For the 16th year in a row, North Korea tops the list of 50 countries ranked for the worst persecution of Christians in the world, according to the Christian watchdog organization Open Doors USA.

A close second is Afghanistan, which jumped up one place since last year’s ranking. With the exception of North Korea, all the countries that cracked the top 10 are predominantly Muslim and most are in the Middle East and Africa.

“Open Doors exists to support and to advocate for persecuted Christians wherever they may be in the world,” Open Doors USA’s CEO and president, David Curry, said in announcing the list in Washington on Wednesday (Jan. 10). “We are asking that the world begin to use its power and its influence to push for justice, that we would use the list to direct us where justice is needed most in the world today.”

Curry also highlighted three trends Open Doors identifies as persecution against Christians — the rise of “rogue agencies” such as the Islamic State group and the North Korean government; “Islamic extremism”; and actions such as rape and forced marriage.

The list is compiled annually by Open Doors, whose researchers assign a point value to incidents of persecution — forced conversions, attacks on churches, arrests, etc. Open Doors has published its list for 26 years.

The group’s top 10 countries where Christians face the most persecution are:

• North Korea (94 points) — Christians and Christian missionaries are routinely imprisoned in labor camps.
• Afghanistan (93 points) — The government of this Muslim country does not recognize any of its citizens as Christian.
• Somalia (91 points) — The Catholic bishop of Mogadishu has described it as “not possible” to be a Christian in Somalia.
• Sudan (87 points) — The Muslim government has slated Christian churches for demolition.
• Pakistan (86 points) — Christians and other non-Muslims sit on death row, facing charges of blasphemy.
• Eritrea (86 points) — Only four religions are officially recognized (Sunni Islam and the Eritrean Orthodox, Roman Catholic and Evangelical Lutheran churches). Those belonging to other faiths are persecuted and those of recognized faiths are routinely harassed by the government.
• Libya (86 points) — The government is reportedly training militants to attack Coptic Christians.
• Iraq (86 points) — Iraqi Christians have yet to return to their homelands after expulsion by ISIS.
• Yemen (85 points) — The ongoing political and humanitarian crisis has further squeezed Christians and other religious minorities, who already faced severe restrictions on practicing their faiths.
• Iran (85 points) — Religious  minorities, including Christians, face “systematic, ongoing, and egregious violations of religious freedom,” according to the U.S. State Department.

Just below the top 10 is India, where rising Hindu nationalism has increased persecution of other religious groups.

Not on the list of the 50 countries where Christians face the worst persecution: the United States.