Countries by Mortality rate, neonatal (per 1,000 live births)
South Sudan ranks first with a neonatal mortality rate of 40.2 per 1,000 live births, the highest among 196 countries measured in 2023. At the opposite end, San Marino records 0.6, producing a range of nearly 6,600 percent between the two extremes. That gap reflects the full breadth of variation in newborn survival conditions across the world.
Ranking 2023
Analysis
This metric counts neonatal deaths occurring in the first 28 days of life, expressed per 1,000 live births in a given year. According to the source definition: 'Neonatal mortality rate is the number of neonates dying before reaching 28 days of age, per 1,000 live births in a given year.' The indicator covers only deaths within that narrow window and does not capture stillbirths or deaths after 28 days. Data are drawn from the World Bank World Development Indicators under indicator code SH.DYN.NMRT for the reference year 2023. Coverage is strong: 196 countries are included, all with data from the last seven years, and 100 percent of datapoints are classified as official quality. Two extreme outliers were identified at the 3-sigma threshold, and the average year-over-year change across the dataset is 2.8 percent, indicating stable trends.
The ten highest-ranked countries — where higher rank means higher neonatal mortality — are concentrated in sub-Saharan Africa and South Asia. South Sudan leads at 40.2, followed by Pakistan at 37.6 and Somalia at 34.9. Afghanistan (34.3), Niger (33.8), Nigeria (33.7), Guinea-Bissau (32.7), Mali (32.4), and Chad (31.4) round out the next positions. Dominica ranks 10th at 30.8, making it the only non-African, non-South Asian country in the top ten. The Central African Republic (30.7) and Guinea (30.3) follow closely. Rates across this group consistently exceed 30 deaths per 1,000 live births.
The middle of the ranking, roughly positions 50 through 100, spans a wide range from about 8 to 20 per 1,000 live births and includes countries from South Asia, Southeast Asia, Latin America, and North Africa. India sits at rank 56 with a rate of 17.3, while the Philippines reaches rank 65 at 14.0 and Brazil ranks 105 at 7.6. A notable placement is Dominica at rank 10 with a value of 30.8, which makes it a statistical outlier among small island states and one of the two extreme outliers flagged in viability checks. The Dominican Republic, a separate country, ranks 40th at 21.7. Among the lowest-mortality countries, San Marino records 0.6 at rank 196, Japan 0.8 at rank 194, and Singapore 0.9 at rank 193.
Several limitations apply to this metric. Neonatal mortality estimates for countries with weak civil registration systems rely on modeled data, which introduces uncertainty especially for high-ranking countries where the burden is largest. Differences in the definition and recording of live births versus stillbirths can affect reported rates across countries. The metric does not account for the absolute number of births, so a small country with a high rate contributes far fewer total deaths than a large country at a similar rate. Comparisons between countries with strong registration systems and those relying on survey-based estimates should be made cautiously. The 2023 data year reflects the most recent available estimates but may incorporate projections rather than fully observed counts for some countries.
Methodology
Rankings are based on the World Bank World Development Indicators, indicator code SH.DYN.NMRT, for the reference year 2023. The source definition is used verbatim: 'Neonatal mortality rate is the number of neonates dying before reaching 28 days of age, per 1,000 live births in a given year.' The unit is deaths per 1,000 live births, and higher values indicate higher neonatal mortality. The dataset covers 196 countries, all of which have data from within the last seven years, representing 100 percent recency. All 196 datapoints are classified as official quality, exceeding the 70 percent threshold. The value range spans 0.60 to 40.20, a spread of 6,600 percent. Two extreme outliers were identified using a 3-sigma threshold. Average year-over-year change is 2.8 percent, well within the 50 percent volatility threshold, indicating reliable trend stability. No microstates below 1 million population were excluded from the dataset.