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Nutritional Status The prevalence estimates of the three key nutrition indicators are underweight 25%, stunting 52% and wasting 14% in Afghanistan based on anthropometric measurements during the field data collection. A detailed review of the anthropometric data and the three nutrition indicators by experts in UNICEF New York and Centre for Disease Control of United States raised questions around the quality of the data. During the analysis children with incomplete birth date (month and year) and children whose measurements are outside a plausible range are excluded from the estimates. Children are excluded from one or more of the anthropometric indicators when their weights and heights have not been measured, whichever applicable. For example, if a child was weighed but his/her height was not measured, the child is included in underweight calculations, but not in the calculations for stunting and wasting. The extent and reasons for these exclusions are shown in the data quality tables (see Appendix D: Tables D.6 and D.7). Based on the findings of the expert review, it was concluded that whilst the data provides a strong indication of a significant problem of malnutrition in children of age under five, the results are likely to be overestimates. It is recommended therefore that the <strong>AMICS</strong> anthropometric data is to be used with caution and should not be used as the sole evidence to trigger policy and program decisions. Breastfeeding, Infant and Young Child Feeding Breastfeeding for the first few years of life protects children from infection, provides an ideal source of nutrients, and is economical and safe. However, many mothers stop breastfeeding too soon and there are often pressures to switch to infant formula. This can contribute to growth faltering and micronutrient malnutrition, and is also unsafe if clean water is not readily available. WHO and UNICEF have the following feeding recommendations: Exclusive breastfeeding for the first six months; Continued breastfeeding for two years or more; Safe, appropriate and adequate complementary foods beginning at six months; Frequency of complementary feeding: twice per day for 6 to 8-month-olds; and three times per day for 9 to 11-month-olds. It is also recommended that breastfeeding be initiated within one hour of birth. The indicators related to recommended child feeding practices are as follows: Early initiation of breastfeeding (within one hour of birth) Exclusive breastfeeding rate (< six months) Predominant breastfeeding (< six months) Continued breastfeeding rate (at one year and at two years) Duration of breastfeeding Age-appropriate breastfeeding (0-23 months) 26
Introduction of solid, semi-solid and soft foods (six-eight months) Minimum meal frequency (six-23 months) Milk feeding frequency for non-breastfeeding children (six-23 months) Bottle feeding (0-23 months) Table 5.1: Initial breastfeeding Percentage of last-born children in the two years preceding the survey who were ever breastfed, percentage who were breastfed within one hour of birth and within one day of birth, and percentage who received a prelacteal feed, Afghanistan, 2010-2011 Region Percentage who were ever breastfed 1 Percentage who were first breastfed: Within one hour of birth 2 Within one day of birth Percentage who received a prelacteal feed Number of lastborn children in the two years preceding the survey Central 93.9 57.2 87.4 22.4 824 Central Highlands 96.4 45.5 84.7 22.1 196 East 84.7 52.5 78.1 26.2 491 North 96.6 53.3 87.6 33.9 743 North East 95.7 70.8 91.3 33.9 869 South 91.8 24.1 71.7 50.1 353 South East 93.6 37.4 77.4 28.0 726 West 92.5 63.5 87.6 25.1 662 Residence Urban 94.6 58.5 87.2 30.4 903 Rural 93.2 52.5 83.8 29.6 3,962 Months since last birth 0-11 months 93.6 54.5 84.3 29.5 2,340 12-23 months 93.2 52.7 84.6 30.1 2,525 Assistance at delivery Skilled attendant 94.6 59.1 87.0 29.0 1,880 Traditional birth attendant 95.7 51.9 86.9 34.4 1,463 CHW/Relative/Friend 96.5 52.8 85.9 28.3 1,294 Other 52.0 23.0 39.3 15.3 228 Place of delivery Public sector health facility 95.5 61.6 88.9 27.1 1,363 Private sector health facility 94.9 47.2 79.0 40.0 237 Home 95.4 52.3 85.7 31.1 3,149 Other 12.2 7.1 10.2 5.1 116 Mother s education None 93.1 53.0 83.8 29.8 4,311 Primary 95.5 63.2 89.4 32.0 286 Secondary + 96.1 53.3 88.9 26.9 268 Wealth index quintile Poorest 92.8 52.1 84.2 32.2 933 Second 93.4 55.1 85.8 29.8 1,029 Middle 93.5 54.6 83.9 28.0 993 Fourth 93.2 51.8 83.1 28.0 967 Richest 94.3 54.3 85.3 31.0 944 Total 93.4 53.6 84.5 29.8 4,865 1 MICS indicator 2.4; 2 MICS indicator 2.5 27
Page 2 and 3: Afghanistan Multiple Indicator Clus
Page 4 and 5: Further, the Government and the don
Page 6 and 7: Tetanus toxoid 3.7 Neonatal tetanus
Page 8 and 9: Table of Contents Foreword ........
Page 10 and 11: Knowledge about HIV Transmission an
Page 12 and 13: Table 7.10: Availability of soap ..
