Afghanistan Mortality Survey 2010 - Measure DHS

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4.2.3 Assistance at DeliveryObstetric care from a trained provider during delivery is recognized as critical for the reduction ofmaternal and neonatal mortality. Table 4.9 shows the type of assistance during delivery by selectedbackground characteristics. Around one-third (34 percent) of births are delivered with the assistance of anSBA (doctor or nurse/midwife). Doctors assist in the delivery of 16 percent of births, and nurse/midwivesassist in 19 percent of deliveries. Other health workers assist in less than 1 percent of deliveries, whiletraditional birth attendants assist in 23 percent of deliveries. Women receive assistance from a relative orsome other person for nearly two in five births (40 percent), while 2 percent of births take place withoutany type of assistance at all.SBAs are more likely to attend births to mothers younger than age 20 and first order births (37percent and 45 percent, respectively). Not surprisingly, nearly all births delivered in a health facility areattended by an SBA as opposed to births delivered elsewhere.Seventy-one percent of urban births are assisted by an SBA, compared with 26 percent of birthsin rural areas. Births in the Central zone are more likely to be attended by an SBA than births in the Northand South zones. Skilled birth attendance ranges from a low of 12 percent of births in the CentralHighland region to a high of 58 percent in the Capital region.There is a strong relationship between a mother’s education and delivery by an SBA. The numberof births delivered by an SBA increases with the level of a mother’s education. Births to highly educatedmothers are more than two and a half times (80 percent) as likely as births to uneducated mothers (30percent) to receive assistance from an SBA. Similarly, assistance during delivery by an SBA varies bywomen’s economic status: births to women in the highest wealth quintile are much more likely to beassisted by an SBA (68 percent) than births to women in the lowest wealth quintile (12 percent). Births inthe least remote households (60 percent) are nearly three times as likely to be delivered by an SBA asbirths in the most remote households (22 percent).As noted earlier in the chapter, the capacity of Afghan health facilities to provide delivery care towomen has been expanding rapidly; around seven in ten health facilities had the capacity to providedelivery care according to BPHS standards in 2008, almost three times the proportion that met thisstandard in 2004 (JHUBSPH and IIHMR, 2009). An examination of AMS 2010 results indicates thatthere has been a similar steady increase in the proportion of women who are using delivery care services.Medically-assisted deliveries rose rapidly during the five-year period, from 26 percent during the period36-59 months prior to the AMS to 42 percent in the 12 months immediately prior to the survey (Figure4.3). The absolute increases in the delivery care rates were roughly similar in urban and rural areas (12percentage points).A comparison of the AMS 2010 results with the findings from several earlier surveys alsodocuments the substantial progress Afghanistan has made in improving access to delivery care fromSBAs (Figure 4.4). 5 At the time of the MICS 2003, 14 percent of births were attended by skilled providers(CSO and UNICEF, 2004). The NRVA 2007/8 found roughly one in four women (including Kuchiwomen) delivered with an SBA (ICON-INSTITUTE, 2009). In the AMS 2010, more than one-third ofbirths were assisted by SBAs.5 Some caution should be exercised in comparing the figures presented in Figure 4.4 since the surveys vary withrespect to sample coverage, the manner in which questions were asked, the reference period for which the resultsapply and other factors. In particular, the trend in rural areas may be somewhat overstated in the AMS 2010 resultsas 16 percent of the rural population, largely in the South zone, could not be interviewed due to security concerns.These women likely have more limited access to services than the rural women who could be interviewed. However,the picture is clearly one of substantial increases in reliance on SBAs to assist deliveries.78 | Maternal Health
Table 4.9 Assistance during deliveryPercent distribution of women age 12-49 who had a live birth in the five years preceding the survey by person providing assistance during delivery ofthe most recent birth, and percentage of births assisted by a skilled provider, according to background characteristics, Afghanistan 2010BackgroundcharacteristicDoctorNurse/midwifePerson providing assistance during deliveryOtherhealthworkerTraditionalbirthattendantRelative/otherNo oneDon’tknow/missingTotalPercentagedeliveredby a skilledprovider 1Number ofbirthsMother’s age at birth
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AfghanistanMortality Survey 2010
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CONTENTSTABLES AND FIGURES ........
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4.3 Postnatal Care.................
