Ugandan women are more likely to die in pregnancy and childbirth than those in Rwanda and Kenya, a new report claims. The Urban Disadvantage, which was released on May 5, is the 16th annual report released by Save the Children.
It evaluates the devastating health disparities between the rich and poor living in major urban hubs around the world and highlights a number of capital cities in developing countries making significant survival gains for the poorest mothers and children.
The five indicators evaluated in 179 countries are: the lifetime risk of maternal death; children’s well-being as measured by their under-five mortality rate; educational status as measured by children’s expected years of formal schooling; economic status as measured by gross national income per capita; and political status measured by women’s participation in national government.
The report found that one in 44 women risk dying during childbirth in Uganda compared to one in 66 in Rwanda and one in 53 in Kenya. Of the 179 countries ranked in terms of maternal health performance, Uganda took the 141st position. This is a decline from last year where Uganda came 133rd out of 178 countries.
“Despite improved efforts at recruitment and deployment, some of the health facilities do not have some of the key health workers such as anesthetists and doctors. Distributional disparities still adversely affect the quality of reproductive health services,” said Dr Jane Ruth Aceng, the director general of health services in the ministry of Health in an earlier interview.
Additionally, the 2014 annual health sector performance report shows that the percentage of deliveries in health facilities is still unacceptably low while the percentage of pregnant women attending at least four antenatal care sessions is only 32 per cent.
The Scandinavian countries of Norway, Finland, Iceland, Denmark and Sweden top the list for the best place to be a mother. Somalia, Democratic Republic of Congo, Central African Republic, Mali and Niger are the worst places for mothers. In war-torn Somalia, one woman in 18 will die in childbirth while in Niger it’s one in 20.
However, the report says that in Kampala under-five mortality declined at an average rate of seven per cent within six years, from 94 deaths per 1,000 live births in 2006 to 65 in 2011. This is one of the sharpest declines seen among the 50 cities surveyed, and the fastest seen in any African capital city.
“The evidence suggests Kampala has achieved relative success in narrowing the child survival gap between the urban rich and poor. The key to success has been in making healthcare more accessible and affordable to the poorest urban families and helping to provide life-saving interventions for many such as immunization, vitamin supplements, safe drinking water, and prenatal check-ups,” said Dr Sarah Naikoba, health advisor, Save the Children-Uganda.
Other cities which showed progress in saving children’s lives include Addis Ababa (Ethiopia); Guatemala City (Guatemala); Manila (Philippines); Phnom Penh (Cambodia); and Cairo (Egypt). In much of the world, the odds of children surviving to celebrate their fifth birthday have improved considerably in recent years.
“Today, 17,000 fewer children die every day than in 1990 and the global under-five mortality rate has been cut nearly in half, from 90 to 46 deaths per 1,000 live births, between 1990 and 2013,” the report reads in part. But beneath remarkable improvements in national averages, inequality is worsening in far too many places, it adds.