Chad and Somalia are the worst countries in the world for a child to fall sick while Switzerland and Finland rank as the best, according to a new index of health worker provision devised by the global health charity Save the Children.
The analysis shows that children living in the bottom 20 countries - where there are only just over two health workers for every thousand people - are five times more likely to die than those further up the index.
The study also highlights countries such as Ethiopia, Nigeria and Sierra Leone where millions of children's lives are at risk due to a lack of trained health workers.
Justin Forsyth, Save the Children's chief executive, said the findings were disturbing.
World leaders should tackle issue
"A child's survival depends on where he or she is born in the world. No mother should have to watch helplessly as her child grows sick and dies, simply because there is no one trained to help," he said. "World leaders must tackle the health worker shortage and realise that failing to invest in health workers will cost lives."
The index measures how many health workers there are, as well as their reach and impact. It also tracks the proportion of children who receive regular vaccinations and mothers who have access to life-saving emergency care at birth.
The analysis found that children living in the most remote areas are least likely to see a health worker. In Ethiopia, for example, just under 70% of women say that a clinic is too far away, while in Sierra Leone, Uganda and Niger more than half of all women surveyed said the health clinic is just too far for them to reach.
The index was published ahead of a United Nations high level summit designed to outline a global action plan on chronic diseases such as cancer, heart disease, diabetes and lung disorders.
Global shortage of healthcare workers
Save the Children urged leaders to focus their efforts on addressing a global shortage of more than 3.5 million doctors, nurses, midwives and community health workers.
"Without them no vaccine can be administered, no life-saving drugs prescribed and no woman can be given expert care during her childbirth. Illnesses such as pneumonia and diarrhoea, which are easily treated, become deadly," the charity said.
The top 20 and bottom 20 countries in the index were:
Bottom 20 COUNTRY RANK Madagascar 142 Bangladesh 143 Sierra Leone 144 Uganda 145 Liberia 146 Afghanistan 147 Guinea-Bissau 148 Papua New Guinea 149 Yemen 150 Nepal 151 Guinea 152 Niger 153 Timor-Leste 154 Equatorial Guinea 155 Cen. African Rep. 156 Nigeria 157 Ethiopia 158 Lao P.D.R 159 Somalia 160 Chad 161
Top 20 COUNTRY RANK Switzerland 1 Finland 2 Ireland 3 Norway 4 Belarus 5 Denmark 6 Sweden 7 Cuba 8 Uzbekistan 9 Germany 10 Russian Federation 11 France 12 Czech Republic 13 United Kingdom 14 United States 15 Kazakhstan 16 Australia 17 New Zealand 18 Lithuania 19 Qatar 20. - (Reuters, September 2011)
Immunisations keep kids safe
Ask the paediatrician