Nutrition in the First 1,000 Days - Save the Children

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48 appeNDix: the MotherS’ iNDex aND coUNtry raNKiNgS what the numbers don’t tell you The national-level data presented in the Mothers’ Index provide an overview of many countries. However, it is important to remember that the condition of geographic or ethnic sub-groups in a country may vary greatly from the national average. Remote rural areas tend to have fewer services and more dire statistics. War, violence and law- lessness also do great harm to the well-being of mothers and children, and often affect certain segments of the population dispro- portionately. These details are hidden when only broad national-level data are available. • Over half of all births are not attended by skilled health personnel. • On average, 1 in 30 women will die from pregnancy-related causes. • 1 child in 7 dies before his or her fifth birthday. • Nearly a third of all children suffer from malnutrition. • 1 child in 6 is not enrolled in primary school. • Fewer than 4 girls are enrolled in primary school for every 5 boys. • On average, females receive about 6 years of formal education. • Women earn less than 40 percent of what men do. • 8 out of 10 women are likely to suffer the loss of a child in their lifetime. The contrast between the top-ranked country, Norway, and the lowestranked country, Niger, is striking. Skilled health personnel are present at virtually every birth in Norway, while only 1 in 3 births are attended in Niger. In Norway, nearly 40 percent of parliamentary seats are held by women; in Niger only 13 percent are. A typical Norwegian girl can expect to receive 18 years of formal education and will live to be over 83 years old. Eighty-two percent of women are using some modern method of contraception, and only 1 mother 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 only 56. Only 5 percent of women are using modern contraception, and 1 child in 7 dies before his or her fifth birthday. This means that every mother in Niger is likely to suffer the loss of a child. chad
afghanistan S av e t h e c h i l D r e N · S tat e o F t h e Wo r l D ’ S M ot h e r S 2 0 1 2 49 The data collected for the Mothers’ Index document the tremendous gaps between rich and poor countries and the urgent need to accelerate progress in the health and well-being of mothers and their children. The data also highlight the regional dimension of this tragedy. Eight of the bottom 10 countries are in sub-Saharan Africa. Sub-Saharan Africa also accounts for 18 of the 20 lowestranking countries. Individual country comparisons are especially startling when one considers the human suffering behind the statistics: • Less than 25 percent of births are attended by skilled health personnel in Afghanistan, Chad, Lao PDR and Nepal. In Ethiopia only 6 percent of births are attended. Compare that to 99 percent in Sri Lanka and 95 percent in Botswana. • According to the most recent estimates, 1 woman in 11 dies in pregnancy or childbirth in Afghanistan. The risk is 1 in 14 in Chad and Somalia. In Italy and Ireland the risk of maternal death is less than 1 in 15,000 and in Greece it’s 1 in 31,800. • A girl born today isn’t likely to live much past the age of 50 in Botswana, Central African Republic, Democratic Republic of the Congo, Guinea- Bissau and Zambia. In Afghanistan, Lesotho, Sierra Leone and Swaziland, the average girl won’t live to see her 50th birthday, while in Japan female life expectancy is over 87 years old. • In Somalia, only 1 percent of women use modern contraception. Rates are 5 percent or less in Angola, Chad, Eritrea, Guinea and Niger. And less than 10 percent of women use modern contraception in 13 other developing countries. By contrast, at least 80 percent of women in Norway, Portugal and Thailand and 84 percent of women in China and the United Kingdom use some form of modern contraception. • In Afghanistan, Jordan, Lebanon, Libya, Morocco, Oman, Pakistan, Syria and Yemen, women earn 25 cents or less for every dollar men earn. Saudi and Palestinian women earn only 16 and 12 cents respectively to the male dollar. In Mongolia, women earn 87 cents for every dollar men earn and in Mozambique they earn 90 cents. Progress in afghanistan After two years as the worst place in the world to be a mother, Afghanistan has moved up one notch on the Mothers’ Index this year. Afghanistan has made note- worthy improvements in maternal and child health and well-being. Skilled birth attendance has risen from 14 to 24 percent. Female life expectancy is up by almost 5 years. The average number of years girls are in school has increased by a year and a half. Child mortality has dropped from around 200 deaths per 1,000 live births to 149. And enrollment in primary school has been climbing steadily. In 2000, only 20 percent of primary-school-age children were enrolled in school, and twice as many boys as girls were in school. Today, enrollment in primary school is at 97 percent. What explains Afghanistan’s progress? One answer is that it has invested in train- ing and deploying more frontline health workers. With support from international partners, Afghanistan increased its cadre of community health workers from 2,500 in 2004 to about 22,000 today. And there are now 3,000 trained midwives, up from about 500 in 2003. Despite this progress, Afghanistan still has a long way to go. Half of the population does not have access to safe drinking water. Only 7 girls for every 10 boys are enrolled in primary school – the second largest gender disparity in education in the world. One child in 3 is underweight. One child in 7 dies before reaching age 5. Only 1 in 4 births is attended by skilled personnel. Just 1 woman in 6 is using modern contraception. And, according to the latest international estimates, 1 woman in 11 will die of a pregnancy-related cause – the highest lifetime risk of maternal mortality in the world. Results from a recent national survey suggest that Afghanistan’s maternal mortality rate is on the decline, but Afghanistan still has the highest lifetime risk of maternal mortality in the world. It also places second to last on female life expectancy and gender disparity in primary education.
Page 1 and 2: Nutrition in the First 1,000 Days S
Page 3 and 4: NUtritioN iN the FirSt 1,000 DayS I
Page 5 and 6: S av e t h e c h i l D r e N · S t
Page 33 and 34: infant and toddler toddler Feeding
Page 49: S av e t h e c h i l D r e N · S t
Page 55 and 56: THE COMPLETE MOTHERS’ INDEX 2012
Page 57 and 58: THE COMPLETE MOTHERS’ INDEX 2012
Page 69 and 70: creDitS managing editor tracy geogh

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