DAKAR, 4 May 2010 (IRIN) - Eight of the bottom 10-ranked countries in Save the Children's annual Mothers Index, which ranks the best and worst places to be a mother, are in sub-Saharan Africa, says the NGO.

Afghanistan, Niger, Chad, Guinea-Bissau, Yemen, Democratic Republic of Congo, Mali, Sudan, Eritrea and Equatorial Guinea form the bottom 10; while Norway, Australia, Iceland and Sweden come top.

One in seven women dies in pregnancy or childbirth in Niger and one in eight in Afghanistan and Sierra Leone; while the risk is one in 25,000 in Greece and one in 47,600 in Ireland.

"The problems around maternal and newborn health have been raised for many years, but there still remains so much to be done," Houleyemata Diarra, Save the Children's newborn health regional adviser for Africa, told IRIN from Mali. "There are not enough skilled attendants at births, and governments are not taking into account where health workers are needed - in communities."

Over half of deliveries take place at home in most sub-Saharan African countries, with no skilled birth attendant present, according to the UN Children's Fund.

Save the Children is calling on governments and donors to prioritize building up a workforce of female health workers to serve in their communities and local clinics.

These workers should be incentivized with better training, pay, and support for career growth, says the NGO.

It costs a lot to train a doctor or run a hospital, but the cost of giving community health workers basic training - to diagnose and treat common early childhood illnesses, organize vaccinations and promote good nutrition and newborn care - does not have to be exorbitant, says Save the Children.

In Bangladesh the NGO found that providing female community health-workers with six weeks of hands-on training and some formal education caused infant mortality rates in affected areas to drop by a third.

"There are a lot of models of this working well around the world," said Save the Children's Diarra. "African countries need to follow these examples."

Very interesting.