The Unhealthiest Countries in the World

There are many factors that can make a country and its population unhealthy. It could be there is not enough healthcare facilities or trained staff, or it can be that political and environmental factors increase the risk of disease. Typically, it is a mixture of many different factors that result in a country’s population struggling to obtain basic healthcare.

Using data from the Legatum Prosperity Index (LPI), we look into the unhealthiest countries in the world. The index scores countries based on a number of health-related factors, such as access to health services, quality of healthcare provision, and also mortality rates, illnesses and risk statistics.

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Central African Republic

According to the LPI, the Central African Republic is the unhealthiest country in the world, scoring just 31.95 out of a possible 100.

The Central African Republic has very little in the way of healthcare provision. The country has suffered civil unrest over the past decade, with periods of instability and some periods of calm. As such, healthcare has been sporadic.

There is just one major hospital in the capital city of Bangui, and some clinics in a few other major towns. Clinics in rural areas are poorly equipped with insufficient staff, and even the hospital in Bangui provides healthcare that’s below minimal standards.

Those in the Central African Republic are also at high risk for a number of diseases, such as malaria, tuberculosis, HIV/AIDS, STIs, and leprosy are all major concerns. Due to little access to clean water – only 37% of people in Central African Republic have access to safe water – water-borne diseases such as typhoid and diarrhoea are common.

Yellow fever is also an issue. According to the WHO, 41% of the population in Central African Republic are currently vaccinated against yellow fever, much lower than the 80% threshold required for a population’s immunity.

South Sudan

South Sudan is the second unhealthiest country in the world, according to the LPI. The north African country scored 35.69 out of a possible 100.

Like the Central African Republic, South Sudan has also experienced political instability and civil unrest, which has had a big impact on healthcare provision. More than 50% of the population live below the poverty line. Around 2% of the national budget goes to healthcare, and 54% of total health expenditure comes from out-of-pocket expenses, meaning many people in South Sidan face huge costs for their healthcare.

South Sudan has some of the worst maternal mortality and under-five mortality rates in the world, being in the bottom 10 for both factors. Around 75% of all child deaths in South Sudan are due to preventable diseases, such as diarrhoea, malaria and pneumonia. Only 28% of the population have access to healthcare services.


Chad is the third unhealthiest country in the world, with an LPI score of 39.17 out of 100.

People in Chad have little access to healthcare, and the system is severely understaffed. It’s been reported that there are only 0.4 doctors for every 1,000 people and 0.31 nurses and midwives for per 1,000 people in Chad. Patients travel an average of nine miles to access basic healthcare.

People in Chad are at high risk of illnesses and diseases such as malnutrition, malaria, tuberculosis, and HIV/AIDS. Diarrhoeal diseases are the leading cause of death for people in Chad, with around 163 deaths per 100,000. Almost half of child deaths in Chad are caused by malnutrition.


According to the LPI, Lesotho is the fourth unhealthiest country in the world. The southern African country has a score of 41.30 out of 100.

Lesotho faces a number of challenges to its healthcare provision. It has some of the highest rates of HIV and tuberculosis in the world. Healthcare services are sparsely located – around 2.2 million people in Lesotho live in small villages and travel to the nearest facility can take hours.

There is also a shortage of healthcare staff. There are just 0.9 doctors per 10,000 people and 10.2 nurses and midwives per 10,000. The WHO AFRO regional average is 2.6 doctors and 12.0 nurses and midwives, so Lesotho is well below what is needed.


Somalia is the fifth unhealthiest country in the world according to the LPI, with a score of 44.38 out of a possible 100.

Conflict and instability in Somalia have had a detrimental effect on the population, including in their healthcare provision. Widespread famine has put millions of people at risk of malnutrition and diseases such as cholera and measles. It’s thought that around 6.5 million people have been affected by famine in Somalia.

According to UNICEF, four in 100 children in Somalia die in the first month of their life, eight in 100 die before they reach one year old, and one in eight die before they’re five years old. One in 20 women aged 15-49 die due to pregnancy or birth-related issues every year.  

The government, in partnership with a number of humanitarian organisations, is taking steps to improve access to services accords the country. The plan is to reform the system, streamlining the delivery of services to create a sustainable, consistent provision.

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