STWR - Share The World's Resources

A report highlighting the great divide between the status of mothers' well-being in rich and poor countries urges governments to do a better job of providing mothers with access to education, income-earning opportunities and basic health care, by Save the Children.

20th November 08 - Save the Children

The Best and Worst Countries to Be a Mother

Read the full report: State of the World's Mothers 2008

Read the summary

Save the Children, a U.S based independent global humanitarian organization released its ninth annual Mothers' Index that ranks the best - and worst - places to be a mother and a child. The Mother's Index, highlighted in the organization's State of the World's Mothers 2008 report, compares the well-being of mothers and children in 146 countries, more than in any previous year.

Nordic countries sweep the top rankings of the best places to be a mother, while countries in sub-Saharan Africa dominate the bottom tier. Sweden tops the list, while Niger ranks last among countries surveyed. The United States places 27th this year, one slot down from last year's ranking.

The top-10 countries, in general, have very high scores for mothers' and children's health, educational and economic status, while the 10 bottom-ranked countries are a reverse image, performing poorly on all indicators.  

Conditions for mothers and their children in countries at the bottom of the Index are bleak. On average, 1 in 21 mothers will die in her lifetime from pregnancy-related causes. More than 1 child in 6 dies before her fifth birthday, and roughly 1 in 3 suffers from malnutrition, and only 3 girls for every 4 boys are enrolled in primary school.

"A mother's well-being is connected to her children's well-being," said Charles MacCormack, president and CEO of Save the Children. "It is not surprising, then, that in the worst places to be a mom, both women and children die young."

"There is a great divide between the status of mothers' health and well-being in rich and poor countries," added MacCormack, referring to the Mother's Index rankings. "In rich nations, where women have access to basic health care, giving birth is usually a time of joy. But in poor countries, where there is little or no access to skilled health workers, it is typically tragic. Every woman in the 10 worst countries is likely to suffer the unbearable loss of a child in her lifetime."

The gap in availability of maternal and child health services is especially striking when comparing Sweden, at the top of the list, and Niger, at the bottom. Skilled health personnel are present at virtually every birth in Sweden, while only 33 percent of births are attended in Niger. A typical Swedish woman has almost 17 years of formal education and will live to be 83. Meanwhile, 72 percent of Swedish women use some modern method of contraception, and only 1 in 185 will lose a child before his or her fifth birthday. In stark contrast, in Niger, a typical woman has less than three years of education and the life expectancy of a girl born today is only 45. Only 4 percent of Nigerian women use modern contraception, and 1 child in 4 never sees a fifth birthday. At this rate, every mother is likely to suffer the loss of a child during her lifetime.

"To close the gap and improve conditions for mothers and children, especially among the poorest, the global community needs to do a better job of providing mothers with access to education, income-earning opportunities, and basic health care – for mothers and their children," said MacCormack.

Zeroing in on the children's well-being portion of the Mothers' Index, Italy finishes first and Niger finishes last out of 168 countries. While nearly every Italian child ─ girl and boy alike ─ enjoys good health and education, children in Niger face a 1 in 4 risk of dying before age 5. In Niger, 44 percent of children are malnourished, and less than half of children are enrolled in primary school.   

Country Comparisons:

The Mothers' Index presents individual country comparisons for poor countries that are especially startling when one considers the human suffering behind the statistics:

• 1 child in 4 does not reach his or her fifth birthday in Afghanistan, Angola, Niger and Sierra Leone. In Sweden, only 1 child in 333 dies before age 5.

• Fewer than 15 percent of births are attended by skilled health personnel in Afghanistan and Chad; 96 percent of births are attended by skilled health personnel in Sri Lanka.

• Over the course of her lifetime, 1 woman in 8 will die in pregnancy or childbirth in Afghanistan. Compare that to 1 in more than 47,000 in Ireland.

• A typical woman in Angola, Dijbouti and Niger has less than four years of schooling versus a typical woman in Australia or New Zealand who receives over 20 years of formal education.

• A girl born in Swaziland will not live to see her 30th birthday. Compare that to a girl born in Japan who will live to 86 years old.

Key Indicators:

The status of mothers was compared in 146 countries based on the following indicators of women's and children's well-being:

• Lifetime risk of maternal mortality 

• Percentage of women using modern contraception

•  Skilled attendant at delivery Female life expectancy

•  Expected number of years of formal schooling for females 

• Ratio of estimated female-to-male earned income 

• Maternity leave benefits

•  Participation of women in national government 

• Under-5 mortality rate

•  Percentage of children under age 5 moderately or severely underweight 

• School enrollment ratios

•  Ratio of girls to boys enrolled in primary school 

• Percentage of population with access to safe water