WASHINGTON - Women's reproductive and sexual health continues to be poor throughout much of the world, according to a report released Wednesday for International Women's Day.

The study by Population Action International and CARE found that 515,000 women die each year in pregnancy and childbirth - about one death a minute - and millions more women take ill or are disabled.

``There is a gaping chasm between rich and poor countries when it comes to the sexual and reproductive health of women,'' said Amy Coen, Population Action president.

The study - ``A World of Difference: Sexual and Reproductive Health & Risks'' -ranked 91 developing and 42 industrialized countries based on 10 indicators, including teen births, contraceptive use, HIV/AIDS prevalence and access to prenatal care.

In the country with the worst record, Ethiopia, a woman has a 1 in 7 chance of dying from a pregnancy-related cause, the report said. Women in Italy, with the best record, face a 1 in 6,261 chance of a pregnancy-related death.

The United States ranked 15th of 25 countries in the lowest-risk category, behind much of Western Europe, Singapore and Australia. American women have a 1 in 3,418 chance of pregnancy-related death.

``For a lot of people, it will be a big surprise that the United States ranks so low in comparison to other industrialized countries,'' Coen said. ``We haven't made the commitment we need to.''

The low ranking for the United States results from high teen births; one in 20 American teen girls gives birth each year. Fewer than one teen in 100 gives birth in Switzerland, Netherlands and Japan.

Population Action wants the report to be a tool and incentive for countries to improve global reproductive health, Coen said.

The 1994 International Conference on Population and Development in Cairo determined that about $17 billion per year is needed for basic global reproductive services.

But the goal is not being met.

The United States, for example, paid only about $394 million in 2000, less than half of what it promised at the conference to contribute, and down from a high of $541 million in 1995.

Further threatening funding is President George W. Bush's decision in January to reinstate a policy blocking U.S. money to international organizations that perform abortions, Coen said.

``The biggest victim of this policy is the poorest women in the world,'' she said.

Rep. Mark Kirk, an Illinois Republican, is sponsoring the Global Democracy Promotion Act in the House to overturn Bush's policy.

The study can raise public awareness about access to contraception and gain support for global reproductive health, he said.

``As modern and effective contraception becomes available, the number of abortions go down,'' Kirk said.

The countries with the greatest risks for pregnant women are Ethiopia, Angola, Chad, Afghanistan, Central African Republic, Mali, Niger, Democratic Republic of Congo, Sierra Leone and Lesotho.

The countries with the lowest risks for pregnant women are Italy, Sweden, Finland, Singapore, Netherlands, Germany, Belgium, Norway, Denmark and Australia.

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