May 10, 2006 CNN~ By Jeff Green
The report listed 10 measures used to compile the Mother's Index:
# Lifetime risk of maternal mortality
# Percent of women using modern contraception
# Percent of births attended by skilled personnel
# Percent of pregnant women with anemia
# Adult female literacy rate
# Participation of women in national government
(CNN) -- An estimated 2 million babies die within their first 24 hours
each year worldwide and the United States has
the second worst newborn mortality rate in the developed world,
according to a new report.
American babies are three times more likely to die in their first month
as children born in Japan, and newborn mortality is 2.5 times higher in
the United States than in Finland, Iceland or Norway, Save the
Children researchers found.
Only Latvia, with six deaths per 1,000 live births, has a higher death
rate for newborns than the United States, which is tied near the bottom
of industrialized nations with Hungary, Malta, Poland and Slovakia with
five deaths per 1,000 births.
"The United States has more neonatologists and neonatal intensive
care beds per person than Australia, Canada and the United Kingdom, but
its newborn rate is higher than any of those countries," said the
annual State of the World's Mothers report.
The report, which analyzed data from governments, research institutions
and international agencies, found higher newborn death rates among U.S.
minorities and disadvantaged groups. For African-Americans, the
mortality rate is nearly double that of the United States as a whole,
with 9.3 deaths per 1,000 births.
Sub-Saharan Africa remains the worst place in the world to be a mother
or child, with Scandinavian nations again taking the top spots in the
rankings by the Connecticut-based humanitarian group.
Sweden heads the list, with Niger last. (10 worst and best)
The "Mothers' Index" in the report ranks 125 nations according
to 10 gauges of well-being -- six for mothers and four for children --
including objective measures such as lifetime mortality risk for mothers
and infant mortality rate and subjective measures such as the political
status of women.
Charles MacCormack, president and CEO of Save the Children, said
the report card "illustrates the direct line between the status of
mothers and the status of their children."
"In countries where mothers do well, children do well," he
said in a written statement accompanying the report.
But each year, according to the report, more than a half-million women
die as a result of pregnancy and childbirth difficulties, 2 million
babies die within their first 24 hours, 2 million more die within their
first month and 3 million are stillborn.
An unhealthy start
As Americans celebrate Mother's Day on Sunday, "5,000 mothers will
mourn the loss of the newborn they bear that very day in the developing
world," said Anne Tinker, director of Save the Children's Saving
Newborn Lives initiative.
"All children, no matter where they are born, deserve a healthy
start in life," Melinda Gates wrote in a foreword to the report,
which was funded in part by the foundation she runs with her husband,
Microsoft co-founder Bill Gates.
MacCormack said "significant progress" had been made in
reducing deaths in children under age 5 in recent years, but "we
have made little progress in reducing mortality rates for babies during
the first month of life."
Causes of death in the developing world were dramatically different from
those in the developed world, the report said. In industrialized nations
deaths were most likely to result from babies being born too small or
too early, while in the developing world about half of newborn deaths
were from infection, tetanus and diarrhea.
The newborn mortality rate in the United States has fallen in recent
decades, the report said, but continues to affect minorities
Only 17 percent of all U.S. births were to African-American families,
but 33 percent of all low-birth weight babies were African-American,
according to the report.
The research also found that poorer mothers with less education were at
a significantly higher risk of early delivery. The study added that in
general lower educational attainment was associated with higher newborn
Tinker said some nations ranked high in part because they offer free
health services for pregnant women and babies, while the United States
suffers from disparities in access to health care.
"We can do better here, but what's really important is that we do
something" in the developing world, she said.
The report said almost all newborn and maternal deaths take place in
developing nations -- 99 percent and 98 percent, respectively. The
newborn mortality rates were particularly high in countries with a
recent history of armed conflict, including Liberia and Sierra Leone.
But the report also concluded that political will was more important
than national wealth. A "newborn score card" ranking 78
developing nations found that some relatively impoverished countries
-- including Colombia, Mexico, Nicaragua and Vietnam -- fare better than
Ranking at the bottom of the scorecard were Liberia, Afghanistan, Angola
and Iraq -- countries where armed conflict and cultural practices impede
"It's tragic that millions of newborns die every year, especially
when these deaths are so easily preventable," Gates wrote. "Three
out of four newborn deaths could be avoided with simple, low-cost tools
that already exist, such as antibiotics for pneumonia, sterile
blades to cut umbilical cords and knit caps to keep babies warm."
'The good news'
The Mothers' Index -- which excluded some nations that lacked sufficient
data -- highlights huge disparities between the nations at the top and
the bottom of the list.
Compared with mothers in the top 10 countries, a mother in the bottom 10
was found to be more than 750 times more likely to die in pregnancy or
In top-ranked Sweden, skilled personnel are present at nearly all
births, but in bottom-ranked Niger, such help is available for only 16
percent of women in labor.
"The good news," said MacCormack, "is that we know what
it takes to help these moms and children survive and thrive."
The report highlights the three areas it says have the most influence on
child well-being: female education, presence of a trained attendant at
birth and use of family planning services.
Educated women, the report said, are more likely to marry and give birth
later in life, to seek health care and to encourage education for their
children, including girls.
The report said that family planning and increased contraception use
leads to lower maternal and infant death rates. Many women and children
in developing nations, it said, die as a result of births that come at
the wrong time -- too close together, too early or too late in the
mother holds her 9-day-old baby in Bangladesh, where 153,000 newborns
die each year.
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