MIAMI — Infant mortality, the share of babies who die before their first birthday, is one of the most closely watched measures of a country’s well-being, and Latin America has cut it dramatically over the past half century, but the gains have been uneven.

Bolivia and the Dominican Republic now report the region’s highest rates, while countries that started from similar conditions in the 1970s, such as Chile, Brazil and Peru, have reduced theirs to a fraction of what they were 50 years ago.

Before 1970, about one in every 12 children born in Latin America died before completing their first year of life. The regional rate fell from roughly 80 deaths per 1,000 live births in 1970 to 14 in 2020, according to WHO data cited in a 2023 study.

The gap between the best and worst performers has not narrowed.

Nations With Highest Rates

The ranking at the top depends on the data series. In UN-backed 2023 estimates (UN IGME), the Dominican Republic is highest at 28 deaths per 1,000 live births, followed by Bolivia (20), Guatemala (18) and Paraguay (15), with Peru at 14, Honduras at 13 and Brazil at 12.

Other estimates put Bolivia higher, at 22.1, against 20.8 for the Dominican Republic. World Population Pyramid’s 2026 projections show Bolivia at 29.6 and the Dominican Republic at 24.2, with Paraguay at 15.2 and Venezuela at 14.0.

The safest statement is that Bolivia and the Dominican Republic are consistently the two highest, with the order varying by source and year.

Nations With Lowest Rates

At the other end of the scale, Uruguay and Chile are among the countries reporting fewer than seven deaths per 1,000 live births. Argentina stands at 8 and Colombia, Ecuador, Mexico and Panama at 11.

Cuba’s rate was reported at 6.2 per 1,000 in 2022. Cuba also records some of the lowest infant mortality rates among its Latin American neighbors, but the island’s government data is historically influenced by the Cuban regime to conceal more concerning rates from an already discontented population.

Starting points in 1970 varied widely. Estimates for that year put Bolivia at about 144 deaths per 1,000 live births, Guatemala at 117, Peru at 116, Brazil at 104 and Chile at 73. Compared with the 2023 figures, Chile (73 to 6), Brazil (104 to 12) and Peru (116 to 14) cut their rates by roughly 88% to 92%, while Bolivia (144 to 20) and Guatemala (117 to 18) fell by about 85%.

Bolivia’s absolute drop is the largest, about 124 deaths per 1,000, yet it still ranks near the top because it started the highest. Costa Rica, Chile and Cuba experienced fast progress well before the 1990s.

Peru’s gains came from expanded primary care in rural areas, conditional cash transfer programs such as Juntos, and targeted maternal and child health programs.

The same analysis found Brazil recorded the fastest average annual reduction among the Southern Cone countries between 2000 and 2023, at 3.67%.

Across the region, income and mothers’ education are important determinants of infant mortality rates.

The Dominican Republic stands out for a relatively high rate for its income level. Venezuela is the clearest reversal among the larger countries.

Between 2000 and 2020, under-five mortality there rose by 12%, while Peru, Bolivia, Uruguay and El Salvador reported drops of more than 60%. A 2025 analysis from the Think Global Health site argued that Argentina, once ahead of its neighbors, has been overtaken by countries that “once lagged behind” it.

National averages hide large internal differences. In Peru, for example, the rate in rural areas reached 25 deaths per 1,000 live births, compared with 16 in urban areas. Poorer, rural and Indigenous communities in many countries continue to face higher risks than the national figures suggest.

The record suggests that large reductions are possible at different income levels when governments expand primary care, maternal and child health services, and targeted social protection. It also shows that progress is not guaranteed. Where health systems, governance or economic conditions deteriorate, as the Venezuelan figures suggest, gains can stall or reverse.