As the mother of two teenagers, my greatest concern tonight is what to put on the dinner table, chicken or fish, pasta or pizza? A world away, in Ethiopiaâ€™s Amhara region, 32 year old Alemeneshe, pictured here breastfeeding her one year old son Ayalres, has far graver things to worry about. One in ten children die before their fifth birthday in Ethiopia, many from preventable diseases. Malnutrition is an underlying factor in at least half of those deaths. Globally, malnutrition claims more than 2.6 million young lives each year according to Save the Children, and at least 171 million children are chronically malnourished.
Save the Childrenâ€™s thirteenth annual State of the Worldâ€™s Mothers report, released earlier this week in anticipation of Motherâ€™s Day, serves as the latest marker of the staggering chasm between rich and poor, between industrialized nations and the developing world. Save the Childrenâ€™s annual index takes measure of conditions including health, education, and economic status for mothers in 165 countries. It looks, too, at critical indicators such as childhood nutrition, since of course, a motherâ€™s well being is inextricably interlinked with that of her child.
â€œNo matter how you look at it, much more needs to be done to support mothers around the world,â€ said Carolyn Miles, president and CEO of Save the Children. â€œToo many countries fail to provide moms with the knowledge, support and tools they need to raise healthy and prosperous children.â€
Norway at the top, Niger at the bottom
That being said, the best place in the world to be a mother this year is Norway, just ahead of Iceland and Sweden. The worst? Niger, which drops down one notch this year to replace Afghanistan. But hereâ€™s what really takes my breath away: that â€œat this rate, every mother in Niger is likely to suffer the loss of a childâ€ according to the report. Every mother the loss of a child? Thatâ€™s an astonishing statistic, especially given the wealth and resources of other nations.
â€œThe contrast between the top-ranked country, Norway, and the lowest-ranked country, Niger, is striking,â€ the report points out. â€œSkilled health personnel are present at virtually every birth in Norway, while only 1 in 3 births are attended in Niger.â€
And when you consider these statistics and the chasm only deepens:
A typical Norwegian girl can expect to receive 18 years of formal education and will live to be over 83 years old.
82% of women are using some modern method of contraception.
Only 1 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% of women are using modern contraception.
1 child in 7 dies before his or her fifth birthday.
And the U.S.?
So how does the U.S. fare? Not so well, actually. At number 25, up six notches from last year, and sitting in between Belarus and the Czech Republic, weâ€™re far behind many industrialized countries. Out of the 43 developed nations in the index, we rank 41st in child mortality.
â€œA woman in the U.S. is more than seven times as likely to die of a pregnancy-related cause in her lifetime than a woman in Italy or Ireland,â€ Miles said. â€œWhen it comes to the number of children enrolled in preschools or the political status of women, the United States also places in the bottom 10 countries of the developed world.â€
Weâ€™re pitifully behind in offering new mothers the crucial supports they need and which come as second nature by now almost everywhere else. As the report notes, we are the only developed country that does not guarantee paid leave for working mothers. The Family and Medical Leave Act, enacted two decades ago guarantees new moms in the U.S. a paltry twelve weeks of unpaid leave. Compare that to Norway where mothers can take up to 36 weeks off work with 100% of their pay, or 46 weeks with 80% pay.
Another area of weakness: the percentage of mothers who breastfeed. Save the Childrenâ€™s â€œbreastfeeding scorecardâ€, which is part of the index, ranks the U.S. as â€œpoor,â€ again behind almost every other developed country. New mothers in this country sometimes just canâ€™t afford the time to breast feed their babies because they canâ€™t afford to take full 12 weeks of unpaid leave. Oftentimes their work environments are not open to breastfeeding. In Norway on the other hand, when mothers return to work, they have the right to take nursing breaks whenever they need them.
Whether or not a mother can breastfeed her baby has implications that reach beyond the crucial bonding time of the first few moths of life. Nutrition is a critical factor not only for raising healthy babies, but for longterm health and productivity.
A focus on nutrition
Save the Childrenâ€™s report focuses this year on the devastating impact of chronic malnutrition around the globe. Nearly one-third of all children in the bottom ten countries suffer from malnutrition, according to the report, and malnutrition kills as many 100,000 mothers every year. Seven of the ten countries at the bottom of the list are in sub-Saharan African and in the midst of a food crisis. The situation in Niger is worsening, threatening the lives of a million children. The vicious cycle caused by malnutrition has devastating effects. Young mothers who may themselves be malnourished can give birth to underweight babies who may not have been properly nourished in the womb, leading to a new generation of children who suffer both the physical and mental effects of stunted growth.
â€œThe Lifesaving Sixâ€
So what is it going to take to break the cycle? The State of the Worldâ€™s Mothers report identifies a set of six nutrition interventions that can be lifesaving. They include breastfeeding, complementary feeding, zinc, iron folate, vitamin A, and good hygiene. Save the Children found that simply supporting mothers to breastfeed can make a palpable difference.
â€œOur research shows that a motherâ€™s breast milk â€“ one single nutrition intervention â€“ can save a million childrenâ€™s lives each year,â€ said Miles. â€œAll mothers should have the support they need to choose to breastfeed if they want to. Breastfeeding is good for babies no matter where they live, but in developing countries, especially those without access to clean water, breastfeeding can be a matter of life or death.â€
The report also outlines recommendations to address the issues surrounding malnutrition including investing in more frontline health workers, helping more girls go to school and stay in school, and increasing government support for proven solutions.
Make nutrition global priority
Last year my Motherâ€™s Day wish for the year was for fewer mothers to die, for more mothers get prenatal health care, and for more girls to have an opportunity to go to school. Afghanistan, which climbed the ladder one up from dead last is a good example of that progress. Still baby steps but progress nonetheless.
So this year, my hope is that world leaders make nutrition a priority. Adequate nutrition plays a key role in preventing a multitude of unnecessary deaths. Itâ€™s aIso a basic human right. A little over a week from now, world leaders will gather at Camp David for the G8 Summit. The Save the Children report calls for action to tackle the cycle of maternal and child malnutrition.
â€œThe 2012 State of the Worldâ€™s Mothers report shows clearly that this crisis of chronic malnutrition has devastating effects on both mothers and their children,â€ said Miles. â€œWe urgently need global leadership on the malnutrition issue, so that policies and programs are put in place to ensure the health and survival of mothers and their babies.â€
On this Motherâ€™s Day, Iâ€™ll be thinking about Alemeneshe and the countless other mothers who donâ€™t have the same luxuries as some of us do in the developed world. Maternal and child malnutrition and death is an ongoing crisis, but itâ€™s not unstoppable. The statistics speak for themselves. But will the leaders of the G8 listen?
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photo credit: Save the Children