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Concern over UK maternal death rates

UK fails to make top ten countries for best maternal health

Mark Gould

Tuesday, 05 May 2015

Women in the UK are more than twice as likely to die during pregnancy and in childbirth than those in Poland, Austria or Belarus, according to a new report.

Save the Children's annual report, State of the World's Mothers 2015: The Urban Disadvantage, this year focusses on the health and survival of urban children, and reveals that the UK is lagging behind several other European nations in terms of maternal death rates.

Women in the UK face a one in 6,900 lifetime risk of maternal death; compared with Poland the rate was much lower at 19,800. In Austria it was 19,200 and 45,200 in Belarus. For the third year in a row the UK has failed to make the top 10 safest nations in in the annual report. The UK was ranked 24th, up from 26th last year.

The latest report, the 16th to be produced, reveals that a child born in the UK is more than twice as likely to die before the age of five than a child born in Luxembourg or Iceland. The UK has a child mortality rate of 4.6 per 1,000 live births compared with 2.1 in Iceland and 2 per 1,000 in Luxembourg. Obesity, IVF, social deprivation and multiple pregnancies as increased maternal age and poorer access to healthcare, especially for some ethnic communities and among asylum seekers, were cited as reasons for the UK's poor performance.

However, the bulk of the report focuses on a "devastating child survival divide between the haves and have-nots", according to Carolyn Miles, president and CEO of Save the Children, who added that "for babies born in the big city, it's survival of the richest".

The report reveals that one-third of all urban residents in the world—including hundreds of millions of mothers and children— live in slums, where a lack of clean water, basic sanitation and health services can equal death.

Yet, Save the Children says average national and urban child survival statistics tell a deceptively positive story. They show that in developing nations children living in big cities are surviving at higher rates than those living in smaller towns or rural areas. But these numbers mask the fact that a child's survival in the city too often is dependent on the family's wealth.

The report reveals that in two-thirds of the countries surveyed, the poorest urban children are at least twice as likely to die as the richest urban children.

The disparity in child survival rates between the rich and poor in urban areas has widened over roughly the past two decades in nearly half of the 40 developing nations surveyed.

According to the report, in 60 per cent of developing nations surveyed, city children living in poverty are more likely to die than those living in rural areas.

The 10 countries with the greatest survival divide between wealthy and poor urban children are: Bangladesh, Cambodia, Ghana, Kenya, India, Madagascar, Nigeria, Peru, Rwanda and Vietnam. In these countries, children from poor families are 3 to 5 times as likely to die as children from wealthy families.

The gap between the health of the rich and poor is just as prevalent in big cities in some of the wealthiest nations:

In Washington DC for example, babies in the lowest income neighbourhood are more than 10 times more likely to die than babies in the wealthiest part of the city.

In a ranking of child survival in 25 capital cities in the wealthiest countries, Washington, DC came in last. Others capitals at the bottom of the list include: Vienna (Austria), Bern (Switzerland), Warsaw (Poland) and Athens (Greece).

Leading the list of capitals where babies are most likely to survive are: Prague (Czech Republic), Stockholm (Sweden), Oslo (Norway), Tokyo (Japan) and Lisbon (Portugal).

However, the report has also uncovered some good news. It has identified a number of cities that are making significant gains for the poorest children, including Addis Ababa (Ethiopia); Cairo (Egypt); Guatemala City (Guatemala); Kampala (Uganda); Manila (Philippines); and Phnom Penh (Cambodia). These cities are working to increase access to basic maternal, newborn, and child services; raise health awareness; and make care more affordable and accessible to the poorest urban families.

"The survival of millions of children in cities should not be a privilege for the rich, but guaranteed for all," said Miles. "We call on our leaders not to forget these mothers and children struggling to survive in the shadows of our bustling metropolises. We must invest in making quality health care more accessible and affordable to all moms and babies."

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