8 | 16 | 32 |
64 | 128 | 250 |
500 | 1000 | 2000 |
4000 | 8000 | 16000 |
32000 | 64000 |
The Save the Children State of the World's Mothers report (SOWM report) [1] is an annual report by the Save the Children USA, which compiles statistics on the health of mothers and children and uses them to produce rankings of more than 170 countries, showing where mothers fare best and where they face the greatest hardships. [2] [3] [4] The rankings are presented in the Mothers’ Index, which has been produced annually since the year 2000. [5]
The 2014 report focuses on saving mothers and children in humanitarian crises. It finds that over half the 800 maternal and 18,000 child deaths every day take place in fragile settings which are at high risk of conflict and are particularly vulnerable to the effects of natural disasters. [6]
The 2014 report ranks Finland the number one place to be a mother. Somalia in the Horn of Africa replaced Democratic Republic of the Congo (ranking 178th) as the worst place in the world to be a mother. The United States is down one spot from 2013, ranking 31st. Statistics show that 1 in 27 women from the bottom ranking countries will die from pregnancy-related causes. In addition, 1 in 7 children will die before his or her fifth birthday. [7]
The 2015 report is the last edition of the report published on the Save the Children website.
An original analysis by Save the Children estimates that within the first month of life, more than 1 million babies could be saved each year with universal access to these products, which cost between 13 cents and $6 each and are ready for rapid scale-up now. The products are:
Stunting - Stunting is when a child is too short for their age. It is caused by poor diet and frequent infections. Generally, stunting occurs before the age of 2, with largely irreversible effects. These effects include: delayed motor development, impaired cognitive function, and poor performance in school.
Wasting - Wasting is when a child's weight is too low for their height. Wasting is caused by acute malnutrition. It is a strong predictor of mortality for children under 5 years old. Usually, it is caused by either food shortage or disease.
Underweight - When a child is underweight, the child's weight is too low for their age. Being underweight can mean the child is stunted, wasted or both. Weight is an indicator of short-term undernutrition. A deficit in height (i.e. stunting) is difficult to correct but a deficit in weight (i.e. underweight) can be resolved if nutrition and health are improved later in childhood.
Micronutrient deficiency - Micronutrient deficiency is when a child is lacking essential vitamins or minerals such as Vitamin A, iron, and zinc. These deficiencies are caused by a long-term lack of nutritious food or they can be caused by infections such as worms.
There are 171 million children (17%) globally who do not have the opportunity to reach their full potential. This is due to not only the physical, but the mental effects of poor nutrition in the earliest months of life.
Out of 171 countries, Iceland is first and Somalia is last.
More than half of the world's children do not have access to the "Lifesaving Six": iron folate, breastfeeding, complementary feeding, vitamin A, zinc, and hygiene.[ citation needed ]
Vitamin A
Zinc
Hygiene
Breastfeeding
Norway [7]
Niger [7]
Norway [8]
Afghanistan [8]
Norway [9]
Afghanistan [9]
The reports have been widely covered in the world press, with attention for local strengths and weaknesses. For example, in 2010 USA Today focused on the low ranking of the U.S. (28th place, below Estonia, Latvia, and Croatia) due to high rates of maternal and infant mortality, low preschool enrollment, and a particularly weak maternal leave benefit. [10] It quoted the report: [11]
"A woman in the United States is more than five times as likely as a woman in Bosnia and Herzegovina, Greece or Italy to die from pregnancy-related causes in her lifetime and her risk of maternal death is nearly 10-fold that of a woman in Ireland."
ABC News interviewed physicians and nonprofit leaders who questioned whether global comparisons could be made reliably, due to possible differences in the definition of ectopic pregnancy, stillbirth, and abortion statistics. Relevant factors may include lack of health insurance, illegal immigration by women with poor prenatal care, and maternal obesity statistics. According to Michael Katz, a senior vice president at the March of Dimes Foundation, "The major question I would ask is, 'Why do African American populations have worse results than the white population?'" [12]
3 | 4 | 8 | 16 |
32 | 64 | 128 | 257 |
Pravda.ru and Sify picked up an IANS/EFE report focusing on Cuba's rating as the best place to be a mother in the developing world. [13] [14] The Herald Sun boasted Australia's second-best placement for mothers, quoting a happy mother about hospital, maternal and child health support, and 12-month workplace maternal leave. [15] However, the Adelaide Advertiser focused on Australia's lower [28th] ranking on the Children's Index, due in part to a child mortality rate three times higher for aboriginal infants. [16] It quoted Save The Children's Annie Pettitt:
An important first step would be to tackle the shortfall of almost 2000 midwives in Australia, especially in remote and rural areas where we know the shortage is greatest.
