Infant Mortality in Pakistan

Pakistan is not exactly a third world country, so I found it odd that it would have a higher infant mortality than say Afghanistan.  Only, it does.  In a published study today, Pakistan has the highest (1-22) deaths for its young.  So, what is going on there that causes so many unnecessary deaths?  In general, an article in the Tribune Lack of basic medical care is part of the problem.  I saw the same excuse in the 2012 report which said Pakistan was the worst place to be born, if you want to live to age 5.  Maybe we should reconsider whether Pakistan is a third world country.  After 5 years they seem to have made no progress.  What kind of country is that?