Infant Mortality Rates: Progress and Challenges in Developing Nations
Child Survival in Low- and Middle-Income Countries: Where Infant Mortality Remains Highest
Infant mortality measures the probability that a child born in a given year dies before reaching age one. It is expressed as deaths per 1,000 live births and reflects newborn care, safe delivery, vaccination, nutrition, sanitation, household poverty and access to timely treatment.
Thank you for reading this post, don't forget to subscribe!The ranking uses the latest complete World Bank World Development Indicators values for 2024, based on estimates developed by the UN Inter-agency Group for Child Mortality Estimation. “Developing nations” is treated here as low- and middle-income countries with comparable international estimates, not as a political label.
Highest current rate
72
South Sudan records the highest value in this table: 72 infant deaths per 1,000 live births.
Low- and middle-income benchmark
30
The World Bank 2024 value for low- and middle-income economies is 30 deaths per 1,000 live births, compared with about 4 in high-income economies.
Regional concentration
24 of 30
Most countries in the highest-mortality group are in Sub-Saharan Africa, where poverty, fragile systems and gaps in newborn care overlap.
Main survival challenge
First month
As deaths from infections after the first month decline, neonatal survival increasingly depends on pregnancy care, safe delivery and immediate newborn support.
Progress has been real, but the remaining gap is concentrated
Infant mortality has fallen sharply over the long run because vaccination, oral rehydration therapy, malaria control, antibiotics, nutrition programmes and safer childbirth have reached more families. The remaining gap is concentrated in countries where poverty, conflict, underfunded primary care, lower maternal education, weak civil registration and long travel times to emergency care overlap.
The top of the ranking is not simply a list of poor countries. It is a map of where multiple risks converge: unsafe delivery, preventable infection, preterm birth complications, low birth weight, poor nutrition, malaria exposure, limited referral systems and fragile public finance.
Further progress depends less on a single intervention than on a connected system: antenatal care, skilled birth attendance, emergency obstetric care, newborn resuscitation, breastfeeding support, immunization, nutrition and reliable referral pathways.
Top 10 countries with the highest infant mortality rates
The upper tier is dominated by fragile and low-income settings. Some countries face active conflict or displacement; others have improved immunization and primary care but still struggle with newborn care, rural access and emergency obstetric capacity.
| Rank | Country | Infant mortality rate | Region |
|---|---|---|---|
| 1 | South Sudan | 72 | Sub-Saharan Africa |
| 2 | Nigeria | 70 | Sub-Saharan Africa |
| 3 | Niger | 66 | Sub-Saharan Africa |
| 4 | Somalia | 65 | Sub-Saharan Africa |
| 5 | Liberia | 63 | Sub-Saharan Africa |
| 6 | Zimbabwe | 62 | Sub-Saharan Africa |
| 7 | Guinea | 60 | Sub-Saharan Africa |
| 8 | Central African Republic | 59 | Sub-Saharan Africa |
| 9 | Chad | 56 | Sub-Saharan Africa |
| 10 | Congo, Dem. Rep. | 56 | Sub-Saharan Africa |
Unit: deaths before age one per 1,000 live births. Values are rounded World Bank 2024 estimates based on UN IGME methods.
Chart: highest infant mortality rates in the 2024 snapshot
The chart highlights the scale of the gap inside the highest-risk group. South Sudan and Nigeria sit near 70 deaths per 1,000 live births, while several countries just below the top line remain clustered between 55 and 66.
Key values: South Sudan 72, Nigeria 70, Niger 66, Somalia 65, Liberia 63 and Zimbabwe 62 deaths per 1,000 live births.
Methodology
Infant mortality rate is the probability of dying between birth and exactly one year of age, expressed per 1,000 live births. International agencies derive it from civil registration, censuses, household surveys and demographic models.
The ranking uses 2024 World Bank World Development Indicators values for indicator SP.DYN.IMRT.IN. The underlying estimates are produced by the UN Inter-agency Group for Child Mortality Estimation, which includes UNICEF, WHO, the World Bank and the UN Population Division.
