Countries by Number of under-five deaths
Nigeria ranks 1st with 768,479 under-five deaths in 2023, more than 119,000 ahead of 2nd-ranked India at 643,970. At the other end, San Marino recorded 0 deaths, illustrating a range of over 768,000 between the highest and lowest values in this 196-country ranking.
Ranking 2023
Analysis
This metric counts the absolute number of children dying before reaching age five in a given year, as recorded under World Bank World Development Indicators indicator SH.DTH.MORT. It measures total deaths, not rates, so larger populations will tend to produce larger absolute counts. Data covers 196 countries, all with values from the last seven years, and 100% of datapoints are classified as official-quality. The dataset contains 30 extreme outliers at the 3-sigma threshold, and values range from 0 to 768,479, a spread the viability checks flag at 999%.
The top of the ranking is dominated by large, high-fertility countries in sub-Saharan Africa and South Asia. Nigeria ranks 1st at 768,479, India 2nd at 643,970, and Pakistan 3rd at 397,325. Congo, Dem. Rep. ranks 4th at 306,481, and Ethiopia 5th at 187,237. Niger, with a comparatively small population, places 6th at 119,782, reflecting very high under-five mortality rates. The top 15 countries account for the vast majority of deaths in the dataset and are concentrated in West Africa, the Horn of Africa, and South Asia.
Several placements in the middle of the ranking are counterintuitive given population size. China, with the world's largest population until recently, ranks only 21st at 62,190, while the United States ranks 40th at 23,989 and Germany 89th at 2,675. High-income countries with large populations rank far lower than their population size alone would suggest, because this metric is driven by both population size and the underlying mortality rate per child. At the bottom, small island nations and microstates cluster near zero: Tuvalu ranks 189th at 5, Nauru and Turks and Caicos Islands share 192nd at 3 each, Andorra and Monaco share 194th at 1, and San Marino ranks 196th at 0.
Because this metric reports absolute counts rather than rates, it does not adjust for population size or birth rates, making direct comparisons between large and small countries misleading. A country with a high under-five mortality rate but a small population may rank far lower than a country with a lower rate but a large population. Reporting reliability varies across countries, particularly in conflict-affected or low-resource settings where civil registration systems may be incomplete. The 30 extreme outliers identified in the viability checks suggest that some values may reflect estimation methods rather than direct counts, and users should treat rankings for countries with known data limitations with caution.
Methodology
Rankings are based on World Bank World Development Indicators indicator SH.DTH.MORT for the data year 2023. The source definition used verbatim: 'Number of children dying before reaching age five.' Values are absolute counts, not rates. The dataset covers 196 countries, all meeting the 80-country coverage threshold. All 196 countries (100%) have data from within the last seven years, and 100% of datapoints are classified as official quality, exceeding the 70% threshold. The viability checks identified 30 extreme outliers at the 3-sigma threshold. The average year-over-year change is 4.6%, well within the 50% volatility threshold. Values range from 0 (San Marino) to 768,479 (Nigeria), a spread flagged at 999%. Higher values rank higher in this ranking, as higher absolute counts indicate greater burden. Users should note that absolute counts are sensitive to population size and birth rates, and may not reflect underlying mortality risk.