Q&A with Kathryn Bolles: Best Places to be a Mother

Frances Alonzo
May 26,2014

The 15th annual issue of State of the World's Mothers report by Save the Children focuses on saving mothers and children whose lives are at risk in times of crisis. Of the over 150 countries reviewed, Singapore at number 15 ranks as the top country in Asia to be a mother. Kathryn Bolles, the Senior Director for Health and Nutrition for Save the Children, tells VOA's Frances Alonzo that there is quite a disparity in the region among Asian countries.

BOLLES: We looked at 178 countries, looking at the best places in the world to be a mom and the toughest places. And so when we look at Asia, we see that Singapore tops the list and is actually ranked 15^th in the overall ranking. Falling at the bottom of the list in Asia we have Papua New Guinea, Pakistan, Myanmar, and North Korea.

One thing that is important to recognize too, is [that] there are disparities within countries. And so we might see in a country like India, for example, some areas that are doing quite well. But then there are pockets that are underperforming, meaning there’s not as much access to quality health care for all mothers and children in some parts versus others. So even though we speak about national rankings, we also want to recognize there are real differences in one section or one ethnic group from another.

ALONZO: You list Singapore, South Korea, Japan and China among the top five Asian countries as being the better places to be a mother. What are those countries doing that have them at the top of the list for Asia?

BOLLES: There are a few countries in Asia that have made incredible advances over the last few years. And some are actually surprising: Bangladesh, Afghanistan, Nepal. Some of the countries who are going through significant conflict and have incredible challenges that they have faced over the last few years that have also been doing quite well. An example of that is Afghanistan, actually Bangladesh as well, over the last few years [they] have cut their maternal death rates in half, and in fact, in Afghanistan, by two-thirds. China has cut their maternal mortality rate almost in half. And so what that means is that these countries are making investments in quality health care, and not just for some mothers and children, but setting policy that allows all women and children to have more access to care.

I highlight Afghanistan in particular as a country that despite being in an humanitarian crisis, which is the focus of this year’s report, Afghanistan has made significant investments that have saved lives, like changing policies in girls education, like training and deploying midwives so that moms around the country - even if they can’t get to a healthcare facility - can deliver their babies with a skilled attendant.

ALONZO: What is it that Singapore, South Korea, Japan and China doing that is really putting them at the top of the list?

BOLLES: Singapore, China, Bangladesh, Japan, Nepal - these are examples of countries that have made particular investments in women focused policies. They have more women in political power, more women are representatives at a national level, and more women are educated. So, these are some of the indicators. The reason we looked at these kinds of indicators in the report is because these really do showcase a story to tell about the health and well-being of a mother and her family. More women that are educated, more ability to make decisions at a local and a national level, greater investment in health of a woman and a child and greater household economic status; all of those are investments that Singapore and China, and some of the higher ranking countries in Asia have made. And we see that’s what places them at the top of the list.

ALONZO: Has there been an Asian country that just slowly, slowly, year after year, incrementally improving the situation for mothers?

BOLLES: Nepal would be the example I would choose of a country that has over the last decade, as you say, incrementally made changes beginning at the local level and then resulting in national level policy change that has shown how investments save lives. Nepal began to employ some of these very simple solutions. And when I say simple, I’m talking about wrapping and warming a baby, and training women volunteers to talk to mothers about how to prevent illness and death in their babies.

And over the years, we have seen changes such that the Nepali government said this needs to be policy. We need to have this practiced all over our country. And in fact, other countries are starting to look to Nepal for those kinds of answers. So, infant mortality has declined significantly. And Nepal really tells the story of that. And I think that when we look at it, even with a country that doesn’t have a lot of resources available, some of these solutions are incredibly simple and low cost. But having the highest levels of government support them, require them is what’s saving lives.