WASHINGTON — Afghanistan is the worst place in the world to be a mother and Norway is the best, an annual report released Tuesday said.
"Afghanistan has the highest lifetime risk of maternal mortality and the lowest female life expectancy in the world," putting it at the bottom of the the Mothers' Index, which has been compiled for the past 12 years by the nonprofit group Save the Children.
In Afghanistan and the nine other countries at the bottom of the index, an average of one in six kids dies before age five and one in three suffers from malnutrition, the report says.
Nearly half the population in the worst countries to raise kids lacks access to clean water, and only four girls for every five boys are enrolled in primary school.
Access to clean water is not only essential to good health but also promotes gender equity, especially in rural areas where women and young girls spend considerable time collecting water, the report says.
Eight out of the 10 bottom-ranked countries in the index are in sub-Saharan Africa. From worst to less bad after Afghanistan they are, in order, Niger, Guinea-Bissau, Yemen, Chad, Democratic Republic of Congo, Eritrea, Mali, Sudan and the Central African Republic.
Five Nordic nations and two in the southern hemisphere made up the top seven countries for mothers.
They were, in order, Norway, Australia, Iceland, Sweden, Denmark, New Zealand and Finland.
Three European nations -- Belgium, the Netherlands and France -- rounded out the top 10.
Save the Children researchers documented conditions for mothers and children in 164 countries: 43 developed nations and 121 in the developing world, which was broken down into 79 "less developed" and 42 "least developed" nations.
Cuba topped the list of "less developed" countries, ahead of Israel, Cyprus, Argentina, Barbados, South Korea, Uruguay, Kazakhstan, Mongolia and the Bahamas.
A gulf of differences, especially in health, separates top-ranked Norway from bottom-of-the-heap Afghanistan.
In Norway "skilled health personnel are present at virtually every birth," greatly reducing the likelihood of the mother or baby dying, while in Afghanistan, only 14 percent of births are attended, the report says.
The average life expectancy for a Norwegian woman is 83 years; in Afghanistan, it is 45.
More than eight in 10 Norwegian women use a modern form of contraception, and only one in 175 lose a child before his or her fifth birthday.
In Afghanistan, meanwhile, less than one in six women use modern contraception, and one child in five dies before reaching the age of five.
"At this rate, every mother in Afghanistan is likely to suffer the loss of a child," the report says.
Germany, Spain and Britain ranked 11th to 13th among developed countries, while the United States was 31st, just above Luxembourg and Belarus.
The overall score of the United States was dragged down by factors including high child and maternal mortality rates.
"A woman in the US is more than seven times as likely as a woman in Italy or Ireland to die from pregnancy-related causes and her risk of maternal death is 15-fold that of a woman in Greece," the report says.
Forty countries had lower rates of child mortality than the United States, where eight children per 1,000 die before reaching the age of five years.
That means that an American child is twice as likely as a child in Finland, Greece, Iceland, Japan, Luxembourg, Norway, Slovenia, Singapore or Sweden to die before reaching age five, the report says.
Save the Children calls in the report on governments around the world, including in developed nations, to improve education, access to health care and economic opportunities for women and girls.
Cutting global maternal and child mortality rates is one of eight Millennium Development Goals set by the United Nations in 2000 to slash poverty and improve health.
Although bringing down deaths among women and children is seen as key in achieving the other UN development goals by the deadline of 2015, the goal for women and children's health is the one on which the least progress has been made, UN officials say.