An editorial in the Philippine Daily Inquirer discussed explanations for the Philippine's 48th-place ranking in the second tier. The column attributed much of the problem to a "brain drain", though it described as "much too high" the SOWM report's figure that 85% of Filipino nurses leave to pursue better pay and standards of living overseas. It questioned standards at "diploma mills" and called for incentives to bring health professionals into poor communities, while criticizing the chilling effects of a "raid on a training session of health-care workers" as subversives in Morong, Rizal. The Philippines local chapter of Save the Children produced a State of Filipino Mothers report in 2008 with rankings by province. [17]
The Times of India lamented India's 73rd of 77th place in the second tier, describing a critical shortage of 74,000 accredited social health activists and 21,066 auxiliary nurse midwives below governmental norms and that thousands of women were dying because they could not access the most basic healthcare facilities or that, if they were available, they were low quality. [18]
Though data for some countries are not known with much certainty, the SOWM 2010 report had many findings in common with a recent study published in The Lancet , which found that 23 of 181 countries are on track to achieve Millennium Development Goal 5 of a 75% reduction in maternal mortality rate between 1990 and 2015. [19] [20]
The 2010 report was released by Save the Children in Canada on May 4, 10:00 a.m., as a part of an action directed toward members of Parliament in support of an announcement by Prime Minister Stephen Harper that child and maternal health would be the top priority at the 36th G8 summit in Huntsville, Ontario in June. As described in the press release: [21]
In the week leading up to Mother's Day, 5,700 mothers around the world will die. During this Mother's Day week, CARE, the Canadian Association of Midwives, Plan Canada, Results, Save the Children Canada, the Society of Obstetricians and Gynaecologists of Canada, UNICEF and World Vision have joined forces in Ottawa to get the attention of the government and public, to have Canada put its leadership at the upcoming G8 into action and stop preventable child and maternal deaths
The list is incomplete and only includes the top 35 countries. [7]
Rank | Country | Lifetime risk of maternal death | Expected # of years of formal schooling |
---|---|---|---|
1 | Finland | 12,200 | 17.0 |
2 | Norway | 7,900 | 17.6 |
3 | Sweden | 14,100 | 15.8 |
4 | Iceland | 8,900 | 18.7 |
5 | Netherlands | 10,500 | 17.9 |
6 | Denmark | 4,500 | 16.9 |
7 | Spain | 12,000 | 17.1 |
8 | Germany | 10,600 | 16.3 |
9 | Australia | 8,100 | 19.9 [note 1] |
9 | Belgium | 7,500 | 16.2 |
11 | Italy | 20,300 | 16.3 |
12 | Austria | 8,100 | 15.6 |
13 | Switzerland | 9,500 | 15.7 |
14 | Portugal | 9,200 | 16.3 |
15 | Singapore | 25,300 | 14.4 |
16 | New Zealand | 3,300 | 19.4 [note 2] |
17 | Slovenia | 5,900 | 16.8 |
18 | Canada | 5,200 | 15.8 |
19 | Ireland | 8,100 | 18.6 [note 3] |
20 | France | 6,200 | 16.0 |
20 | Greece | 25,500 | 16.5 |
22 | Luxembourg | 3,200 | 13.9 |
23 | Israel | 25,100 | 16.5 |
24 | Czech Republic | 12,100 | 16.4 |
24 | Lithuania | 9,400 | 16.7 |
26 | Belarus | 16,300 | 15.7 |
26 | United Kingdom | 4,600 | 16.2 |
28 | Estonia | 5,100 | 15.7 |
29 | Poland | 14,400 | 15.5 |
30 | South Korea | 4,800 | 17.0 |
31 | United States | 2,400 | 16.5 |
32 | Japan | 13,100 | 15.3 |
33 | Croatia | 4,100 | 14.5 |
34 | Latvia | 2,000 | 15.5 |
35 | Cuba | 1,000 | 14.5 |
Notes
Infant mortality is the death of an infant before the infant's first birthday. The occurrence of infant mortality in a population can be described by the infant mortality rate (IMR), which is the number of deaths of infants under one year of age per 1,000 live births. Similarly, the child mortality rate, also known as the under-five mortality rate, compares the death rate of children up to the age of five.
