Subnational monitoring of public health and development indicators often relies on household surveys where data are sparse at the desired spatial resolution. Small area estimation (SAE) methods address this challenge by borrowing strength across areas and incorporating auxiliary information. However, comparing these estimators remains difficult in the absence of ground truth. We propose a design-based cross-validation framework for evaluating small area estimators that accommodates complex survey designs. Our approach enables model-agnostic comparisons between area-level and unit-level SAE models. We derive a decomposition of the conditional mean squared error that yields a consistent cross-validation score, show that finite-sample comparisons carry an unidentifiable bias that can be bounded, and use this bound as a principled threshold for ranking models. We further show that leave-one-area-out cross-validation, a popular alternative, targets extrapolation rather than smoothing error and can reverse the correct ranking. We evaluate the framework through extensive design-based simulations. We apply the framework to compare subnational female literacy estimators in Zambia using the 2024 Demographic and Health Survey. The framework applies broadly across prevalence mapping and other SAE problems and is applicable to any small area estimator irrespective of the underlying model class.

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