NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Tuesday, May 5, 2015

Less than six miles separate the crowded public hospital in an industrial district where Emilie Kabala gave birth from the gleaming private clinic in the tree-lined suburb where Rose Rogers had her baby. But in many ways, their daughters were born into different universes.

Ms. Kabala, a Congolese immigrant, spent much of her pregnancy waiting in line at the city’s overstrained public clinics. Ms. Rogers, a TV producer, consulted with midwives and attended prenatal classes that advised on breastfeeding techniques and brands of baby monitors.

Kabala had eight hours after she gave birth to Bernice to vacate her bed in a delivery room crowded with nearly two-dozen other expectant mothers. Rogers and Isabella stayed two days in a private suite. When Bernice fell ill, her mother had to choose between paying rent and buying medicines. When Isabella developed bronchitis, she quickly got appointments with pediatricians and physiotherapists.

Over the past two and a half decades, maternal healthcare around the world has made breathtaking strides: Deaths linked to pregnancy and childbirth are down by 45 percent globally, and the number of young child deaths have been cut in half. But as the overall health of mothers and babies globally has improved in leaps and bounds, a massive gap looms in coverage between the rich and the poor — particularly in the cities of the developing world, according to a report released Monday by Save the Children.

South Africa, with its historically high rates of inequality, offers proof of that divide. Each year, 75,000 children under the age of five die, with nearly two-thirds tied to preventable failures within the public health system, according to UNICEF.

“People around the world come to urban areas because of the opportunities they offer, but in many places there’s a devastating divide between haves and have-nots in the healthcare they are able to access once they arrive,” says Robert Clay, Save the Children’s vice president for health and nutrition. “In many ways, it’s become the survival of the richest.”