Human nutrition deals with the provision of essential nutrients in food that are necessary to support human life and good health. Poor nutrition is a chronic problem often linked to poverty, food security, or a poor understanding of nutritional requirements. Malnutrition and its consequences are large contributors to deaths, physical deformities, and disabilities worldwide. Good nutrition is necessary for children to grow physically and mentally, and for normal human biological development.
Malnutrition occurs when an organism gets too few or too many nutrients, resulting in health problems. Specifically, it is "a deficiency, excess, or imbalance of energy, protein and other nutrients" which adversely affects the body's tissues and form. Malnutrition is not receiving the correct amount of nutrition. Malnutrition is increasing in children under the age of five due to providers who cannot afford or do not have access to adequate nutrition.
The United Nations World Summit for Children was held in the United Nations Headquarters in New York City on 29–30 September 1990. The summit had the then-largest-ever gathering of heads of state and government to commit to a set of goals to improve the well-being of children worldwide by the year 2000. It was the first time a UN conference had set a broad agenda for a wide range of goals in health, education, nutrition and human rights.
India's population in 2021 as per World Bank is 1.39 billion. Being the world's second-most-populous country and one of its fastest-growing economies, India experiences both challenges and opportunities in context of public health. India is a hub for pharmaceutical and biotechnology industries; world-class scientists, clinical trials and hospitals yet country faces daunting public health challenges like child undernutrition, high rates of neonatal and maternal mortality, growth in noncommunicable diseases, high rates of road traffic accidents and other health related issues.
Child mortality is the mortality of children under the age of five. The child mortality rate refers to the probability of dying between birth and exactly five years of age expressed per 1,000 live births.
Stunted growth, also known as stunting or linear growth failure, is defined as impaired growth and development manifested by low height-for-age. It is a primary manifestation of malnutrition and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, due to malnutrition during fetal development brought on by a malnourished mother. The definition of stunting according to the World Health Organization (WHO) is for the "height-for-age" value to be less than two standard deviations of the median of WHO Child Growth Standards. Stunted growth is usually associated with poverty, unsanitary environmental conditions, maternal undernutrition, frequent illness, and/or inappropriate feeding practice and care during early years of life.
Pakistan is the fifth most populous country in the world with population approaching 225 million. It is a developing country struggling in many domains due to which the health system has suffered a lot. As a result of that, Pakistan is ranked 122nd out of 190 countries in the World Health Organization performance report.
Health care services in Nepal are provided by both public and private sectors and are generally regarded as failing to meet international standards. Prevalence of disease is significantly higher in Nepal than in other South Asian countries, especially in rural areas. Moreover, the country's topographical and sociological diversity results in periodic epidemics of infectious diseases, epizootics and natural hazards such as floods, forest fires, landslides, and earthquakes. But, recent surge in Non communicable diseases has emerged as the main public health concern and this accounts for more than two-thirds of total mortality in country. A large section of the population, particularly those living in rural poverty, are at risk of infection and mortality by communicable diseases, malnutrition and other health-related events. Nevertheless, some improvements in health care can be witnessed; most notably, there has been significant improvement in the field of maternal health. These improvements include:
Breastfeeding, or nursing, is the process by which human breast milk is fed to a child. Breast milk may be from the breast, or may be pumped and fed to the infant. The World Health Organization (WHO) recommends that breastfeeding begin within the first hour of a baby's life and continue as often and as much as the baby wants. Health organizations, including the WHO, recommend breastfeeding exclusively for six months. This means that no other foods or drinks, other than vitamin D, are typically given. WHO recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding with appropriate complementary foods for up to 2 years and beyond. Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months, and 58% of mothers continue breastfeeding up to the age of two years and beyond.
