Targeted violence against female public officials, dismal healthcare and desperate poverty make Afghanistan the world's most dangerous country in which to be born a woman, according to a global survey released on Wednesday.
The Democratic Republic of the Congo (DRC), Pakistan, India and Somalia feature in descending order after Afghanistan in the list of the five worst states, the poll among gender experts shows.
The appearance of India, a country rapidly developing into an economic super-power, was unexpected. It is ranked as extremely hazardous because of the subcontinent's high level of female infanticide and sex trafficking.
Others were less surprised to be on the list. Informed about her country's inclusion, Somalia's women's minister, Maryan Qasim, responded: "I thought Somalia would be first on the list, not fifth."
The survey has been compiled by the Thomson Reuters Foundation to mark the launch of a website, TrustLaw Woman, aimed at providing free legal advice for women's groups around the world.
High maternal mortality rates, limited access to doctors and a "near total lack of economic rights" render Afghanistan such a threat to its female inhabitants. "Continuing conflict, Nato airstrikes and cultural practices combine to make Afghanistan a very dangerous place for women," said Antonella Notari, head of Women Change Makers, a group that supports women social entrepreneurs around the world.
"Women who do attempt to speak out or take on public roles that challenge ingrained gender stereotypes of what is acceptable for women to do or not, such as working as policewomen or news broadcasters, are often intimidated or killed."
The "staggering levels of sexual violence" in the lawless east of the DRC account for its second place in the list. One recent US study claimed that more than 400,000 women are raped there each year. The UN has called Congo the rape capital of the world.
"Rights activists say militia groups and soldiers target all ages, including girls as young as three and elderly women," the survey reports, "They are gang raped, raped with bayonets and some have guns shot into their vaginas."
Pakistan is ranked third on the basis of cultural, tribal and religious practices harmful to women. "These include acid attacks, child and forced marriage and punishment or retribution by stoning or other physical abuse," the poll finds.
Divya Bajpai, reproductive health adviser at the International HIV/Aids Alliance, added: "Pakistan has some of the highest rates of dowry murder, so-called honour killings and early marriage." According to Pakistan's human rights commission, as many as 1,000 women and girls die in honour killings annually.
India is the fourth most dangerous country. "India's central bureau of investigation estimated that in 2009 about 90% of trafficking took place within the country and that there were some 3 million prostitutes, of which about 40% were children," the survey found.
Forced marriage and forced labour trafficking add to the dangers for women. "Up to 50 million girls are thought to be 'missing' over the past century due to female infanticide and foeticide,", the UN population fund says, because parents prefer to have young boys rather than girls.
Somalia, a state in political disintegration, suffers high levels of maternal mortality, rape, female genital mutilation and limited access to education and healthcare.
Qasim added: "The most dangerous thing a woman in Somalia can do is to become pregnant. When a woman becomes pregnant her life is 50-50 because there is no antenatal care at all. There are no hospitals, no healthcare, no nothing.
"Add to that the rape cases that happen on a daily basis, and female genital mutilation being done to every single girl in Somalia. Add to that famine and drought. Add to that the fighting [which means] you can die any minute, any day."
Monique Villa, the chief executive of the Thomson Reuters Foundation, said: "Hidden dangers – like a lack of education or terrible access to healthcare – are as deadly, if not more so, than physical dangers like rape and murder which usually grab the headlines.
"In Afghanistan, for instance, women have a one in 11 chance of dying in childbirth. In the top five countries, basic human rights are systematically denied to women.
"Empowering women tackles the very roots of poverty. In the developing world when a woman works, her children are better fed and better educated because they spend their money for their family."
The survey was based on responses from more than 200 aid professionals, academics, health workers, policymakers, journalists and development specialists chosen for their expertise in gender issues.
Each country was also ranked in terms of six risk factors including: health, discrimination and lack of access to resources, cultural and religious practices, sexual violence, human trafficking and conflict-related violence.
In terms of individual risk categories, Afghanistan was deemed to be the most dangerous for health, economic/discrimination and non-sexual violence; the Congo is most plagued by rape and sexual violence; and India has most problems with trafficking.
"You have to look at all the dangers to women, all the risks women and girls face," said Elisabeth Roesch, who works on gender-based violence for the International Rescue Committee in Washington.
"If a woman can't access healthcare because her healthcare isn't prioritised, that can be a very dangerous situation as well."
The TrustLaw website has been in existence for some time, linking up local NGOs and social entrepreneurs with established law firms who are prepared to offer legal advice on a pro-bono basis. The groups are vetted by Transparency International.
More than 450 law firms are already involved including some from China. Among those that have recently benefited have been the charity Riders for Health, which delivers medicine to remote villages, and reviewed its contracts in Nigeria.