Countries are sorted from the highest infant mortality rate to the lowest among low- and middle-income economies with comparable values. The full table is limited to the 30 highest values, so it should be read as a high-mortality ranking rather than a complete list of all developing economies.
Values are shown as whole deaths per 1,000 live births to match the public World Bank display. Revisions can occur when new surveys, registration data or model updates become available.
Comparability limits
International comparability is strongest for broad patterns and weaker for small differences between countries with similar values. Conflict-affected states and countries with weak civil registration may rely more heavily on household surveys and extrapolation. Infant mortality does not show the exact cause of death, so it should be interpreted together with neonatal mortality, vaccination, nutrition, maternal health and access-to-care indicators.
Top 30 low- and middle-income countries by infant mortality rate
The full table shows the countries with the highest 2024 infant mortality rates in the dataset used for this article. The filters help compare broad regional patterns while keeping the source values visible.
Showing 30 countries.
| Rank | Country | Infant mortality rate | Region |
|---|---|---|---|
| 1 | South Sudan | 72 | Sub-Saharan Africa |
| 2 | Nigeria | 70 | Sub-Saharan Africa |
| 3 | Niger | 66 | Sub-Saharan Africa |
| 4 | Somalia | 65 | Sub-Saharan Africa |
| 5 | Liberia | 63 | Sub-Saharan Africa |
| 6 | Zimbabwe | 62 | Sub-Saharan Africa |
| 7 | Guinea | 60 | Sub-Saharan Africa |
| 8 | Central African Republic | 59 | Sub-Saharan Africa |
| 9 | Chad | 56 | Sub-Saharan Africa |
| 10 | Congo, Dem. Rep. | 56 | Sub-Saharan Africa |
| 11 | Lesotho | 56 | Sub-Saharan Africa |
| 12 | Sierra Leone | 55 | Sub-Saharan Africa |
| 13 | Afghanistan | 48 | South Asia |
| 14 | Equatorial Guinea | 48 | Sub-Saharan Africa |
| 15 | Mali | 48 | Sub-Saharan Africa |
| 16 | Pakistan | 48 | South Asia |
| 17 | Benin | 45 | Sub-Saharan Africa |
| 18 | Cote d'Ivoire | 45 | Sub-Saharan Africa |
| 19 | Burkina Faso | 44 | Sub-Saharan Africa |
| 20 | Mozambique | 44 | Sub-Saharan Africa |
| 21 | Djibouti | 43 | Middle East & North Africa |
| 22 | Madagascar | 43 | Sub-Saharan Africa |
| 23 | Sudan | 43 | Sub-Saharan Africa |
| 24 | Guinea-Bissau | 42 | Sub-Saharan Africa |
| 25 | Eswatini | 42 | Sub-Saharan Africa |
| 26 | Cameroon | 40 | Sub-Saharan Africa |
| 27 | Haiti | 39 | Latin America & Caribbean |
| 28 | Kiribati | 39 | Pacific |
| 29 | Malawi | 38 | Sub-Saharan Africa |
| 30 | Uganda | 36 | Sub-Saharan Africa |
Source: World Bank World Development Indicators, SP.DYN.IMRT.IN, 2024 values based on UN IGME estimates. Unit: deaths before age one per 1,000 live births. Values are rounded to whole numbers.
Insights from the distribution
The upper end of the ranking shows how infant mortality becomes most severe when weak health systems and social stressors reinforce one another. South Sudan, Somalia, Chad, the Central African Republic and the Democratic Republic of Congo are health-system cases and also examples of how conflict, displacement, insecurity and limited infrastructure raise risks before, during and after birth.
The middle of the high-mortality group points to a different challenge. Countries such as Benin, Cote d’Ivoire, Burkina Faso and Mozambique have made meaningful progress in vaccination and primary care, but preventable infant deaths remain elevated where rural referral systems, skilled birth attendance, newborn resuscitation and treatment of infection are not consistently available.
