Discussion article for May 14th

Here’s a map of the best and worst countries to be a mother

By Max Fisher, Published: May 8, 2013 at 6:30 amE-mail reporter

Click to enlarge. (Data source: Save the Children)

A new report by Save the Children, a London-based NGO, gauges and ranks the conditions for mothers in almost every country in the world. Their annual report, just out, shows that Nordic countries are the best places to be mothers. Sub-Saharan Africa and South Asia are the worst.

The Mother’s Index, based on a wide range of data gathered from the United Nations and other sources, are mapped out above. Bluer countries are best for mothers, red countries are worst and purple are somewhere in the middle.

The report measures conditions for mothers using five different metrics: risk of maternal death, infant mortality rate, the number of years an average child will spend in school, gross national income per capita and participation of women in government. Those last two variables are built on the inferences, fleshed out in the report, that mothers with more money will be more likely to secure food and medical care, and that countries where women participate in governance are more likely to pass laws promoting womens’ health and well-being.

Here are a few interesting details from the report.

(1) In India, 309,300 babies die every year within 24 hours of birth

That’s 847 per day. India makes up 29 percent of all first-day deaths around the world, part of the country’s serious issues with maternal health and care-giving. An estimated 28 percent of infants in South Asia are born underweight, which is often a product of poor maternal health and makes infant death more likely. It is also due to unusually early marriage and childbearing ages in the region – 47 percent of Indian girls marry by age 18, including 75 percent of girls in the lowest income quintile.

(2) Motherhood is hard and dangerous in bottom-ranked countries

The report provides these facts about the average mother in the ten bottom-ranked countries, all of which are in Africa:

• On average, 1 woman in 30 is likely to die from a pregnancy-related cause.

• 1 child in 7 dies before his or her fifth birthday.

• Eight out of 10 women are likely to suffer the loss of a child in their lifetime.1

(3) Northern Europe is the best for mothers, sub-Saharan Africa the worst

Much of Sub-Saharan Africa did poorly, often because of undernourishment, scant access to health care or weak legal protections for mothers.All 10 of the best countries for mothers are in Europe, with the highest-ranking in Northern Europe. The report cites a combination of high-quality and widely available health care, state assistance for new mothers so that they can choose voluntarily whether to focus on work or caring for their infants, high school retention rates and other factors.

(4) Much more than just national wealth at play

Although rich countries generally score higher and poor countries score lower, there are clearly other factors cutting against this. The wide variation across the Middle East, for example, shows countries such as Algeria, Tunisia and Lebanon outperforming their neighbors on making health care and state services available to mothers.

Vietnam, for example, though quite poor, scored relatively well as a place for moms, in part by cutting its newborn death rate by an impressive 47 percent over 20 years. Several Latin American countries, such as Peru, also seemed to do better than comparably wealthy states.

Spain and Portugal, it’s worth noting, dramatically outperformed several Western countries that are much wealthier. But it will be worth watching to see whether they can sustain those positive conditions even as the Euro crisis takes its economic toll.

(5) Many lack access to sufficient care during birth

Having a skilled caretaker with you at birth can go a long way toward preventing a mother or child’s death. But not everyone has access to that kind of care, either because of physical location, money or local government services.

(6) The U.S. scores poorly because of inequality

Ranked 30th internationally and way toward the bottom of the industrialized nations, below Belarus and Lithuania, how can one of the world’s richest countries not better serve its mothers?

The U.S., it turns out, has the second-highest preterm birth rate in the world, meaning that babies are born too early, and the highest first-day infant death rate in the developed world. Adolescent birth rates are also unusually high. These and other poor statistical showings mean that, even if lots of well-off American mothers probably have Norwegian-quality experiences, the overall U.S. average is on par with that of some post-Soviet Eastern European countries.

Save the Children’s report suggests that the U.S. statistics may be due in part to inequality. The U.S. ranks at the very bottom of the developed world in terms of income inequality. Economically and/or socially disadvantaged mothers are less likely to have a happy and healthy experience from pregnancy through childhood, are more likely to become pregnant by accident rather than by choice and are less likely to receive the best possible care. Here’s a snip from the report:

Many babies in the United States are born too early. The U.S. preterm birth rate (1 in 8 births) is one of the highest in the industrialized world (second only to Cyprus). In fact, 130 countries from all across the world have lower preterm birth rates than the United States. The U.S. prematurity rate is twice that of Finland, Japan, Norway and Sweden. The United States has over half a million preterm births each year – the sixth largest number in the world (after India, China, Nigeria, Pakistan and Indonesia).

According to the latest estimates, complications of preterm birth are the direct cause of 35 percent of all newborn deaths in the U.S., making preterm birth the number one killer of newborns. Preterm birth is a major cause of death in most industrialized countries and is responsible for up to two-thirds of all newborn deaths in countries such as Iceland and Greece.

The United States also has the highest adolescent birth rate of any industrialized country. Teenage mothers in the U.S. tend to be poorer, less educated, and receive less prenatal care than older mothers. Because of these challenges, babies born to teen mothers are more likely to be low-birthweight and be born prematurely and to die in their first month. They are also more likely to suffer chronic medical conditions, do poorly in school, and give birth during their teen years (continuing the cycle of teen pregnancy). 

http://www.washingtonpost.com/blogs/worldviews/wp/2013/05/08/heres-a-map-of-the-best-and-worst-countries-to-be-a-mother/