Basic Guide to the World:
Trends in Male and Female Infant Mortality Rates

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Infant mortality rate (IMR) has often been used as an indicator of human development (Gerring, Thacker and Alfaro, 2012) or population health (United Nations, 2013). Thus, a basic understanding of the world would include a study of infant mortality rates.

A great deal of research has been conducted about IMR, indicating that lower IMR is associated with higher GDP per capita and education (Pamuk, Fuchs and Lutz, 2011; Wang et al, 2014), better water and sanitation (Cheng, Schuster-Wallace, Watt, Newbold and Mente, 2012), better access to health care (Gruber, Hendren and Townsend, 2014), more foreign aid (Arndt, Jones, Tarp, 2013) having a history of democracy (Gerring, Thacker and Alfaro, 2012), and in Sub-Saharan Africa, with democratization (Kudamatsu, 2012). Wang et al (2014) attribute the reduction to higher income, more education, and to "secular trends", which include some of the above characteristics and also improved infrastructure (e.g., roadways).

However, IMR is often a problematic measure. IMR is often under reported, especially in poorer countries, because infant deaths are less likely to be reported (Anthopolos and Becker, 2010).   For example, Gonzalez (2014) reports that IMR is substantially under-counted in Cuba. In addition, the UN indicates that data sources for mortality vary in quality over time, and among countries (United Nations, 2013) and similarly, Unicef indicates that many countries do not have complete vital registration system, and so may not accurately record all births and deaths (Unicef, 2014). There are a variety of ways to deal with these problems, including statistical estimates of data quality and statistical adjustments (United Nations, 2013), and the use of multiple sources of data, such as population censuses, household surveys and sample registration systems, where vital registration systems are insufficient (Unicef, 2014).

Thus, the way to understand this report, and any report about IMR, is to not focus too much on numerical details, but to look for broad patterns, especially ones that are consistent with other indicators of human development or wellness. Where multiple indicates tell the same story, we can have more confidence in the truth of any of them.

I. Worldwide

The major trend in IMR over the past half century, worldwide, has been a steady decline. The decline has been about the same for both males and females. Male IMR has been slightly higher than has been female IMR.

world infant mortality rates, male,

II. Least Developed Countries

The major trend in IMR among the Least Developed Countries (LDC) has also been a steady decline, for both males and females.  IMR for both declined about 60%.

IMR, Least Developed Countries

III. More Developed Countries

IMR has also declined among the More Developed Countries (MDC), at about the same rate for males and females. IMR declined for both about 85%.

IMR, more developed countries

IV. Ratio of IMR, Least to More Developed Countries

Figure 4, below, shows trends in the ratio of (IMR in the LDCs) to (IMR in the MDCs). For example, in 1955-1960, the IMR for males in the LDCs was 193.5, and the IMR for males in the MDCs was 47.3. The ratio of these two (193.5/47.3) was 4.1. By 2005-2010, the IMR for males in the LDCs was 76.7, and the IMR for males in the MDCs was 6.9. The ratio of these two (76.7/6.9) was 11.1. The trends are shown for both males and females.

IMR, males, 1955-1960
IMR, males, 2005-2010

Unfortunately, the figure shows that IMR has become more unequal over the past half century. IMR declined worldwide, but declined more among MDCs than it did among the LDCs. At the start of this time, IMR among LDCs was 4 times higher than was IMR among MDCs. At the end of this time, IMR among LDCs was 11 times higher than was IMR among MDCs. The trend was pretty much the same among males and females.


V. IMR: 1955-1960 compared to 2005-2010

There is a fairly high correlation between IMR in 1955-1960 and IMR in 2005-2010 (0.72). That means that, overall, most countries that had high IMR in 1955-1960 still had high IMR in 2005-2010, compared to other countries.  IMR declined in all countries, but most countries that started off among the worst stayed among the worst.

