Rank Region Coun­tries 2006 2008 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 1 North America 2 8.64 8.64 8.63 8.59 8.59 8.59 8.59 8.56 8.56 8.56 8.56 8.59 8.58 2 Western Europe 21 8.60 8.61 8.45 8.40 8.44 8.41 8.41 8.42 8.40 8.38 8.35 8.35 8.29 3 Latin America and the Caribbean 24 6.37 6.43 6.37 6.35 6.36 6.38 6.36 6.37 6.33 6.26 6.24 6.13 6.09 4 Asia and Australasia 28 5.44 5.58 5.53 5.51 5.56 5.61 5.70 5.74 5.74 5.63 5.67 5.67 5.62 5 Central and Eastern Europe 28 5.76 5.67 5.55 5.50 5.51 5.53 5.58 5.55 5.43 5.40 5.42 5.42 5.36 6 Sub-Saharan Africa 44 4.24 4.28 4.23 4.32 4.33 4.36 4.34 4.38 4.37 4.35 4.36 4.26 4.16 7 Middle East and North Africa 20 3.54 3.48 3.52 3.62 3.73 3.68 3.65 3.58 3.56 3.54 3.54 3.53 3.44 World 167 5.52 5.55 5.46 5.49 5.52 5.53 5.55 5.55 5.52 5.48 5.48 5.44 5.37