Thursday, May 5, 2011

The Best Place and Worst Place to be a Mum

According to a recent report, Australian mums are ranked number 2 in the world – second only to Norway out of 168 countries.

In the 2011 Mothers’ Index Rankings1, Australian mums scored high on key indicators such as health, education, economic and political status and children’s well-being. This should not be surprising in a country that provides universal health-care, free education and has a stable and growing economy. The story is the same for most developed, industrialised countries with the exception of the US - but that’s another story!

But what about countries that don’t have these same advantages? The 10 lowest ranking countries are in a reverse image of the top 10, performing poorly on all indicators. Conditions for mothers and their children in these countries are devastating.

  •  The Maternal Mortality Ratio (which measures the number of maternal deaths per 100,000 live births) is 1,200 per 100,000 live births compared to 8.4 per 100,000 live births in Australia2;
  • The Infant Mortality Ratio is 142 in 1,000 births compared to 4.7 per 1,000 in Australia2;
  • It is estimated that the proportion of births taking place in health facilities is just 9% with nearer to 100% in Australia2.

Improving maternal health is one of the 8 Millennium Development Goals adopted by the international community in 2000. Under MDG5, countries are committed to reducing maternal mortality by three quarters between 1990 and 2015.

Since 1990, maternal deaths worldwide have dropped but the rate of progress is far behind other MDG goals. For example, the global mortality ratio declined by only 2.3% per year, well below the annual decline of 5.5% required to achieve the MDG52.

Women in developing countries face many challenges but refugee and displaced women face even more. A fundamental right of any woman is to have control over her reproductive health and by extension to be able to give birth in a safe and clean environment.

A group of Somali women wait outside
a medical centre in Bossaso
So what can be done? The good news is that there are relatively simple interventions that can have a huge impact on the well being of mothers and their children.

Infection, which is a number one contributor to morbidity in both mothers and children after childbirth, can be eliminated if good hygiene is practiced and if early signs of infection are recognised and treated in a timely manner.

Complications such as preeclampsia (hypertension and high blood pressure) can be detected by trained birthing staff and managed before the onset of convulsions and other life threatening complications.

Severe bleeding after birth (which can kill a healthy woman within two hours if she is unattended) can be treated immediately after childbirth effectively reducing bleeding.

Australia for UNHCR’s Safe Mother and Baby Program, which we have implemented in Myanmar, Chad and now Somalia, aims to provide effective interventions to address each of these key areas effecting refugee and displaced women and their children.

The Somali project is being run at Galkayo Hospital in the Puntland region of Somalia. Galkayo is one of the few operational hospitals in all of Somalia. The Safe Mother and Baby Program is the only one of its kind being implemented across Somalia and it is one area where Australian donors are making a huge difference for the well being of mothers and their children.

Central to the program is the very simple but also very effective  Clean Delivery Kit – a plastic bag containing a clean razor blade, a plastic sheet, a swaddling cloth, soap and a piece of string. Each of these key items is designed to help a birthing mum and her helpers deliver a baby in clean and hygienic conditions. Where it has been introduced it has been able to significantly reduce mortality rates.

Australia for UNHCR is also funding the training of traditional birth attendants and community outreach workers to educate women about the need for regular check ups during pregnancy to avoid complications such as preeclampsia. It has also funded medical outpost clinics and mobile health clinics to provide early intervention and referrals when conditions first emerge.

In order to improve women’s access to hospitals – the safest place to give birth – Australia for UNHCR is raising funds to provide two ambulances, upgraded facilities and equipment in the Galkayo hospital and salaries for trained Doctors and midwives.

Issues around the situation of refugees and displaced people can sometimes appear insurmountable. The Safe Mother and Baby Program which has at its heart the Clean Delivery Kit is an example that big problems sometimes do have simple solutions.

Naomi Steer

Visit to find out more about UNHCR Programs. To show your support for refugee women this Mother’s Day go to

1. Save the Children “State of the World’s Mothers”, 2011
2. WHO Publication Maternal Mortality Fact Sheet 348, November 2010.