However, while most high IMR countries remained high IMR countries, this is not true for all high IMR countries.  A number of countries, including Afghanistan, Angola, Burkina Faso, Côte d'Ivoire, Guinea, Sierra Leone and South Sudan were among the 20 countries with the highest IMR in 1955-1960 and remained in the 20 countries with the highest IMR in 2005-2010. Several other countries, though, started with the highest IMRs. By 2005-1010, though, their IRMs were still high, but not among the highest. These countries included Bhutan, Liberia, Nepal, Timor-Leste and Yeman. A few countries, including Egypt, Iran, Libya, Maldives, Tunisia and Turkey, made an even larger transition, from having the highest IMR to having IRMs in the middle ranks.

Clearly, there are many factors involved in reducing IMR, so those stuck with high IMRs at one time are not doomed to remain with those bad conditions.

Table 1
20 countries with highest IRM in that time period (unshaded boxes)
Country 1955-1960
Country 2005-2010
Afghanistan 261.75
Afghanistan 78.28
Angola 215.04
Angola 104.35
Bhutan 238.95
Burkina Faso 209.14
Burkina Faso 80.40

Burundi 93.45

Cameroon 82.47

Central African Republic 105.48

Chad 105.30
Côte d'Ivoire 236.91
Côte d'Ivoire 86.57

Democratic Republic of the Congo 115.90
Egypt 204.63

Equatorial Guinea 101.73
Guinea 200.11
Guinea 80.99

Guinea-Bissau 101.94
Iran (Islamic Republic of) 197.62
Liberia 218.49
Libya 230.08

Malawi 95.24
Maldives 226.50
Mali 223.84
Mali 100.29
Mozambique 201.60
Mozambique 87.12
Nepal 201.14

Nigeria 89.93
Sierra Leone 229.39
Sierra Leone 127.18

Somalia 89.78
South Sudan 226.18
South Sudan 89.66
Timor-Leste 241.82
Tunisia 218.03
Turkey 201.77
Yemen 297.25

Data Source

Data from: United Nations, Department of Economic and Social Affairs, Population Division, World Population Prospects: The 2012 Revision, New York, 2013   


Rebecca Anthopolos, Charles M. Becker. Global Infant Mortality: Correcting for Undercounting. World Development. Volume 38, Issue 4, April 2010, Pages 467–481   and  

Channing Arndt, Sam Jones and Finn Tarp. Assessing Foreign Aid’s Long-Run Contribution to Growth in Development. WIDER Working Paper No. 2013/072. 
and  also here
Channing Arndt, Sam Jones, Finn Tarp, Assessing Foreign Aid’s Long Run Contribution to Growth and Development, World Development, Available online 18 January 2014, ISSN 0305-750X,  (

June J Cheng, Corinne J Schuster-Wallace, Susan Watt, Bruce K Newbold and Andrew Mente. An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality. Environ Health. 2012 Jan 27;11:4  

John Gerring, Strom Thacker and Rodrigo Alfaro. Democracy and Human Development. Journal of Politics 74:1 (January 2012)  

Gonzalez, Robert M, Underreporting of the Infant Mortality Rate: Evidence and Adjustments for Cuba (May 27, 2014). Available at SSRN:  or  

Jonathan Gruber, Nathaniel Hendren, and Robert M. Townsend. The Great Equalizer: Health Care Access and Infant Mortality in Thailand. Am Econ J Appl Econ. Jan 1, 2014; 6(1): 91–107.  

Masayuki Kudamatsu. Has Democratization Reduced Infant Mortality in Sub-Saharan Africa? Evidence from Micro Data. Journal of the European Economic Association, 10, pp. 1294-1317. December 2012. 

Elsie R. Pamuk, Regina Fuchs and Wolfgang Lutz. Comparing Relative Effects of Education and Economic Resources on Infant Mortality in Developing Countries. Population and Development Review. Volume 37, Issue 4, pages 637–664, December 2011.  

Unicef. Under Five Mortality, Current Status and Progress. 2014.   see the Notes on the Data section.

United Nations. The World Mortality Report 2013. United Nations, Department of Economic and Social Affairs, Population Division.   

Wang, Haidong, and others, see below.  Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. 2014 May 2. doi: 10.1016/S0140-6736(14)60497-9.  
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