Despite India's 50% increase in GDP since 2013, more than one third of the world's malnourished children live in India. Among these, half of the children under three years old are underweight.
The 2010 maternal mortality rate per 100,000 births for Tanzania was 790. This is compared with 449 in 2008 and 610.2 in 1990. The UN Child Mortality Report 2011 reports a decrease in under-five mortality from 155 per 1,000 live births in 1990 to 76 per 1,000 live births in 2010, and in neonatal mortality from 40 per 1,000 live births to 26 per 1,000 live births. The aim of the report The State of the World's Midwifery is to highlight ways in which the Millennium Development Goals can be achieved, particularly Goal 4 – Reduce child
Health in Mozambique has a complex history, influenced by the social, economic, and political changes that the country has experienced. Before the Mozambican Civil War, healthcare was heavily influenced by the Portuguese. After the civil war, the conflict affected the country's health status and ability to provide services to its people, breeding the host of health challenges the country faces in present day.
Malnutrition continues to be a problem in the Republic of South Africa, although it is not as common as in other countries of Sub-Saharan Africa.
Expenditure on health in Senegal was 4.7% of GDP in 2014, US$107 per capita.
Both maternal and child health are interdependent and substantially contributing to high burden of mortality worldwide. Every year, 289 000 women die due to complications in pregnancy and childbirth, and 6.6 million children below 5 years of age die of complications in the newborn period and of common childhood diseases. Sub-Saharan Africa (SSA), which includes Tanzania, contribute higher proportion of maternal and child mortality. Due to considerable proportion of mortality being attributed by maternal and child health, the United Nations together with other international agencies incorporated the two into Millennium Development Goals (MDGs) 4 and 5. In this regard, Tanzania through the Ministry of Health and Social Welfare (MoHSW) adopted different strategies and efforts to promote safe motherhood and improve child survival. Similarly, in an effort to improve maternal and child health, Tanzania's government has declared maternal and child health services to be exempt from user fees in government facilities.
Malnutrition is a condition that affects bodily capacities of an individual, including growth, pregnancy, lactation, resistance to illness, and cognitive and physical development. Malnutrition is commonly used in reference to undernourishment, or a condition in which an individual's diet does not include sufficient calories and proteins to sustain physiological needs, but it also includes overnourishment, or the consumption of excess calories.
Undernutrition in children, occurs when children do not consume enough calories, protein, or micronutrients to maintain good health. It is common globally and may result in both short and long term irreversible adverse health outcomes. Undernutrition is sometimes used synonymously with malnutrition, however, malnutrition could mean both undernutrition or overnutrition. The World Health Organization (WHO) estimates that malnutrition accounts for 54 percent of child mortality worldwide, which is about 1 million children. Another estimate, also by WHO, states that childhood underweight is the cause for about 35% of all deaths of children under the age of five worldwide.
The maternal mortality rate is 224 deaths per 100,000 births, which is the 23rd highest in the world. The mean age of mothers at birth is 19.3 years old, and the fertility rate is 5.72 children born per woman, which is the 7th highest in the world. The contraceptive rate is only 40.8%, and the birth rate is the 4th highest in the world at 42.13 births/1,000 population. Infectious disease is a key contributor to the poor health of the nation, and the risk is very high for diseases such as protozoal and bacterial diarrhea, hepatitis A, typhoid fever, malaria, dengue fever, schistosomiasis, and rabies. The adult prevalence rate of HIV/AIDS is 12.37%, which is the 7th highest in the world.
Child health and nutrition in Africa is concerned with the health care of children through adolescents in the various countries of Africa. The right to health and a nutritious and sufficient diet are internationally recognized fundamental human rights protected by international treaties and conventions on the right to life, as well as in charters, strategies and declarations. Millennium Development Goals (MDGs) 1, 4, 5 and 6 highlight, respectively, how poverty, hunger, child mortality, maternal health, the eradication of HIV/AIDS, malaria, tuberculosis and other diseases are of particular significance in the context of child health.