Democratic Republic of Congo world’s toughest place to be a mother, Finland the best – Save the Children

Thursday 2 May 2013

Democratic Republic of Congo world’s toughest place to be a mother, Finland the best – Save the Children

The Democratic Republic of the Congo (DRC) is the toughest place in the world to be a mother – and Finland the best – according to Save the Children’s State of the World’s Mothers report.

The Nordic countries sweep the top spots while, for the first time, countries in sub-Saharan Africa take up each of the bottom ten places in the annual list.

The Mothers’ Index, in the State of the World’s Mothers report, is a unique ranking of 176 countries around the globe, showing those that are succeeding – and those failing – in their support to mothers.  It assesses mothers’ well-being using indicators of maternal health, child mortality, education and levels of women’s income and political status.

The startling disparities between mothers in the developed and developing world are summed up around maternal risk.  A woman or girl in Democratic Republic of the Congo has a one in 30 chance of dying from maternal causes – including childbirth – but in Finland the risk is one in 12,200. In the Democratic Republic of the Congo, which performs poorly across all indicators, girls are likely to be educated for eight and half years compared to Finland at the top, where girls can expect to receive over sixteen years of education.  

Save the Children International’s Chief Executive, Jasmine Whitbread, said: “By investing in mothers and children, nations are investing in their future prosperity. If women are educated, are represented politically, and have access to good quality maternal and child care, then they and their children are much more likely to survive and thrive – and so are the societies they live in.  Huge progress has been made across the developing world, but much more can be done to save and improve millions of the poorest mothers and newborns’ lives.”  

The Mothers’ Index reveals the United States ranks 30th, behind countries with much lower incomes, such as Lithuania or Slovenia, owing to weaker performance on measures of maternal health and child-wellbeing: in the US, a girl is ten times more likely to die of a maternal cause than a girl Singapore.  Singapore itself is ranked 15th, above countries such as Canada (22nd) and the UK (23rd). But the report shows how all countries need to improve the education and health care of disadvantaged mothers.

The Birth Day Risk Index, alsocontained in the report, compares first-day death rates for babies in 186 countries. . One million babies die each year on the day they enter the world, – or two every minute – making the first day by far the riskiest day of a person’s life in almost every country in the world.

This is despite the low-cost interventions that are available to tackle the high rate of baby deaths on the first day of life. Sub-Saharan Africa remains by far the most dangerous region to be born – with the deaths of newborns actually increasing there in the past few decades.  There, babies are more than seven times as likely to die on the day they are born as babies born in industrialised countries.  A baby in Somalia, the most dangerous country, is 40 times more likely to die on its first day than a child born in Luxembourg, the safest.

Throughout sub-Saharan Africa, the poor health of mothers, where between 10 – 20 per cent are underweight,  contributes to high rates of death for babies, as does the number of young mothers, giving birth before their bodies have matured.  Other factors are low use of contraception, poor access to decent healthcare when pregnant and a severe shortage of health-workers.

In East Asia and the Pacific, progress has been made and the number of new-born deaths is declining. In South Asia,Bangladesh and Nepal have made significant progress in reducing newborn deaths, but in other countries including India, Afghanistan and Pakistan, child marriage and poor nutritional status of mothers are factors in the region’s stubbornly high levels of newborn deaths.    

In the industrialised world, the United States has the highest first-day death rate. The U.S. has approximately 50 per cent more first-day deaths than all other industrialised countries combined, due, in part, to higher premature birth rates.

The report identifies four lifesaving products that can be used universally:  corticosteroid injections to women in preterm labour to reduce deaths caused by newborns’ breathing problems; resuscitation devices to save babies who do not breathe at birth; chlorhexidine cord cleansing to prevent umbilical cord infections and injectable antibiotics to treat newborn sepsis and pneumonia.

Save the Children calls on world leaders to:

  • Strengthen health systems so mothers have greater access to skilled birth attendants. They can provide lifesaving interventions to all mothers and children, in addition to providing more funding for maternal, newborn and child health programmes. More should be invested in frontline healthcare workers and community health workers to reach the most vulnerable mothers and babies.
  • Fight the underlying causes of newborn mortality, especially gender inequality and malnutrition. Helping mothers become strong and stable – physically, financially and socially – make their children stronger and more likely to survive and thrive.
  • Invest in low-cost solutions that can dramatically reduce newborn mortality. Proper cord care and newborn/paediatric doses of antibiotics can prevent and treat simple but deadly infections. Exclusive breastfeeding and skin-to-skin contact (known as “kangaroo mother care”) should be encouraged. Such practices cost very little but can save hundreds of thousands of babies’ lives each year. Additionally, birth attendants should be trained and given proper support and supplies.

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