Life is hardest for sub-Saharan Africa mothers - report

by Misha Hussain | | Thomson Reuters Foundation
Tuesday, 7 May 2013 15:38 GMT

Senegal blazes a trail in maternal health for its West African neighbours to follow. Fatick, Senegal, Misha Hussain, 11 March 2013

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Poverty and instability are major reasons for the plight of mothers in many sub-Saharan African countries, according to the latest survey of mothers' lot in nations rich and poor

(Corrects source of data in paragraph 13)

DAKAR, Senegal (Thomson Reuters Foundation) – Eight of the 10 worst nations in which to be a mother are in West and Central Africa, and the two others are also African countries, according to a new report by the international children’s charity Save the Children.

The Democratic Republic of Congo, Sierra Leone, Nigeria, Gambia and Burkina Faso all finished in the bottom 10 of the State of the World’s Mothers 2013 report , which ranks 176 countries on maternal and child mortality, women’s education, earnings and political representation.

“It is heartbreaking that so many of the worst performing nations are in sub-Saharan Africa. It all revolves around poverty and instability,” said Natasha Quist, Regional Director Save the Children for West and Central Africa.   

“The whole idea of the State of the Mothers Report is [to serve as] a reflection on the state of humanity in West and Central Africa,” she said.

The DRC was ranked worst country in the world to be a mother. Unlike neighbouring countries in the region that perform well in at least one indicator, the DRC fails to deliver across the board, the report, published on Tuesday, said.  

“We have old hospitals with little or no equipment, very low salaries for health workers as well as poor access to hospitals for expectant mothers. There’s no budget in the Ministry of Health,” Dr. Claude Sabwa in Mbuji-Mayi, about 1,000 km east of the capital Kinshasa, told Thomson Reuters Foundation.   

“The current conflict is also creating a lot of movement of people and with this comes the spread of infectious disease, in particular cholera, so we need to improve hygiene and sanitation,’ Sabwa said.  


Cape Verde and Senegal were placed 81st and 126th respectively, below some North African countries and South Africa, but blazing a trail for most other countries in the region to follow.   

Senegal invests six percent of its GNP in health care, and we need to see more of this kind of investment in low-cost opportunities, said Quist.   

“Access to steroids to make sure the baby’s weight is not too low, resuscitation equipment that allows babies to breathe once they’re born and sterilisation gels for the umbilical cord to prevent infection of mother or baby,” said Quist. “These are very simple and cheap ($0.30-$6) and can save millions of lives.” 

The report relies on previously published data by UN agencies as well as the latest Demographic Health Surveys (DHS), usually done every five to 10 years.

This can lead to inaccuracies as many countries have made significant improvements since the last available data was published.

Sierra Leone has worked very hard to increase contraceptive prevalence from six percent in 2008 (last DHS survey) to over 20 percent, according to a Marie Stopes International 2011 survey. This trend is expected to  reduce maternal and child mortality and raise the country’s position in the listings.

Data collection is notoriously difficult in this sector. In Bangladesh, the error margin for maternal mortality in the 2011 DHS is so wide that it can place Bangladesh as either the best or the worst performing country in South Asia, depending on which value is taken.    

“The story will not change massively in a country like DRC even if it [the data] is a little old. If you add in statistical errors, the story will remain the same,” said Quist.  


In East Asia and the Pacific, the region’s impressive economic growth has yet to translate into better wellbeing for all mothers and their children, the report said. Instead, inequality within countries is posing a continuing challenge to reducing maternal and newborn mortality and improving women’s education and political status.

The newborn mortality gap between rich and poor has widened, despite falling national rates. In Cambodia, the poorest fifth of the population has a newborn death risk 144 percent higher than that of the richest 20 percent.

Micronesia has no female nationally elected representatives, while Papua New Guineans can, on average, expect to complete less than six years of formal education, one of the lowest levels of educational achievement in the world.

Tory Clawson, Save the Children’s regional representative in Asia, said that while East Asia and the Pacific has made the most progress in reducing deaths of newborn babies by 65 percent since 1990, the size of the population means the absolute numbers are still high.

“For example, while Indonesia has made tremendous strides in the reduction of newborn deaths – reducing the death rate by 48 percent since 1990 – 66,000 newborns still die there each year,” she told Thomson Reuters Foundation.

Singapore, ranked 15, is above Western nations such as Canada (22), the United Kingdom (23) and the United States (30), while Nordic countries dominated the top of the table.

Elsewhere in the East Asia/Pacific region, several countries are languishing near the bottom of the rankings. Papua New Guinea came in at 158, Myanmar 152 and Solomon Islands and Micronesia joint 133.

Misha Hussain is West Africa correspondent for the Thomson Reuters Foundation

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