The lower part of the Top 30 contains countries with different development paths. Haiti reflects a Caribbean crisis of poverty, instability and service disruption; Kiribati shows the vulnerability of small island systems; Malawi and Uganda show the importance of sustaining gains in community health, nutrition and malaria control.
What infant mortality means for readers, analysts and policy
For readers, infant mortality translates a complex health environment into a direct survival risk during the first year of life. It reflects whether pregnancy care is timely, whether births are attended safely, whether newborns receive warmth and breathing support, whether infections are treated quickly and whether families have food, clean water and transport to care.
For analysts, the indicator is useful because it is comparable across countries and strongly connected to poverty, education, gender equity and public-health capacity. It should still be interpreted with caution because national rates cannot show district-level differences, cause of death or the quality of services used by the poorest households.
For governments and donors, a high infant mortality rate points to practical priorities: skilled attendance at birth, antenatal care, emergency obstetric care, newborn resuscitation, kangaroo mother care, breastfeeding support, routine immunization, malaria prevention, nutrition, clean water and better civil registration.
For NGOs and development partners, the ranking helps identify where maternal and newborn health investments may deliver large social returns. The strongest programmes usually combine facility quality, community outreach and data systems rather than treating infant survival as a hospital-only problem.
FAQ
What does infant mortality rate measure?
It measures the probability that a child born in a specific year dies before reaching age one, expressed per 1,000 live births. A value of 50 means about 50 infant deaths for every 1,000 live births under the conditions represented by the estimate.
Is infant mortality the same as under-five mortality?
No. Infant mortality covers deaths before age one. Under-five mortality covers deaths before age five. Infant mortality is a major part of under-five mortality, but it does not include deaths between ages one and four.
Why are rates higher in some developing countries?
Higher values usually reflect overlapping risks: preterm birth complications, infections, malnutrition, malaria, poor sanitation, low maternal education, limited skilled birth attendance, weak referral systems and delays in reaching emergency care.
Why can estimates differ between sources?
Sources can differ because they use different revisions, country definitions, survey years, civil-registration inputs or model methods. UN IGME estimates are designed for international comparability, while national releases may emphasize administrative records or newer local data.
Why is neonatal mortality so important now?
As vaccination and infection control reduce deaths after the first month, a larger share of infant deaths occurs during the neonatal period. That shifts the policy focus toward pregnancy care, safe delivery, birth complications, prematurity and immediate newborn support.
Can a country reduce infant mortality quickly?
Rapid progress is possible when basic interventions reach the most vulnerable families: skilled delivery, immunization, malaria control, nutrition, clean water, antibiotics, breastfeeding support and reliable referral care. Sustaining progress becomes harder when remaining deaths are concentrated around birth and remote areas.
Does a high infant mortality rate always mean poor hospitals?
No. Hospitals matter, but infant mortality also reflects household poverty, transport, sanitation, maternal education, primary care, nutrition, community health workers and whether families can reach the right service in time.
Why be careful with conflict-affected countries?
Conflict can disrupt health services and data collection at the same time. Estimates for these countries are essential for comparison, but uncertainty is often higher because surveys are harder to conduct and civil registration may be incomplete.
Sources
- World Bank Data — Mortality rate, infant, SP.DYN.IMRT.IN. Used for the 2024 country values, global benchmark and income-group comparisons. https://data.worldbank.org/indicator/SP.DYN.IMRT.IN
- UN Inter-agency Group for Child Mortality Estimation. Used for the methodology behind internationally comparable infant and child mortality estimates. https://childmortality.org/
- WHO Global Health Observatory. Used for the definition, unit of measure, estimation approach and comparability context. https://www.who.int/data/gho
- UNICEF Data — Levels and Trends in Child Mortality. Used for long-term child survival context, fragile settings and newborn survival interpretation. https://data.unicef.org/resources/levels-and-trends-in-child-mortality/
