Maldives ranks 45th best place to be a mother among developing nations

Maldives has been ranked as the 45th best place to be a  mother among 80 developing nations compared in international NGO Save the Children’s 13th State of the World’s Mothers report.

The ranking includes 165 countries split into three categories – 43 more developed  countries , 80 less developed countries and 42 least developed countries.

Norway is ranked first, ahead of Iceland and Sweden, while Niger is the worst place to be a mother in the world – replacing Afghanistan for the first time in two years.

The Maldives landed first out of  42 countries listed in the ‘least developed’ tier of the 2011 mother’s index rankings.

However, with the transition to a less developed country status from January 2011, the Maldives was placed in the second tier in 2012, which looked at 80 developing countries across the globe, out of which the island nation ranked 45th.

That puts Maldives three points below the neighboring Sri Lanka but far ahead of India, Pakistan and several other Islamic nations in the Middle East.

“More than 90 years of experience on the ground has shown us that when mothers have health care, education and economic opportunity, both they and their children have the best chance to survive and thrive,” said President and CEO of Save the Children USA, Carolyn Miles, in the report.”But many are not so fortunate.”

“Alarming numbers of mothers and children in developing countries are not getting the nutrition they need. For mothers, this means less strength and energy for the vitally important activities of daily life. It also means increased risk of death or giving birth to a pre-term, underweight or malnourished infant,” Miles observed.

She added: “For young children, poor nutrition in the early years often means irreversible damage to bodies and minds during the time when both are developing rapidly. And for 2.6 million children each year, hunger kills, with malnutrition leading to death.”

Maldives achievements

The 45th ranking was derived from the Maldives’ performance in the factors or areas measured for the State of the World’s Mothers report, including the mother’s health, education and economic status, as well as critical child indicators such as health, mortality rate and nutrition.

The statistics included in the report shows that in the past six years the Maldives with a population of approximately 350,000 has achieved notable success in improving the maternal health, thus achieving the goal 5 of Millennium Development Goals.

According the report, lifetime risk of maternal deaths in Maldives has been significantly reduced to 1 per 1200 and females have a life expectancy of 77 years while under-five mortality rate dramatically declined to 15 per 1000, compared to 41 per 1000 in 1990, as the country’s 95 percent of births are attended  by a skilled health worker.

Almost 95 percent of the population has access to safe drinking water and the school enrollment ratio remains significantly high, the report adds.

Maldives Health Statistics Report 2011 concluded: “Overall it can be said that the trends show improvement in the health and wellbeing of people in the Maldives”.

These successes were attributed to the effective immunisation programs, and improved accessibility of health services across the islands.

“Consistent improvements in quality of services are crucial to sustain these developments and further the achievement” the report read.

Challenges

Predictably, the statistics revealed that the Maldives needs to improve on areas of reproductive health with increasedaccess to contraceptives, economic and political participation of women and dietary needs of children –  issues highlighted by the stake holders in various platforms.

• Malnutritution: Minivan News reported in April about the increasing concern among the health experts as malnutrition in the country remains “quite alarming” considering the number of medical advances made in the country over the last few years. According to figures published in 2009 by the World Health Organisation (WHO), 17.8 percent of children under five years of age were found to be underweight in the Maldives according to international standards for ascertaining health in young people. The same figures found that 6.5 percent of children were classed as overweight in the country. 20.3 percent of children in the same age group were found to be suffering from ’stunting’, a term describing children suffering growth retardation as a result of poor diet and infection

• Economic and Political Participation: Gender inequality is one of the social determinants at the heart of inequity in health, so progress in  equal participation of women is crucial. However, with the Maldives’ Islamic background, the society prescribes predominantly domestic and traditional roles for women, while men take the role of breadwinner.According to the ‘Household Income and Expenditure Survey 2009-2010′, out of the 38,493 people unemployed in 2010, 63 percent were women, almost double the male rate of unemployment. Meanwhile in the political sphere, women’s representation is significantly low with only 57 out of 1091 are island level councilor seats filled by women and 5 out of 77 Parliament members as women.

  “The absence of childcare facilities make it difficult for women to remain employed after they have children. HRCM also received reports that some employers discouraging women from marriage or pregnancy, as it could result in employment termination or demotion,” the UNDP ‘s “Women in Public Life in the Maldives”report said.

  Restrictions on women’s mobility and reluctance from family members to allow women to travel alone to other islands for work were also identified as key obstacles to employment.

• Reproductive Health and Access to Contraception: Greater attention to improving sexual and reproductive health care and universal access to all its aspects are required to prevent unintended pregnancies and provide high- quality pregnancy and delivery care, according according to the UNFPA in the Maldives.However, there is social stigma surrounding the purchase of contraceptives and “talks” of sex several reproductive illnesses.

  Data suggests that contraceptive prevalence rate for modern methods declined from 34 per cent  in 2004 to 27 per cent in 2009, and the number of adolescent pregnancies has increased. Abortion is illegal, yet the number of women experiencing complications from unsafe abortions is reported to be increasing.

  “These complications, along with the high contraceptive discontinuation rate and the high unmet need for family planning, are jeopardising previous gains in maternal health. Policies and services do not adequately address the reproductive health needs,” UNFPA said in the country programme document (2011-2015) for Maldives.

  While Maldivian women aged 15-49 is expected to grow for the next 30 years, the Maldives needs a comprehensive program to create awareness and set up wider adequate reproductive and maternal health facilities and services.