The Best and Worst Places in the World to be a Mother

Every year, the non-profit organization and registered charity Save the Children looks at the health status, nutrition, education, economic well-being and political participation of women around the world to come up with their annual  State of the World’s Mothers report. Along with providing rankings for 165 countries around the world, each report has a different theme. This year, the report focuses on the critical impact of nutrition in the first 1000 days of life, starting with pregnancy. The report also contains an Infant and Toddler Early Feeding Score for 73 developing countries and a Breastfeeding Policy Scorecard which looks at breastfeeding practices, support and policies for 36 industrialized countries. You can read more about the Breastfeeding Policy Scorecard in this companion blog post.

So what are the best and worst places in the world to be a mother?

Top 10 best places in the world to be a mother :

1. Norway
2. Iceland
3. Sweden
4. New Zealand
5. Denmark
6. Finland
7. Australia
8. Belgium
9. Ireland
10. Netherlands

Top 10 Worst places to be a mother:

1. Niger
2. Afghanistan
6. Eritrea
9. South Sudan
10. Democratic Republic of the Congo

From the report:

“The gap in availability of maternal and child health services is especially dramatic when comparing Norway and Niger. Skilled health personnel are present at virtually every birth in Norway, while only a third of births are attended in Niger. A typical Norwegian girl can expect to receive 18 years of formal education and to live to be over 83 years old. Eighty-two percent of women are using some modern method of contraception, and only 1 in 175 is likely to lose a child before his or her fifth birthday. At the opposite end of the spectrum, in Niger, a typical girl receives only 4 years of education and lives to be only 56. Only 5 percent of women are using modern contraception, and 1 child in 7 dies before his or her fifth birthday. At this rate, every mother in Niger is likely to suffer the loss of a child.”

“Conditions for mothers and their children in the bottom countries are grim. On average, 1 in 30 women will die from pregnancy-related causes. One child in 7 dies before his or her fifth birthday, and more than 1 child in 3 suffers from malnutrition. Nearly half the population lacks access to safe water and fewer than 4 girls for every 5 boys are enrolled in primary school.”

Malnutrition is a global crisis and it affects millions of children. Save the Children’s 13th annual report highlights the impact of this crisis and makes suggestions for improving conditions for mothers and children worldwide.

From the report, in answer to the question “Why focus on the first 1,000 days?”:

“Malnutrition is an underlying cause of 2.6 million child deaths each year.1 Million more children survive, but suffer lifelong physical and cognitive impairments because they did not get the nutrients they needed early in their lives when their growing bodies and minds were most vulnerable. When children start their lives malnourished, the negative effects are largely irreversible.”

Save the Children has identified six key nutrition solutions that have the greatest potential to save children’s  lives in the first 1,000 days and beyond. These solutions are ones that could be easily implemented at minimal cost if only there was the political will to do so:

“Three of the six solutions iron, vitamin A and zinc are typically packaged as capsules costing pennies per dose, or about $1 to $2 per person, per year. The other three solutions breastfeeding, complementary feeding and good hygiene  are behavior-change solutions, which are implemented through outreach, education and community support…… All combined, the entire lifesaving package costs less than $20 per child for the first 1,000 days.”

Save the Children has estimated that nearly 1.3 million children’s lives could be saved each year if the six interventions they identify were  fully implemented in the 12 countries most heavily burdened by child malnutrition and under-5 mortality.

One of the things that I really like about the report is that it highlights breastfeeding as an important way to combat child malnutrition, and in their section on barriers to breastfeeding, they address the aggressive marketing of infant formula. For more information about the devastation that is caused in developing countries by this unethical marketing, please read the article Milking it.

This year’s report from Save the Children includes an Infant and Toddler Early Feeding Score for 73 developing countries. The score is based on the percentage of children who are put to breast within one hour of birth, exclusively breastfed for the first six months, breastfed with complementary foods from ages 6-9 months and breastfed at age 2. The scorecard also looks at each countries progress towards the Millennium Development Goal of reducing child mortality by two-thirds by 2015 and the degree to which they have implemented the International Code of Marketing of Breastmilk Substitutes (although these last two indicators are not included in the calculation of the overall score). Only 4 countries out of 73 score “very good” on these indicators, and more than two-thirds fall into the “fair” or “poor” category. The top 4 countries are Malawi, Madagascar, Peru and Soloman Islands. The bottom 4 are Equatorial Guinea, Botswana, Côte d’Ivoire and Somalia. The top 4 countries on the Infant and Toddler Early Feeding Scorecard have made an effort to address child malnutrition, and their efforts are paying off. Change is possible!

Malnutrition in developing countries may seem like a distant problem and one that doesn’t affect us, but the children of the world not just our own neighbourhoods, are our future. The malnutrition crisis in the developing world is not new. It is an ongoing problem, and what is so frustrating is that the means exist to address the issue! Despite this fact, children in these countries have been suffering for years and will continue to do so unless the governments of the world decide to stop their posturing on these important issues and take action. Imagine how much good could be accomplished if some of the hundreds of millions of dollars that are spent every at the G8 and G20 summits were actually spent on taking action on some of the issues they are discussing. We don’t need more research or discussion, we need for people, governments and individuals alike, to step up and say “We’re going to do something about this“.