Sub-Saharan Africa is by far the riskiest region to be born. The 14 countries with the highest first-day risk rates are in sub-Saharan Africa. As a region, sub-Saharan Africa's first-day mortality rate is 12 per 1,000 live births. Poor health among African mothers contributes to high rates of first-day death for babies. Serious maternal undernutrition is common in the region, where 10-20 percent of women are underweight. Especially large numbers of underweight mothers are found in Ethiopia (24 percent), Madagascar (28 percent)and Eritrea (38 percent).Across the region, less than 16 percent of women use a modern method of contraception. Contraceptive use is lowest in Somalia (1 percent) and Chad (2 percent). Mothers in Malawi, Mali, Somalia and Zambia have six children on average. Niger has the highest fertility rate in the world at nearly seven children per woman.
On average, only half the women in the region received skilled health care during birth. In Ethiopia, Niger and South Sudan, more than half of all women receive absolutely no skilled prenatal care. The most severe shortages of health workers are found in Guinea, Niger, Sierra Leone and Somalia, where there are fewer than two skilled health workers for every 10,000 people.
The lowest ranked country globally for first-day mortality rate per 1,000 live births is Somalia at 18 followed by the DRC, Mali, and Sierra Leone at 17, Central African Republic at 16, Angola, Cote d'Ivoire, Chad, Burundi and Guinea-Bissau at 15.
Other countries in East Africa and the Horn ranked as follows. Djibouti had a first-day mortality rate of 12 per 1,000 live births. Ethiopia and Sudan had 11. Uganda had 10. Tanzania and Kenya had 9 and Eritrea had 8.
