The present situation in the Middle East and North Africa Region (MENA) regarding primary school drop-out and repetition, with special reference to the situation of the girl child, is examined in this study. The in-school as well as out-of-school causes of primary school drop-out are examined, and solutions that help reduce or eliminate the problem in the region are introduced. Part I presents a brief description of the purpose, the methodology, the organization, and the limitations of the study. Part II seeks to stress the importance of studying the drop-out problem in primary education in general, followed by an assessment of its characteristics and extent in MENA countries. In Part III, underlying causes of the drop-out problem in primary school are discussed, with special references to the factors leading to girls' drop out. In the final section, culture-sensitive action recommendations are provided to help meet the drop-out challenge. Twenty four strategies are introduced in five categories: child-centered, family-centered, community-centered, education-oriented, and leadership-oriented recommendations, which include: provide preparatory training, mobile counseling units, and peer tutoring; establish houses of culture; provide continued education for drop-outs; involve the family; raise the family awareness; empower the family; introduce educated role models; mobilize influential members of the community; adapt the school to local conditions and needs; equip the teachers; make the school child friendly; delegate responsibility to the students; introduce organizational reform; provide non-formal education alternatives; gather accurate data about school drop-out; raise public awareness about drop-out; provide opportunities for continued education; provide education loans; and foster sister schools. Contains 62 references. (AA)