ISLAMABAD - Though Pakistan has halved maternal mortality, the state is the toughest place in South Asia to be a mother, says a Mothers' Index that documents conditions for mothers around the world.
Save the Children's annual State of World's Mothers Report 2014, now in its fifteenth edition, compares 178 countries around the globe, showing which are succeeding - and which are failing - in saving and improving the lives of mothers and their children.
Overall, Finland was ranked the best place to be a mother for the second straight year and Somalia came in last. Finland, Norway and Sweden top the ranking this year.
The top 10 countries, majority of them European countries, in general attain very high scores for mothers' and children's health, educational, economic and political status. While the 10 bottom-ranked countries-all but one of them from West and Central Africa- are a reverse image of the top 10 countries. The United States ranks 31st. Dr Qudsia Uzma, Director Health & Nutrition at Save the Children sharing key findings said, globally Pakistan ranks 147th out of total 178 countries while 20th out of 45 fragile states affected by conflicts and natural disasters.
Sri Lanka is the best place to be a mother in South Asia. While Pakistan performs the worst in the region as all neighboring countries score high leaving Pakistan at the bottom-Sri Lanka ranks 89th, Nepal 116th, Bangladesh 130th , India 137th and Afghanistan 146th.
This year's State of the World's Mothers report focuses on mothers in humanitarian crises in order to better understand and respond to their needs. Mothers in humanitarian crises are often faced with many obstacles to keep their children healthy - such as physical and economic access to essential services - while their own vulnerability to poverty, malnutrition, sexual violence, unplanned pregnancy and unassisted childbirth greatly increases.
'More than half (59 percent) of maternal and deaths worldwide occur in fragile states, many of them affected by conflict and recurring natural disasters. And Pakistan and Nigeria had the largest numbers of people affected by conflict-28 million and 19 million respectively'.
Worldwide, women and children are up to 14 times more likely to die in a disaster. Disasters affect states where poverty is an existing problem. The issues that result are further compounded by the lack of access and delivery to the health needs of the people, and failing to cater to these basic human needs becomes a cause and consequence of such disasters. Mortality risk is the highest; during labour, childbirth and the first week after delivery, says the report.
In Pakistan, maternal mortality has been cut by almost half, child mortality decreased by a quarter, expected years of schooling increased by 3.3 years and gross national income per capita rose 270 percent over the past 15 years. Pakistan has seen improvements on child and maternal well-being over the past 15 years, but conflicts and natural disasters have marginalised these improvements, said David Skinner, Country Director for Save the Children in Pakistan.
'We should be concerned that we have fallen behind our neighbours because we are not making improvements for mothers and children quickly enough. Many children are still dying from preventable causes, mothers are giving birth alone at home and children are not staying in school' the country Director said.
The report states that around 80 percent of countries are unlikely to achieve Millennium Development Goals of 4 and 5, related to reducing maternal and child mortality rates, are affected by conflict or natural disasters or both and Pakistan is one of them.
To protect mothers and children in the aftermath of disasters in Pakistan, the report calls upon the federal and provincial governments, and civil society to ensure that every mother and newborn living in crisis has access to high quality health care, including family planning services, and breastfeeding counseling.
It recommends building the resilience of health systems to minimise damaging effects of crises on health and develop national and local preparedness plans tailored to respond to the specific needs of mothers, children and babies in emergencies.