Save the Children Once Ranked Congo the Worst Place on Earth to Be a Mother

In May 2013, Save the Children released its annual “State of the World’s Mothers” report, ranking 176 countries on where mothers and children fare best, and the Democratic Republic of the Congo came in last. The index did not rely on a single figure. It combined maternal health, child mortality, women’s education, income and political representation into one comparative score, and on nearly every measure the DRC sat at or near the bottom.

The maternal health figure drove most of the attention: a woman or girl in the DRC faced a one-in-30 lifetime risk of dying from causes related to pregnancy or childbirth, according to the report. Save the Children set that number against Finland, which topped the index that year, where the equivalent lifetime risk was one in 12,200. The gap illustrated by that comparison, a Congolese woman facing odds of maternal death several hundred times steeper than a Finnish one, was the starkest single figure in the report.

The other measures behind the DRC’s last-place finish painted a similarly bleak picture. Save the Children calculated the country’s gross national income per capita at $190, among the lowest of any nation surveyed, and found women held just 8.3% of seats in the national legislature. Average years of formal schooling for Congolese women stood at roughly eight and a half, another figure the index weighed against far higher averages in the top-ranked countries. Save the Children’s index used different criteria than the United Nations’ own rankings, factoring in political and economic status alongside health outcomes, but the DRC’s position at the very bottom of the list held up regardless of which measure was emphasized.

The report followed years of conflict in the eastern DRC that had devastated health infrastructure across large parts of the country, leaving pregnant women in many regions without reliable access to trained birth attendants or emergency obstetric care. The 2013 ranking of the DRC as the world’s hardest place to be a mother remains one of the most cited data points in advocacy campaigns for Congolese maternal health to this day.