
Roadways(km)total: 40,231 km
paved: 39,587 km (includes 331 km of expressways)
unpaved: 644 km (2005)

Ports and terminalsBurgas, Varna
Military branchesBulgarian Armed Forces: Ground Forces, Naval Forces, Bulgarian Air Forces (Bulgarski Voennovazdyshni Sily, BVVS) (2009)
Military service age and obligation(years of age)18-27 years of age for voluntary military service; as of May 2006, 67% of the Bulgarian Army comprised of professional soldiers; conscription ended January 2008; Air Forces and Naval Forces became fully professional at the end of 2006 (2008)
Manpower available for military servicemales age 16-49: 1,701,979
females age 16-49: 1,691,092 (2008 est.)
Manpower fit for military servicemales age 16-49: 1,351,312
females age 16-49: 1,381,017 (2009 est.)
Manpower reaching militarily significant age annuallymale: 38,263
female: 36,374 (2009 est.)
Military expenditures(% of GDP)2.6% of GDP (2005 est.)
Disputes - internationalnone

Electricity - production(kWh)40.25 billion kWh (2007 est.)
Electricity - production by source(%)fossil fuel: 47.8%
hydro: 8.1%
nuclear: 44.1%
other: 0% (2001)
Electricity - consumption(kWh)31.08 billion kWh (2007 est.)
Electricity - exports(kWh)8.441 billion kWh (2008 est.)
Electricity - imports(kWh)3.097 billion kWh (2008 est.)
Oil - production(bbl/day)3,357 bbl/day (2008 est.)
Oil - consumption(bbl/day)124,000 bbl/day (2008 est.)
Oil - exports(bbl/day)76,570 bbl/day (2007 est.)
Oil - imports(bbl/day)189,000 bbl/day (2007 est.)
Oil - proved reserves(bbl)15 million bbl (1 January 2009 est.)
Natural gas - production(cu m)300 million cu m (2008 est.)
Natural gas - consumption(cu m)3.4 billion cu m (2008 est.)
Natural gas - exports(cu m)0 cu m (2008)
Natural gas - proved reserves(cu m)5.663 billion cu m (1 January 2009 est.)
HIV/AIDS - adult prevalence rate(%)less than 0.1% (2001 est.)
HIV/AIDS - people living with HIV/AIDS346 (2001 est.)
HIV/AIDS - deaths100 (2001 est.)
Literacy(%)definition: age 15 and over can read and write
total population: 98.2%
male: 98.7%
female: 97.7% (2001 census)

School life expectancy (primary to tertiary education)(years)total: 14 years
male: 13 years
female: 14 years (2006)
Education expenditures(% of GDP)4.5% of GDP (2005)








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