Answer:
Lack of Health Facilities & Awareness
Explanation:
Birth Rate is number of births per thousand people & Death Rate is the number of deaths per thousand people.
These both are high when a country is in first stage of demographic growth. Birth Rate is high due to social outlook of having big families & many other factors.
Death Rate or Mortality Rate is high due to lack of health facilities. This includes lack of sanitation & social health awareness : eg - less awareness about importance, benefits of sanitation , small family size etc. It also includes lack of proper infrastructure (hospitals, laboratories) & proper manpower (doctors, other staff) for maintaining & providing health facilities.
All above mentioned factors are major factors affecting high mortality rate.