State Of The World's Mothers Report 2013 released

Save the Children released its 14th annual State of the World's Mothers (SOTWM) report: 'Surviving the First Day.' The report focuses on the staggering number of newborn deaths that occur in a baby's earliest days -- and the opportunity to reduce this universal tragedy. It includes data on women's health, children's health and economic wellbeing for 176 countries.

Key highlights of the Report

The first day of life is the most dangerous day for mothers and babies. Save the Children’s first-ever Birth Day Risk Index compares first-day death rates for 186 countries and finds that in most countries, children are at greatest risk on the day they are born. Babies in Somalia have the highest risk of dying on their birth day. First-day death rates are almost as high in Democratic Republic of the Congo, Mali, and Sierra Leone. Mothers in these four countries are also at high risk on this day. Mothers in Somalia and Sierra Leone face the second and third highest lifetime risk of maternal death in the world, respectively.

The first day is also a day of unequaled opportunity to save lives and set the stage for a healthy future. Most newborn and maternal deaths could be prevented by ensuring that mothers and newborns have access to low-cost, lifesaving interventions through improved and expanded health care systems. Ensuring access to well-trained and equipped health care workers during childbirth is part of the solution. 

According to the United Nations, four products could greatly assist health workers in saving many newborn lives. The products are: 

a) steroid injections for women in preterm labor (to reduce deaths due to premature babies’ breathing problems); 
b) resuscitation devices (to save babies who do not breathe at birth);
c) hlorhexidine cord cleansing (to prevent umbilical cord infections); and 
d) injectable antibiotics (to treat newborn sepsis and pneumonia). 
Other low-cost interventions such as kangaroo mother care and early and exclusive breastfeeding would save many more babies. Such interventions, as part of strengthened health care systems, not only can dramatically reduce maternal and newborn deaths, but also can prevent a lifetime of negative health consequences such as long-term disabilities, intellectual impairment and increased vulnerability to illness. 

Poor health is not only costly for individuals and their families, it can also impede a nation’s efforts toward economic growth. 

Mothers and babies in sub-Saharan Africa face the greatest risks. Maternal, child and newborn death rates have declined across the developing world since 1990, but progress has been slowest in sub-Saharan Africa. The bottom 10 countries on the Mothers’ Index are all in sub-Saharan Africa. Many of these same countries also have very high rates of first-day death, and sub-Saharan Africa also occupies the 10 worst spots on the Birth Day Risk Index. Seven countries – Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Mali, Sierra Leone and Somalia – score in the bottom 10 on both indices. While mothers and babies struggle for survival in much of sub-Saharan Africa, a number of countries have demonstrated that progress is possible despite great challenges.

On the Mother's Index -- the global ranking system for maternal and infant health -- Finland, Sweden and Norway top the list, while Sierra Leone, Somalia and the Democratic Republic of the Congo bring up the rear. The United States fell from number 25 to number 30 in 2013 and is also the country in which more than half of all first-day deaths in the industrialized world occur.

India and South Asia

Further over three lakh newborns in India die within 24 hours of their birth every year – the highest number in the world. With a total of 3,09,000 babies hardly surviving a day, India tops the list for such deaths. The country accounts for 29 per cent of all such deaths — ahead even of Nigeria, Pakistan and China. 

Quoting Sample Registration Survey (SRS 2011) figures, the report says Madhya Pradesh has the highest burden of early newborn deaths (0-7 days) at 32, followed closely by Uttar Pradesh and Odisha (30). Other States with high burden are Rajasthan, Chhattisgarh, Bihar, Jharkhand and Jammu & Kashmir. Kerala is the leader in reducing neonatal mortality by a wide margin, while Tamil Nadu, Delhi and Maharashtra too have improved the national rate.

The report also claims that 4,20,000 babies across South Asia die on their first day – almost one every minute. According to the report, of the one million babies who die each year on the day they are born, almost 40 per cent are in India, Pakistan and Bangladesh. Chronic malnourishment which leads to mental or physical impairment or ‘stunting’ is particularly severe in the region.

Bangladesh has reduced newborn mortality by 49 per cent since 1990. Community health workers reaching mothers and babies at home, and training birth attendants and medical staff in resuscitation devices to help babies breathe are factors in this progress. Nepal has reduced mortality by 47 per cent since 1990.

In South Asia, there are striking differences among countries in the case of maternal risk to life. In Afghanistan, a mother has a one in 32 risk of maternal death, in India it is 1 in 170, and in Nepal one in 190. The top five countries in the South Asian mothers’ ranking are: Maldives, Sri Lanka and Bhutan. The bottoms five are (in descending order) Pakistan, India and Afghanistan.

Nigeria has 89,700 deaths in this category, followed by Pakistan (59,800), China (50,600), Congo (48,400), Ethiopia (28,800), Bangladesh (28,100), Indonesia (23,400), Afghanistan (18,000) and Tanzania (17,000).