The African nation of Niger has ousted Afghanistan as the worst place in the world to be a mother, largely due to hunger, according to an annual report out Tuesday by Save the Children.

In contrast, Norway is the best according to the group’s “Best and Worst Places to Be a Mom” ranking which compares 165 countries in terms of maternal health, education, economic status and children’s health and nutrition.

The report, which this year focuses on nutrition particularly from the time a woman gets pregnant until the child is two, said that malnutrition is an underlying cause of 2.6 million child deaths worldwide each year.

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After Niger, the next worst countries were listed as Afghanistan — which held the lowest spot for two years — Yemen, Guinea-Bissau, Mali, Eritrea, Chad, Sudan, South Sudan and the Democratic Republic of Congo.

“Of the 10 countries at the bottom of Save the Children’s annual index, seven are in the midst of a food crisis,” it said.

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The top countries after Norway were Iceland, Sweden, New Zealand, Denmark, Finland, Australia, Belgium, Ireland, The Netherlands and Britain.

The United States ranked 25th, up from last year’s 31st place but still below most wealthy nations.

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