Instruct: Given a question, retrieve relevant documents that can help answer the question.
Query: What country has the highest birth rate?
According to the CIA's The World Factbook,[26] the country with the highest birth rate is Niger at 6.49 children born per woman and the country with the lowest birth rate is Taiwan, at 1.13 children born per woman.
Thus, from 1989–2001 the pattern of population change was one of slight growth in Kiev, slight declines in western Ukraine, large declines in eastern, central and southern Ukraine and slight decline in Crimea due to a large influx of Crimean Tatars.
Ukraine's total fertility rate is one of the lowest in Europe. However, significant regional differences in birth rates may account for some of the demographic differences. In the third quarter of 2007, for instance, the highest birth rate among Ukrainian regions occurred in Volyn Oblast, with a birth rate of 13.4/1,000 people, compared to the Ukrainian country-wide average of 9.6/1,000 people. Volyn's birthrate is higher than the average birth rate of any European country with the exceptions of Iceland and Albania.
The average number of new cases of PKU varies in different human populations. United States Caucasians are affected at a rate of 1 in 10,000. Turkey has the highest documented rate in the world, with 1 in 2,600 births, while countries such as Finland and Japan have extremely low rates with fewer than one case of PKU in 100,000 births. A 1987 study from Slovakia reports a Roma population with an extremely high incidence of PKU (one case in 40 births) due to extensive inbreeding. It is the most common amino acid metabolic problem in the United Kingdom.
Since the Taliban's fall in 2001, fertility levels are decreasing, stemming from the Taliban's belief in not educating girls, child brides, and not providing healthcare for women. The decreased presence of the Taliban has allowed an entrance of aid workers to the country to provide educational funding for schools, family planning, and more access to birth control. The uncontrolled high fertility rates make it difficult for Afghanistan to manage the poverty levels and improve other social conditions which leaves a high dependence on aid from other countries. High fertility rates cause high birthrates, which contribute to the high fetal mortality rate. Afghanistan has the highest fetal mortality rate in the world, with 110.6 deaths per 1000 births. Mothers are also 19.9 years old on average at her first birth. As access to education across Afghanistan is increasing due to the fall of the Taliban, the fetal mortality rate is also decreasing. In rural areas the mortality rate still remains high, but aid workers are being sent to many regions of the country after receiving training on deliveries and care for newborns.
There is much variation regarding birth weight within continents, countries, and cities. Even though over 20 million babies are born each year with low birth weight, it is hard to know the exact number as more than half of babies born in the world are not weighed at birth. The baby’s weight is an indicator of the mother and babies health. In 2013 22 million newborns had low birth weight, around 16 percent of all babies globally. Data on low birth weight is adjusted to account for under reporting. South Asia has the highest rate of babies not weighted at birth with 66 percent, but also have the highest low birth weight at 28 percent worldwide. West and Central Africa and least developed countries are next with 14 percent low birth weight worldwide.
In 2008, Massachusetts has emerged as the most prolific producer of multiple births in the United States. The state has a twin birth rate of 4.5 for every 100 live births, compared with a national rate of 3.2.
The birth rate of Irish Travellers has decreased since the 1990s, but they still have one of the highest birth rates in Europe. The birth rate for the Traveller community for the year 2005 was 33.32 per 1,000, possibly the highest birth rate recorded for any community in Europe.
The maternal mortality rate is 224 deaths per 100,000 births, which is the 23rd highest in the world. The mean age of mothers at birth is 19.3 years old, and the fertility rate is 5.72 children born per woman, which is the 7th highest in the world. The contraceptive rate is only 40.8%, and the birth rate is the 4th highest in the world at 42.13 births/1,000 population. Infectious disease is a key contributor to the poor health of the nation, and the risk is very high for diseases such as protozoal and bacterial diarrhea, hepatitis A, typhoid fever, malaria, dengue fever, schistosomiasis, and rabies. The adult prevalence rate of HIV/AIDS is 12.37%, which is the 7th highest in the world.
