According to the 2014 Mother’s Index Rankings published in the Save The Children’s State of the World’s Mothers Report last week, you are statistically safer giving birth in Slovenia, (ranked the 17th safest country in which to give birth), or Estonia (ranked the 23rd), than you are in the United States of America (which is way down the list at number 31). In fact last week at the launch of the State of the World’s Mothers Report at the United Nations in New york City I was shocked to learn that the United States is one of the few countries where the risk to mothers in childbirth has gone up rather than down.
Global Team of 200 Member Harriet Shugarman, Exec. Dir. of ClimateMama, and Carolyn Miles, President and CEO of Save The Children pictured here with the author at the State of the World’s Mothers Report launch in NYC .
The Mothers’ Index is part of the overall annual State of the World’s Mothers Report that Save The Children has produced for the past 15 years. The five indicators used in the index are the lifetime risk of maternal death, the under 5 year child mortality rate, the expected years of formal schooling, the gross national income per capita, and the participation of women in national government.
Credit: Save The Children
To see how other countries rank you can view the entire Mothers’ Index HERE.
So why does the United States perform so poorly on the Mothers’ Index? According to the State of the World’s Mothers report :
Although the U.S. performs quite well on economic and educational status it lags behind all other top ranked countries on maternal health and children’s well-being, and performs quite poorly on political status ( the #of women in government).- Save The Children p. 74 State of the World’s Women Report
The lag in the United States is alarming, but this year the report specifically addresses the preventable maternal and child deaths in crisis-affected places. The 2014 report focuses primarily on saving mothers and children, who tend to be the most vulnerable, in humanitarian crisis. The launch event last week was co-hosted by the Permanent Mission of the Philippines to the United Nations. Save The Children responded immediately with aid to the crisis in the Philippines caused by Typhoon Haiyan in 2013, as it has done in crisis areas around the world for over 90 years. Save The Children provides health care, food, and protection to those most vulnerable in humanitarian crisis, most often the women and children. It is not surprising that all of bottom 10 countries on the Mothers’ Index are areas that have recently been in, or are currently in conflict situations, or experienced natural disaster. Statistics in the report show that more than half of maternal and child deaths take place in these types of fragile settings.
Cover photo of the Save The Children’s State of the World’s Mothers Report Photo by Phil Moore
Looking at trends so far in this century, we see how armed conflict, political instability and natural disasters have played a major role in undermining the well-being of mothers and children in the world’s poorest countries. We also see that progress is possible, even in countries suffering from devastating humanitarian crisis.- SOWM
One of the countries I was surprised to hear had made such progress was war-torn Afghanistan, which has moved up the Mothers’ Index list by 32 places. At the UN event Yasmin Haque, Deputy Director of the Office of Emergency Programmes for UNICEF noted that the key components for improvement in Afghanistan were the training of mid-wives, putting medical interventions in place for safe birth, educating girls, and immunization campaigns against vaccine preventable diseases. Proving, as she said, that “the investment of minds and funding works”. She also noted that the recommendations coming from the State of the World’s Mothers Report are pressing.
HRH Princess Sarah Zeid of Jordan and Carolyn Miles, President and CEO of Save The Children
Princess Sarah Zeid of Jordan is a global champion for maternal and child health and she backed this up with the urgency of the Syrian crisis. She described things becoming so dire in the refugee camps bursting at the seams, that food rations from the World Food Program have recently been reduced by 20% per family to accommodate the influx. Some of the Syrian mothers in these camps who were not breastfeeding their infants but using formula to feed their babies, have turned to sugar-water as a substitute as formula has become more and more scarce, and costly.
So what are the recommendations that this report says need to happen? You can read the detailed recommendations in the full SOWM report, but to give you an idea here are a few bullet points of the overall suggestions:
1. Ensure that even mothers and newborns in crisis areas have access to high quality health care. This includes ensuring at least the basic high-impact public health interventions of clean water, sanitation and vaccines. Increased number of female health care workers, and safe birth during the highest risk times of birth and the first week of life as recommended by the Every Newborn Action Plan.
2. Invest in women and girls and ensure their protection. One component is that by educating girls and putting an end to child marriage entire communities are positively impacted. Educated girls grow up to better contribute to the economy, tend to have fewer children, and her children have better survival rates than children of uneducated mothers.
3. Build longer term resilience to minimize the damaging effects of crisis on health. Early warning systems need to be put in place. There is a need for community based disaster preparedness, response and contingency planning. These plans should prioritize infants and children who often suffer the most in the face of disaster.
4. Design emergency interventions with a longer term view and the specific needs of mothers and newborns in mind. Prioritize maternal and newborn survival in crisis settings by ensuring access to safe birthing, medical care, and setting up specific safe spaces for them. Continue vaccines programs even during crisis.
5.Ensure adequate financing, coordination, and research to guarantee the above can be accomplished. This includes donor countries committing to increased long-term and reliable aid to fragile areas. Reconciling short-term disaster aid with long-term development financing, addressing gender issues, and proper data reporting.
We have the solutions to many of the issues impacting women and children around the world, stories of progress like Ethiopia and Afghanistan prove that it can be done. The State of the World’s Mothers Report aims to highlight unmet needs, effective solutions, and recommended policy changes to that end.
I was invited by Save The Children to the State of The World’s Mothers Report at the UN last week in NYC as a member of The Global Team of 200, a highly specialized group of members of Mom Bloggers for Social Good that concentrates on issues involving women and girls, children, world hunger and maternal health. Our Motto: Individually we are all powerful. Together we can change the world. We believe in the power of collective action to help others and believe in ourselves to make this world a better place for our children and the world’s children.
The major issue in Ethiopia is that approximately 80% of women give birth at home, often without the presence of a trained health care worker. The majority of the population lives in rural areas with poor access to health care.Dr. Abebe’s own story also illustrates that even in the presence of the most skilled physician, without resources, or transportation to a hospital from a remote area, lives can still be lost. The fact that less than half of newborns are protected against tetanus is another major contributing factor, especially for home births in unsterile conditions.The country’s success on MDG 4 illustrates that with dedicated financial and intellectual commitment, Ethiopia’s goal to reduce the number of newborn deaths by 2015 can be achieved. The Health Extension Plan implemented by the government to target the issue is deploying trained Health Extension Workers, and the Health Development Army, both key delivery platforms at the primary level.The ultimate goal is one health care post for every 5,000 regional inhabitants attended by two Health Extension Workers. Then one larger health care center serving every five health care posts and one major hospital for each of the 800 districts of Ethiopia. Health Extension Workers train for one year after graduating high school in the communities in which they will serve. The Health Development Army volunteers have been key to the success of the program on a local level by educating their own communities.
