Japan's infant mortality rate in 1991 was four per 1,000, the lowest in the world. Contributing factors are the universal use of the Boshi Kenko Techo (maternal–child health handbook) and universal access to care. Most births occur to women aged 25–29 years and there are few unmarried mothers. Ninety-nine and seven-tenths percent of births are attended by qualified professionals either in hospitals or private clinics, with an average stay of one week postpartum. Abortion is available when contraceptives fail. There are government subsidies for medical, obstetric, and pediatric complications. Japanese citizens are highly literate and seek out medical advice, and their society is organized to support children. Efficient systems of community support, public health education, and excellent medical care encompass events from conception to school age.