State of the World's Mothers 2006: Saving the Lives of Mothers and Newborns

Summary: In commemoration of Mother’s Day, Save the Children US is focusing on the 60 million mothers in the developing world who give birth every year with no professional help and their newborns, many of whom struggle to live past their first month of life.

[WESTPORT, CT, 9 May 2006] - For most children in the developing world, the most dangerous day of their lives is their birthday.

Of more than 10 million children under the age of 5 who die each year, about 1 in 5 - an estimated 2 million babies - die within the first 24 hours of life, according to the seventh annual State of the World’s Mothers report issued today by Save the Children USA. According to the report, an additional 1 million babies die during days 2 through 7. A total of 4 million babies die during the first month of life.

“The first hours, days and weeks of a baby’s life are critical. Yet, only a tiny minority of babies in poor countries receive proper health care during this highly vulnerable period,” said Save the Children President and CEO Charles MacCormack, in issuing the report. “The most simple health measures taken for granted in the United States can mean the difference between life and death for these babies. Low-cost interventions such as immunising women against tetanus and providing a skilled attendant at birth could reduce newborn deaths by as much as 70 per cent if provided universally.”

The report notes that most newborn deaths are the result of preventable or treatable causes such as infections, complications at birth and low birth weight.

“Newborn deaths are one of the world’s most neglected health problems,” said MacCormack. “While there has been significant progress in reducing deaths among children under age 5 over the past decade, we have made little progress in reducing mortality rates for babies during the first month of life. In fact, newborn deaths are so common in many parts of the developing world that parents put off naming their babies until they are a week to 3 months old.”

The report found that 10 countries account for more than two-thirds of all newborn deaths worldwide, with the highest number of deaths taking place in India (more than 1 million) and China (416,000). However, because of their large populations, neither India nor China has the highest rate of newborn deaths.

Overall, the region of the world with the highest newborn death rates is sub-Saharan Africa where 1 out of 5 mothers has lost at least one baby in childbirth, the report said. The industrialised world, including the United States, accounts for only about 1 per cent of all newborn deaths worldwide.

In evaluating the well-being of mothers and newborns in 53 low-income countries, Save the Children ranked Liberia and Afghanistan at the bottom, and placed Vietnam and Nicaragua at the top. Liberia’s newborn mortality rate is more than five times that of Vietnam.

The report also evaluated 25 middle-income developing countries and placed Iraq at the bottom (6 deaths per 100 births) and Colombia at the top (1 death per 100 births).

Among 33 industrialised countries reviewed in the report, the United States ranked next to last, ahead of Latvia and tied with Hungary, Malta, Poland and Slovakia. The report said the US newborn mortality rate is nearly three times higher than that of Finland, Iceland, Norway and Japan.

Among the world’s developing countries, the report singled out Vietnam, Nicaragua, Eritrea, Tajikistan, Indonesia and Philippines as making significant strides in saving newborn lives despite limited financial resources.

Vietnam, the report noted, has a per capita gross domestic product (GDP) of under $3,000, but it has still kept newborn death rates relatively low by aggressively assisting mothers prior to and during childbirth. In Vietnam, more than half of the women use modern contraception and nearly all pregnant women receive prenatal care and the services of a skilled birth attendant.

In contrast, Angola, with nearly the same per capita GDP as Vietnam, has a newborn death rate more than four times higher - 5 deaths per 100 births. In Angola, only 5 per cent of women use modern contraception, more than half of the population has no access to health care and more than half of all babies are born without the assistance of skilled personnel.

Going beyond the numbers, the report also offers dramatic accounts in developing countries of how communities are working together to reduce newborn deaths. For example, in Mali, grandmothers, who are highly respected and influential in family matters, were enlisted as agents of change. They were educated on simple actions to protect the health of mother and baby. As a result, the number of mothers who provided nothing but breast milk during the first three days increased by 27 per cent, and the number of mothers whose infants received newborn care rose 17 per cent in targeted areas.

Recommendations

To achieve similar newborn survival successes in other developing countries, Save the Children’s report offers the following recommendations:

  • Invest more to help girls and young women in poor countries have greater access to education, nutrition and modern contraceptives.
  • Provide low-cost, low-tech solutions to mothers and babies that save lives during pregnancy, at birth and immediately after birth. These measures include tetanus immunisations, skilled attendant at childbirth, prompt treatment of newborn infections and education about proper hygiene, warmth and breastfeeding for infants.
  • Expand the availability of good quality health care to mothers after childbirth.

The report calls on governments to increase their political and financial support for these proven solutions that save the lives of mothers and babies. The American public is asked to support increased international assistance for newborn, child and maternal heath that will help save lives.

MacCormack noted that Save the Children is committed to helping save newborn lives worldwide. Through funding from the Bill and Melinda Gates Foundation in 2000, Save the Children has been working to prevent newborn illness and death among babies most at risk of dying in Asia, Africa and Latin America. Since the project’s start, more than 20 million mothers and babies have been reached with essential health services. Save the Children, through a new Bill and Melinda Gates Foundation grant received in December 2005, is focusing on ways to identify and promote the large-scale adoption in 18 countries of proven, low-cost tools and approaches that address the three main killers of 1-week-old babies - infections, lack of oxygen supply to a baby during delivery and at birth, and low birth weight.

In addition to its special focus on newborns and mothers, the report includes Save the Children’s seventh annual Mothers’ Index that identifies the best - and worst - countries to be mother and child through a comprehensive look at their well-being in 125 countries. For the seventh year in a row, Scandinavian countries dominate the top tier of the rankings with Sweden taking first place. The United States and United Kingdom tie for 10th place. Niger is in last place.

Further information

pdf: http://www.savethechildren.org/publications/SOWM_2006_final.pdf

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