15. Ethiopia
> Population: 96.5 million
> GNI per capita: $1,428
> Life expectancy at birth: 64.1 years
> Pct. of pop. with at least some high school: 12.5%

Ethiopia ranks among the least livable countries by several measures of education, health, and income. Ethiopians receive an average 2.4 years of schooling, one of the lowest such amounts of any country reviewed. Doctors in the Sub-Saharan nation are scarce. There is only one physician for every 40,000 residents, one of the worst doctor-to-patient ratios in the world. With an annual per capita income of $1,428, Ethiopians are also among the poorest in the world.

Nearly two in five members of Ethiopia’s workforce is employed in agriculture, one of the highest shares in the world. While the low-paying agricultural jobs partially explain the low incomes in the country, the sector is also contributing to Ethiopia’s development. According to the African Development Bank Group, Ethiopia’s economy grew by 10.3%, one of the top performing economies in the continent.

14. Gambia
> Population: 1.9 million
> GNI per capita: $1,507
> Life expectancy at birth: 60.2 years
> Pct. of pop. with at least some high school: 24.3%

As in many of the least livable countries, deaths due to preventable diseases are relatively common in Gambia. Roughly 84 deaths are attributable to malaria for every 100,000 people in the country, the 13th highest rate in the world. Additionally, there are roughly 51 tuberculosis deaths for every 100,000 people, also one of the highest rates of countries reviewed. One reason for the prevalence of preventable deaths is likely a lack of physicians. With only one doctor for every 10,000 people in Gambia, access to medical care in the country is likely very insufficient. A lack of physicians and a high incidence of preventable diseases has contributed to the country’s low life expectancy of 60.2 years at birth.

13. Democratic Republic of the Congo
> Population: 69.4 million
> GNI per capita: $680
> Life expectancy at birth: 58.7 years
> Pct. of pop. with at least some high school: 22.4%

The Democratic Republic of Congo is one of the poorest countries in the world. The country’s GNI per capita is just $680, second lowest of countries reviewed. The U.S. GNI per capita, by contrast, is 78 times that value. Extreme poverty on such a scale has broad-reaching impacts on the health and wellbeing of a population. The country has among the world’s worst rates of malaria deaths, tuberculosis deaths, and among the highest rates of premature death in each of the three age groups considered by the HDI: infant, child, and adult.

12. Liberia
> Population: 4.4 million
> GNI per capita: $805
> Life expectancy at birth: 60.9 years
> Pct. of pop. with at least some high school: 26.7%

Liberia shares a border with three other countries on this list: Cote d’Ivoire, Guinea, and Sierra Leone. With an annual income per capita of only $805, the people in Liberia are among the poorest in the world. Gender inequality is also a major hindrance to Liberia’s development. While the literacy rate among men between the ages of 15 and 24 is 63.5%, the literacy rate among women in the same age group is only 37.2%. Similarly, only 15.4% of women in the country have completed at least some secondary school. The corresponding rate among men in Liberia is 39.3%. Based on a range of factors comprising the gender inequality index, Liberia ranks 10th worst for gender inequality.

11. Guinea-Bissau
> Population: 1.7 million
> GNI per capita: $1,362
> Life expectancy at birth: 55.2 years
> Pct. of pop. with at least some high school: N/A

Guinea-Bissau has one of highest child mortality rates in the world. For every 1,000 live births in the country, roughly 124 children do not live to the age of five. The prevalence of death in early childhood drives down overall life expectancy in the Sub-Saharan nation. It is one of only 23 countries in the world where life expectancy at birth does not exceed 60 years.

Guinea-Bissau also lags behind the majority of countries reviewed by several economic and education measures. The average citizen only receives 2.8 years of schooling, less than in all but 10 other countries. Furthermore, per capita income among the country’s residents is $1,362, one of the lowest of countries reviewed. With such inadequate resources, the country’s rapid population growth may be unsustainable. The fertility rate in the country is among the highest, at roughly five births for every female resident.