According to the CIA - The World Factbook, the country with the highest birth rate currently is Niger at 51.26 births per 1000 people. The country with the lowest birth rate is Japan at 7.64 births per 1000 people. Hong Kong, a Special Administrative Region of China, is at 7.42 births per 1000 people. As compared to the 1950s, birth rate was at 36 births per 1000 in the 1950s,[84] birth rate has declined by 16 births per 1000 people. In July 2011, the U.S. National Institutes of Health announced that the adolescent birth rate continues to decline.[85]
West/Central Africa has the highest rate of children under five underweight in the world. Of the countries in this region, the Congo has the lowest rate at 14%, while the nations of Democratic Republic of the Congo, Ghana, Guinea, Mali, Nigeria, Senegal and Togo are improving slowly. In Gambia, rates decreased from 26% to 17% in four years, and their coverage of vitamin A supplementation reaches 91% of vulnerable populations. This region has the next highest proportion of wasted children, with 10% of the population under five not at optimal weight. Little improvement has been made between the years of 1990 and 2004 in reducing the rates of underweight children under five, whose rate stayed approximately the same. Sierra Leone has the highest child under five mortality rate in the world, due predominantly to its extreme infant mortality rate, at 238 deaths per 1000 live births. Other contributing factors include the high rate of low birthweight children (23%) and low levels of exclusive breast feeding (4%). Anemia is prevalent in these nations, with unacceptable rates of iron deficient anemia. The nutritional status of children is further indicated by its high rate of child wasting - 10%. Wasting is a significant problem in Sahelian countries – Burkina Faso, Chad, Mali, Mauritania and Niger – where rates fall between 11% and 19% of under fives, affecting more than 1 million children.
Afghanistan has the 11th highest birth rate in the world, and also the highest birth rate of any non-African country (as of 2016).[32] The rapid population growth of Afghanistan is considered a problem by preventing population stabilization, and affecting maternal and infant health.[34][35] Reasons for large families include tradition, religion, the low status of women and the cultural desire to have several sons.[34][36]
The rising maternal death rate in the U.S. is of concern. In 1990 the U.S. ranked 12th of the 14 developed countries that were analyzed. However, since that time the rates of every country have steadily continued to improve while the U.S. rate has spiked dramatically. While every other developed nation of the 14 analyzed in 1990 shows a 2017 death rate of less than 10 deaths per every 100,000 live births, the U.S. rate has risen to 26.4. By comparison, the United Kingdom ranks second highest at 9.2 and Finland is the safest at 3.8. Furthermore, for every one of the 700 to 900 U.S. woman who die each year during pregnancy or childbirth, 70 experience significant complications such as hemorrhage and organ failure, totaling more than 1 percent of all births.
The country generally has an efficient and widespread system of health care. It implements a universal healthcare system, which co-exists with the private healthcare system.[82] Infant mortality rate in 2009 was 6 deaths per 1000 births, and life expectancy at birth in 2009 was 75 years.[84] Malaysia has the highest levels of obesity among ASEAN countries.[85][86]
The region of Sub-Saharan Africa has the highest birth rate in the world. As of 2016, Niger, Mali, Uganda, Zambia, and Burundi have the highest birth rates in the world.[32] This is part of the fertility-income paradox, as these countries are very poor, and it may seem counter-intuitive for families there to have so many children. The inverse relationship between income and fertility has been termed a demographic-economic "paradox" by the notion that greater means would enable the production of more offspring as suggested by the influential Thomas Malthus.[33]
Huge disparities in under-5 mortality rates exist. Globally, the risk of a child dying in the country with the highest under-5 mortality rate is about 60 times higher than in the country with the lowest under-5 mortality rate. Sub-Saharan Africa remains the region with the highest under-5 mortality rates in the world: All six countries with rates above 100 deaths per 1,000 live births are in sub-Saharan Africa.
The number of Russians living in poverty has decreased by 50% since the economic crisis following the disintegration of the Soviet Union, and the improving economy had a positive impact on the country's low birth rate. The latter rose from its lowest point of 8.27 births per 1000 people in 1999 to 13.3 per 1000 in 2014. Likewise, the fertility rate rose from its lowest point of 1.157 in 1999 to 1.777 in 2015. 2007 marked the highest growth in birth rates that the country had seen in 25 years, and 2009 marked the highest total birth rate since 1991.
There are large variations in the birth rates as of 2016: Zala County has the lowest birth rate with 7.5 births per thousand inhabitants, while Szabolcs-Szatmár-Bereg County has the highest birth rate with 11.2 births per thousand inhabitants.
The regions of Surxondaryo and Qashqadaryo have the highest birth rate and the lowest death rates in Uzbekistan. On the other hand, the city of Tashkent has the lowest birth rate and the highest death rate of the country.
