Countries by Mortality rate, under-5 (per 1,000 live births)
Niger ranks first with an under-5 mortality rate of 114.8 per 1,000 live births, meaning roughly 1 in 9 children born there does not reach age five. At the opposite end, San Marino records 1.4, the lowest among all 196 countries measured. The gap of 113.4 points between first and last reflects the extreme range in child survival outcomes across the world.
Ranking 2023
Analysis
This metric measures the probability that a newborn will die before reaching age five, expressed per 1,000 live births. The World Bank defines it precisely: under-five mortality rate is the probability per 1,000 that a newborn baby will die before reaching age five, if subject to age-specific mortality rates of the specified year. The unit is an absolute value, and higher values indicate worse child survival outcomes, meaning higher rank in this dataset corresponds to worse performance. Data cover 196 countries for the year 2023, with 100% of data points classified as official quality and all 196 countries reporting from within the last seven years. The dataset shows 28 extreme outliers beyond the 3-sigma threshold, reflecting the very wide spread of values from 1.4 to 114.8, a range of 8,100%.
The ten worst-performing countries are all located in sub-Saharan Africa. Niger (rank 1) records 114.8, followed by Nigeria (rank 2) at 104.9, Somalia (rank 3) at 104.0, Chad (rank 4) at 101.1, and South Sudan (rank 5) at 98.7. Guinea (rank 6, 95.0), Sierra Leone (rank 7, 94.3), Central African Republic (rank 8, 92.2), and Mali (rank 9, 91.3) also exceed 90. Benin (rank 10, 77.9) and Burkina Faso (rank 11, 77.3) round out the top tier of highest-mortality countries. All nine countries recording rates above 90 are in West or Central Africa.
Several notable patterns appear in the middle of the ranking. Pakistan (rank 22, 58.5) and Afghanistan (rank 24, 55.5) are the highest-ranked countries outside sub-Saharan Africa, placing them among the worst performers globally. Haiti (rank 25, 55.1) ties with Kiribati (rank 25, 55.1), a Pacific island nation, at the same value. India ranks 62nd at 27.7, while China ranks 144th at 6.2, a difference of 21.5 points between two of the world's most populous countries. The United States ranks 143rd at 6.5, placing it below Romania (rank 142, 6.6) and above China. Among high-income Gulf states, Saudi Arabia (rank 144, 6.2) and Qatar (rank 149, 6.0) record rates comparable to several European countries.
Under-5 mortality rates rely on a combination of civil registration systems, household surveys, and modeled estimates, which vary in reliability across countries. Countries with weaker civil registration may have rates based on statistical modeling rather than complete birth and death records, introducing uncertainty especially at the extremes of the ranking. The metric captures deaths before age five but does not disaggregate by cause of death, age at death within the under-5 window, or geographic subgroup within a country. Ties in the ranking, such as Haiti and Kiribati both at 55.1, or Rwanda and Turkmenistan both at 40.0, indicate rounding that can obscure small real differences. The 28 extreme outliers flagged in the dataset suggest the distribution is heavily skewed, and comparisons between countries near the middle of the ranking should be made with caution given potential measurement variation.
Methodology
The metric is sourced from the World Bank World Development Indicators under indicator code SH.DYN.MORT, with data for the reference year 2023. The World Bank defines under-five mortality rate as the probability per 1,000 that a newborn baby will die before reaching age five, if subject to age-specific mortality rates of the specified year. Values are absolute rates per 1,000 live births. In this ranking, higher values indicate worse outcomes. The dataset covers 196 countries, all with data from within the last seven years, and 100% of data points are classified as official quality. The observed range runs from 1.4 (San Marino) to 114.8 (Niger), a spread of 8,100%. The average year-over-year change across the dataset is 3.6%, well within the 50% volatility threshold. Twenty-eight countries were flagged as extreme outliers beyond the 3-sigma threshold, consistent with the heavily skewed distribution of child mortality outcomes globally.