Page 14 and 15: List of Figures Figure 2.1: Map Sho
Page 16 and 17: U5MR UNAIDS UNDP UNFPA UNGASS UNICE
Page 18 and 19: Executive Summary The Afghanistan M
Page 20 and 21: the prevalence of anaemia among pre
Page 22: In 2010/2011, 29% of school eligibl
Page 25 and 26: The Government of Afghanistan ratif
Page 28 and 29: Sample Design The sample for the AM
Page 30 and 31: Of the 13,468 households selected f
Page 32: to mock interviews between trainees
Page 35 and 36: Percent and frequency distribution
Page 37 and 38: were as follows: household water so
Page 39: Percent and frequency distribution
Page 42 and 43: thousand live births. These estimat
Page 44 and 45: The child mortality findings from A
Page 47: Introduction: Nutrition Children s
Page 51 and 52: In Table 5.2, breastfeeding status
Page 53 and 54: Table 5.3 shows the median duration
Page 55 and 56: Percentage of children age 0-23 mon
Page 59 and 60: In Afghanistan, the Universal Salt
Page 61 and 62: For countries with Vitamin A defici
Page 63 and 64: Table 5.10: Anaemia Status of Child
Page 65: under age five are moderately under
Page 68 and 69: Table 6.2: Vaccinations in first ye
Page 70 and 71: Percentage of children age 12-23 mo
Page 72 and 73: Percentage of women age 15-49 years
Page 74 and 75: ORT with continued feeding among ch
Page 76 and 77: Table 6.6: Feeding practices during
Page 78 and 79: Table 6.7: Oral rehydration therapy
Page 80 and 81: Care Seeking and Antibiotic Treatme
Page 84 and 85: Solid Fuel Use More than three bill
Page 86 and 87: Percent distribution of household m
Page 89 and 90: Safe Drinking Water Safe drinking w
Page 91 and 92: Overall, 57% of the Afghan populati
Page 93 and 94: Table 7.2: Household water treatmen
Page 95 and 96: Percent distribution of household p
Page 97 and 98: Table 7.5: Types of sanitation faci
Page 99 and 100:
Table 7.6: Use and sharing of sanit
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Percent distribution of children ag
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Table 7.8: Drinking water and sanit
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Table 7.9: Water and soap at place
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According to Table 7.10, nationally
Page 110 and 111:
As shown in Table 8.1, 10% of women
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Table 8.3: Use of contraception Per
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Antenatal Care The antenatal period
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Table 8.5: Number of antenatal care
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midwifery skills is present at ever
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Percent distribution of women age 1
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Almost 33% of births in Afghanistan
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Early Childhood Education and Learn
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Percentage of children age 36-59 mo
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The presence of children s books is
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low throughout the country. Childre
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Literacy Among Young Women One of t
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Primary and Secondary School Partic
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Percentage of children of primary s
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The secondary school net attendance
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Some differences among regions are
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The ratio of girls to boys attendin
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Birth Registration The Internationa
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than the numbers specified in the c
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education (26%) are twice as likely
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Percentage of children age 2-14 yea
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Table 11.6: Children's living arran
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Early Marriage and Polygamy Accordi
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Wealth index quintile Poorest 19.2
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Table 11.10: Spousal age difference
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Percentage of women age 15-49 years
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140
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Page 166 and 167:
Percentage of young women age 15-24
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Page 170 and 171:
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The initial estimated required the
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Since the estimated number of house
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Appendix B. List of Personnel Invol
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18 Abdul Baser Assistant Balkh 19 R
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Hameed, Editor Bakhtawar, Editor/Me
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Nangarhar (Team #46) Nangarhar (Tea
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Fahima Haidari Zarmina Mahbob Hashi
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Age-appropriate breastfeeding 5.4 0
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School readiness 10.2 0.105 0.023 0
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Measles immunization coverage 6.3 0
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Prevalence of children with at leas
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Tuberculosis immunization coverage
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Transition rate to secondary school
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Polio immunization coverage 6.3 0.4
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Appendix D. Data Quality Tables Tab
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78 25 0.0 9 0.0 79 4 0.0 4 0.0 80+
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South 1,866 12.1 1,815 12.1 98.8 So
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Table D.7: Completeness of informat
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Table D.8: Heaping in anthropometri
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Table D.11: Observation of women's
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Table D.13: Presence of mother in t
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Table D.16: Sex ratio at birth amon
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2.8 Continued breastfeeding at 2 ye
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6. CHILD DEVELOPMENT 6.1 Support fo
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[5] Breastfeeding children: Solid,
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HH18. Record the time: Hour .......
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EDUCATION ED1. Line number For hous
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WS5. WHO USUALLY GOES TO THIS SOURC
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HC5. Main material of the exterior
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CHILD LABOUR To be administered for
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CD9. Write name and line number of
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HH19. Record the time. Hour and min
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QUESTIONNAIRE FOR CHILDREN UNDER FI
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BIRTH REGISTRATION BR1. DOES (name)
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EC5. DOES (name) ATTEND ANY ORGANIZ
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BF12. DID (name) DRINK ANY OTHER LI
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CA6. WHAT (ELSE) WAS GIVEN TO TREAT
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IMMUNIZATION If an immunization car
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IM18. HAS (name) RECEIVED A VITAMIN
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No. End the interview with this hou
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QUESTIONNAIRE FOR INDIVIDUAL WOMEN
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CHILD MORTALITY All questions refer
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DESIRE FOR LAST BIRTH This module i
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MN9. DID YOU RECEIVE ANY TETANUS IN
Page 260 and 261:
ILLNESS SYMPTOMS IS IS1. Check Hous
Page 262 and 263:
ATTITUDES TOWARD DOMESTIC VIOLENCE
Page 264 and 265:
HIV/AIDS HA1. NOW I WOULD LIKE TO T
Page 266 and 267:
ANTHROPOMETRY After questionnaires
Page 268 and 269:
- D TEST SCW This questionnaire is
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