20. South Sudan
> Population: 11.7 million
> GNI per capita: $2,332
> Life expectancy at birth: 55.7 years
> Pct. of pop. with at least some high school: N/A

South Sudan, which gained independence from Sudan in 2011, faces many of the development problems shared by other poor African nations. Its rapid population growth — 4% each year since 2010, third fastest in the world — may be somewhat unsustainable as 31.1% of Sudanese children under five years old do not receive adequate nutrition. Only 30% of Sudanese infants are properly vaccinated for measles, and only 57% for diphtheria, pertussis, and tetanus. These rates are low even compared to the Sub-Saharan region where vaccinations are far less common than in Western nations.

South Sudan has one of the lowest shares of children enrolled in primary school worldwide. If current enrollment patterns continue, Sudanese children on average will receive just 7.6 years of schooling, fewer years of expected education than in all but six other countries.

19. Senegal
> Population: 14.5 million
> GNI per capita: $2,188
> Life expectancy at birth: 66.5 years
> Pct. of pop. with at least some high school: 10.8%

Located on the western coast of Africa, Senegal has one of the lowest standards of living in Africa and the world. It is one of the poorest countries, with an income per capita of just $2,188. Like many of Africa’s poorest countries, educational attainment is sparse. Sudanese adults spend just 2.5 years in school on average, the seventh lowest level of education of any country.

For every 1,000 Senegalese residents, 192 females and 244 males die before reaching the age of 60. Senegal’s adult mortality rate is significantly worse than that of the OECD nations, where 60 females and 113 males die prematurely for every 1,000 people.

18. Afghanistan
> Population: 31.3 million
> GNI per capita: $1,885
> Life expectancy at birth: 60.4 years
> Pct. of pop. with at least some high school: 18.2%

Afghanistan is one of the least livable countries in the world. Despite the aftermath of the largely unsuccessful U.S-led invasion in 2001, which kicked off an international conflict formally ended just last year, Afghanistan’s position on the HDI has improved faster than all but two other nations reviewed by the UN. The country is slowly recovering from a destructive Taliban regime. Under the Taliban, women were not allowed to go to school, were married at a young age, and received inadequate health care. A decade ago, each Afghani woman bore 7.4 children on average, the second highest fertility rate at the time. Today, the average woman bears five children, a significant decline in fertility rate. Gender inequality is still a major problem in Afghanistan, however. While 29.8% of Afghani males have gone to secondary school, just 5.9% of women have.

The country is plagued by poverty. Across the country, 59.3% of children under the age of five are malnourished — a higher share than anywhere in the world.

17. Cote d’Ivoire
> Population: 20.8 million
> GNI per capita: $3,171
> Life expectancy at birth: 51.5 years
> Pct. of pop. with at least some high school: 22.4%

Cote d’Ivoire — or the Ivory Coast — survived several uprisings and a brutal rebellion in the early 2000s. Since then, tension and unrest have persisted. Like many of the African nations that rate poorly on the HDI, the country is one of the worst places in the world to give birth. An estimated 720 mothers die for every 100,000 births, the seventh worst maternal mortality rate in the world. Newborns in Cote d’Ivoire are even more likely to suffer fatal injury than the mothers. For every 1,000 live births in the country, 71.3 die, the 10th highest rate in the world. High infant mortality has driven down life expectancy at birth in the country, and even those who survive infancy are expected to live relatively short lives. Life expectancy at birth in the country is just 51.5 years, the fifth lowest life expectancy in the world.

16. Malawi
> Population: 16.8 million
> GNI per capita: $747
> Life expectancy at birth: 62.8 years
> Pct. of pop. with at least some high school: 16.3%

The southeastern African nation of Malawi, home to fewer than 17 million people, is one of the worst countries in the world by standards of wealth, health, and education. Malawi’s population, like the citizens of many other countries in the region, suffer from high poverty rates, high infant mortality, and a short life expectancy. Malawi also has an abysmal adult literacy rate and a similarly poor secondary education attainment rate. Just 61.3% of the nation’s adults can read and write, and only 16.3% have at least some high school experience. Very low literacy rates and poor educational attainment are often indicative of a poor, less diverse economy. Malawi is no exception. The nation’s GNI per capita of just $747 is a fraction of the size of the U.S.’s GNI per capita.