Collecting the accurate statistics of infant mortality rate could be an issue in some rural communities in developing countries. In those communities, some other alternative methods for calculating infant mortality rate are emerged, for example, popular death reporting and household survey.
The country-to-country variation in child mortality rates is huge, and growing wider despite the progress. Among the world's roughly 200 nations, only Somalia showed no decrease in the under-5 mortality rate over the past two decades.The lowest rate in 2011 was in Singapore, which had 2.6 deaths of children under age 5 per 1,000 live births. The highest was in Sierra Leone, which had 185 child deaths per 1,000 births. The global rate is 51 deaths per 1,000 births. For the United States, the rate is eight per 1,000 births.
In 2006, in a bid to compensate for the country's demographic decline, the Russian government started simplifying immigration laws and launched a state program "for providing assistance to voluntary immigration of ethnic Russians from former Soviet republics". In 2009 Russia experienced its highest birth rate since the dissolution of the Soviet Union. In 2012, the birth rate increased again. Russia recorded 1,896,263 births, the highest number since 1990, and even exceeding annual births during the period 1967–1969, with a TFR of about 1.7, the highest since 1991. (Source: Vital statistics table below)
The West African country of Benin has the highest national average of twinning, with a rate of 27.9 twins per 1,000 births.
Angola represents a country with one of the highest maternal death rates in the world. Statistics vary, but the estimated maternal mortality ratio (MMR) toward the end of the Civil War was between 1,281–1,500 maternal deaths to 100,000 live births. This estimate was taken during the late 1990s and, again, in 2002 by UNICEF and represents the MMR situation in the country at the end of the War. In 2008, the estimate decreased to around 610 deaths per 100,000 live births. In comparison, Sweden is estimated to have an MMR of 5deaths to 100,000 live births.
According to the United States Agency for International Development (USAID), the MMR of the country appears to be decreasing since the end of the Civil War in 2002. However, it is still one of the highest in the world. On average, women give birth 7.2 times. The infant mortality ratio is 154 deaths per 1,000 live births. The mortality rate of children under 5 years of age is 254 per 1,000 live births. These figures represent improvement since the end of the War, although they still are very high and show the need for improvement in maternal health.
In 2013, the lowest birth rates were reported in the Northeast, while the highest rates were located in the south east. For example, a 2001 study by UNICEF found that the US teenage birth rate was the highest among 28 OECD nations in the review; in a 1999 comparison by the Guttmacher Institute, U.S. teen pregnancy and teen birth rates were the second-highest among the 46 developed countries studied. In 2002, the U.S. was rated 84th out of 170 World Health Organization member countries based on teenage fertility rate.
The general improvement of health conditions in the country is reflected in the lower mortality rate, down to an estimated 6.49 deaths per 1,000 in 2000, as compared with 17.8 per 1,000 in 1938. In 2000, average life expectancy was estimated at 74 years, compared to 38 years at the end of World War II. Albania's infant mortality rate, estimated at 20 per 1,000 live births in 2000, has also declined over the years since the high rate of 151 per 1,000 live births in 1960. There were 69,802 births in 1999 and the fertility rate in 1999 was 2.5 while the maternal mortality rate was 65 per 100,000 live births in 1993. In addition, in 1997, Albania had high immunization rates for children up to one year old: tuberculosis at 94%; diphtheria, pertussis, and tetanus, 99%; measles, 95%; and polio, 99.5%. In 1996, the incidence of tuberculosis was 23 in 100,000 people. In 1995 there were two reported cases of AIDS and seven cases in 1996. In 2000 the number of people living with HIV/AIDS was estimated at less than 100. The leading causes of death are cardiovascular disease, trauma, cancer, and respiratory disease. In 2015 it still had the highest mortality in Europe, at 766 per 100,000 population, the highest rate of death from non-communicable diseases (672 per 100,000) and the second highest rate of male smokers in Europe - 51%. 
Sri Lanka is the 57th most populated nation in the world, with roughly 21,670,000 people, and an annual population growth rate of 1.14%. Sri Lanka has a birth rate of 17.6 births per 1,000 people and a death rate of 6.2 deaths per 1,000 people. Population density is highest in western Sri Lanka, especially in and around the capital. Sinhalese constitute the largest ethnic group in the country, with 74.8% of the total population.