Putting women and children first
You’ll feel rage but not despair, and be astonished but not surprised on reading State of the World’s Mothers 2010, the latest annual report from NGO Save the Children, with its country rankings of the health, education and economic situation of mothers, women and children, and the stories behind the statistics.
Rage at figures like these: every year 8.8 million children die before reaching age 5 and 343,000 women lose their lives due to pregnancy or childbirth complications. Practically all of these deaths occur in the developing world, where 50 million women give birth at home each year with no professional help.
Rage at families denying women and children care, even when it is available. Often, it’s because men don’t want another man to examine a female patient. Often it’s due to ignorance. An Egyptian woman tells how her mother-in-law refused to let her go to hospital because severe bleeding after childbirth was “normal”.
Egypt is one of several countries where the birth of a child isn’t celebrated immediately. Ceremonies like Egypt’s el sebou’, practiced by Muslims and Christians alike, recognise a grim truth: many babies do not live very long. The first four weeks of life are the most dangerous, accounting for 41% of infant deaths.
Despite the depressing situation (57 countries have “critical shortages” of health workers, 36 of them in Africa) there’s optimism too. What astonished me is the way terms and ideas I’ve encountered so often that they’ve become meaningless suddenly become real again. Here for instance: “Increased investments in girls’ education are essential… to empower future mothers to be stronger and wiser advocates for their own health and the health of their children.”
Concretely, this is because educated girls tend to marry later and have fewer, healthier and better-nourished children. Mothers with little or no education are much less likely to receive skilled support during pregnancy and childbirth, and both they and their babies are at higher risk of death. They are also more likely to respect harmful traditional practices such as delaying breastfeeding for up to 24 hours after giving birth.
Relatively minor investments pay huge dividends – “leverage” as we’d say here at the OECD. In Bangladesh for instance, female community health workers with limited formal education and only 6 weeks of hands-on training contributed to a 34% reduction in newborn mortality. Women with a few years of formal schooling can master the skills needed to diagnose and treat common early childhood illnesses, mobilise demand for vaccinations, and promote improved nutrition, safe motherhood and essential newborn care.
Some of the techniques are incredibly simple, low tech and low cost, or even no-cost, as when mothers of underweight, preterm babies are taught “kangaroo care”. The mothers serve as human incubators, keeping their babies next to their skin for warmth, and encouraging them to breastfeed frequently. A review of 15 studies in developing countries found kangaroo care was more effective than incubator care, cutting newborn deaths by 51% for preterm babies who were stable. Up to half a million newborns could be saved each year if kangaroo care were used everywhere.
Finally, as you’d expect, the Scandinavian countries top the rankings, along with Australia and New Zealand. At the other end of the scale, every mother in Afghanistan is likely to lose at least one child.
The OECD Education Directorate conference on the economic crisis and early childhood education and care is here.
The OECD Family Database provides data on “family outcomes and family policies” with over 50 indicators for all OECD countries on everything from breastfeeding to participation in elections.
Doing Better for Children looks at the state of child wellbeing in OECD countries.
Gender Aid at a Glance provides statistics on Official Development Assistance focused on gender equality and women’s empowerment
educationtoday OECD’s “education lighthouse for the way out of the crisis”.
Wikigender is designed to help participants “share and exchange information and best practices on gender equality”
The article on kangaroo care is published in the April 2010 issue of the International Journal of Epidemiology. This issue is on “Development and use of the Lives Saved Tool (LiST): a model to estimate the impact of scaling up proven interventions on maternal, neonatal and child mortality”.