LONDON (Reuters) - 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.

"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 in a statement.

"World leaders must tackle the health worker shortage and realize 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 percent 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 due to be held in New York on September 19 and 20 designed to outline a global action plan on chronic diseases such as cancer, heart disease, diabetes and lung disorders.

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 diarrhea, which are easily treated, become deadly," the charity said.

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

Meanwhile, a year after Sierra Leone introduced free healthcare for pregnant and breastfeeding women, many still struggle to get medicine and are asked to pay for drugs they can't afford, Amnesty International said on Tuesday.

Health care in the poverty-stricken West African nation is inadequate and difficult to access in rural areas, and clinics suffer routine drugs shortages, the human rights group said in a report.

"They say free care, but there's none here," the report quoted Hawa, a pregnant 28-year-old, as saying. "(The) nurses said you are wasting my time, and kicked me out. I had to beg. But no money, no medicine," she said.

Sierra Leone has among the world's highest maternal death rates with 970 deaths for every 100,000 live births, according to 2008 figures published by UNICEF. Amnesty said many of the women who die can not afford care.

Sierra Leone's government announced last year it would provide free healthcare to pregnant and breastfeeding women in an effort to cut the number of deaths.