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Japan is the best country for newborn survival and Pakistan is the worst while the United States ranks 22nd in the world, according to a report released Monday from the United Nations Children’s Fund (UNICEF).

The report ranks countries based on their 2016 neonatal mortality rate, which measures the number of deaths per 1,000 births. The report found that a baby born in Pakistan is almost 50 times more likely to die in its first month of life than a Japanese baby, according to UNICEF.

Many high-income countries, such as the United States, are noticeably absent from the top 10.

The United States is ranked 22nd, right below Russia and tied with Serbia. In the U.S., 1 in 270 newborns die compared to 1 in 1,111 newborns in Japan, the report said.

Inequity within those high-income countries is the reason, according to Willibald Zeck, head of the Global Maternal, Newborn and Adolescent Health Program at UNICEF. Not everyone within those nations has the same access to quality health care.

“There are different ethnicities, different parts of the country, some are better off, some are worse off. And these pockets of inequity influence the overall numbers,” he told PIX11.

Infant mortality rates can differ among demographics in the same areas.

The infant mortality rate for black infants in New Jersey, for example, is nearly triple the rate of white infants and double the rate of Hispanic infants, according to a New Jersey State Health Assessment Data report released earlier this month.

Best Nations for Infant Survival

  1. Japan
  2. Iceland
  3. Singapore
  4. Finland
  5. Estonia, Slovenia
  6. Cyprus
  7. Belarus, Luxembourg, Norway, Republic of Korea
  8. Sweden, Czechia
  9. Spain, Italy, Israel
  10. Portugal

Worst Nations for Infant Survival

  1. Pakistan
  2. Central African Republic
  3. Afghanistan
  4. Somalia
  5. Lesotho
  6. Guinea-Bissau
  7. South Sudan
  8. Côte d’Ivoire
  9. Mali
  10. Chad

The UNICEF report found that eight of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions.

UNICEF said that overall, global deaths of newborn babies remain “alarmingly high.”

More than 80 percent of newborn deaths are due to prematurity, complications during birth or infections such as pneumonia and sepsis, according to the data.

“What we see through this report is that it’s really preventable diseases, and often preventable by relatively simple intervention,” Zeck said.

To combat the issue, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns.

“We know we can save the vast majority of these babies with affordable, quality health care solutions for every mother and every newborn,” said Henrietta H. Fore, UNICEF’s executive director. “Just a few small steps from all of us can help ensure the first small steps of each of these young lives.”