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TABLES AND FIGURESCHAPTER 1INTRODUC
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Table 5.2 Early childhood mortality
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APPENDIX CDATA QUALITY TABLESTable
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AMS 2010 TECHNICAL ADVISORY GROUP M
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AMS 2010 CONTRIBUTORS TO THE REPORT
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INTRODUCTION 11.1 GEOGRAPHY, HISTOR
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After the fall of the communist reg
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Afghanistan, in cooperation with th
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workload of the BHC, up to two addi
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complete list of names of persons i
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1.7 QUESTIONNAIRESFour questionnair
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survey, a detailed review of the qu
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1.10 RESPONSE RATESTable 1.2 shows
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72 percent of the rural population
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Figure 2.1 Population Pyramid80 +75
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Table 2.3 Children’s orphanhood s
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Table 2.5 presents information on h
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Table 2.7 Household possessionsPerc
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Page 56 and 57: The data also show that more than h
Page 58 and 59: 2.10 CONCLUSIONThe AMS 2010 enumera
Page 60 and 61: 3.1.2 Data Quality AssessmentThe pr
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Page 64 and 65: Table 3.2 Fertility by background c
Page 66 and 67: Another frequently used approach to
Page 68 and 69: 3.2.6 Birth IntervalsA birth interv
Page 70 and 71: 3.2.7 Age at First BirthThe onset o
Page 72 and 73: Table 3.9 Teenage pregnancy and mot
Page 74 and 75: Table 3.11 Age at first marriagePer
Page 76 and 77: the community level by utilizing al
Page 78 and 79: difference may be due to difference
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Page 82 and 83: Table 3.17 Total fertility rate and
Page 85 and 86: MATERNAL HEALTH 4Afghanistan is com
Page 87 and 88: Table 4.1 Antenatal carePercent dis
Page 89 and 90: Figure 4.2 Trends in Antenatal Care
Page 91 and 92: 4.1.3 Problems with Pregnancy at Fi
Page 93 and 94: 4.1.4 Number and Timing of Antenata
Page 95 and 96: About one-third (32 percent) of mot
Page 97 and 98: As with other maternal health indic
Page 99: Table 4.8 Reasons for not deliverin
Page 103 and 104: 4.2.4 Procedures Performed at Deliv
Page 105 and 106: Figure 4.6 Reasons for Not Seeking
Page 107 and 108: Table 4.12 presents information on
Page 109 and 110: Table 4.13 Problems in accessing he
Page 111 and 112: INFANT AND CHILD MORTALITY 5Early c
Page 113 and 114: first seven days of life, to estima
Page 115 and 116: In considering the mortality trends
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Page 119 and 120: Central zone and 32 percent in the
Page 121 and 122: Table 5.4 Early childhood mortality
Page 123 and 124: The patterns of perinatal mortality
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Page 132 and 133: Table 6.4 shows adult mortality rat
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Page 136 and 137: Table 6.6 Female and male life tabl
Page 138 and 139: Table 6.7 Mean sibship size and sex
Page 140 and 141: 6.4.2 Household ReportingIn the Hou
Page 142 and 143: The unexpectedly low crude death ra
Page 144 and 145: Figure 6.8.2 Estimates of Female Ad
Page 146 and 147: The third panel estimates life expe
Page 148 and 149: Maternal mortality in Afghanistan i
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other words, about two in five deat
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It is useful to compare the seven-y
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50PercentFigure 7.1Timing of Pregna
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ased on the sibling history (270).
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The VA interview started by checkin
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Figure 8.1 Causes of Female and Mal
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Table 8.4 Causes of deaths among ch
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Global Agricultural Information Net
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Streatfield, P.K., S.E. Arifeen, A.
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• The Cluster Level Questionnaire
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A.3 STRUCTURE OF THE SAMPLE AND THE
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ased on sampling probabilities sepa
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ESTIMATES OF SAMPLING ERRORSAppendi
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For the total sample, the value of
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Table B.3 Sampling errors for Urban
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Table B.5 Sampling errors for North
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Table B.7 Sampling errors for South
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Table B.9 Sampling errors for North
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Table B.11 Sampling errors for Cent
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Table B.13 Sampling errors for East
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Table B.15 Sampling errors for Sout
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Table C.2 Myers’ Blended IndexPre
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Table C.5 Births by calendar years
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Table C.6 Reporting of age at death
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Table C.9 Sex ratio of live birthsS
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mother and the household. The morta
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The estimated infant mortality rate
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D.3.1 Evidence of Underreporting of
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Given the apparent omission of livi
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totally consistent with the estimat
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Perhaps a more sensitive indicator
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Figure D.6 Neonatal and Postneonata
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PERSONS INVOLVED IN AMS 2010Appendi
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Office EditorsMaleMohammad NaseemFe
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AshiqullahAssadullah JavedAtiqullah
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QUESTIONNAIRESAppendix FAppendix F
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Introduction and ConsentHello. My n
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SECTION 2. MIGRATION FROM HOUSEHOLD
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SECTION 4. INPATIENT HEALTH EXPENDI
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SECTION 5. OUTPATIENT HEALTH EXPEND
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SECTION 6. HOUSEHOLD CHARACTERISTIC
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NO. QUESTIONS AND FILTERS CODING CA
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SECTION 2. MARITAL STATUSNO.201QUES
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Now I would like to record the name
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SECTION 4. ANTENATAL, DELIVERY AND
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SECTION 6. MATERNAL MORTALITYNO. QU
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COMMENTS ABOUT RESPONDENT:INTERVIEW
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DEATH OF A CHILD AGED 0-28 DAYSSECT
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SECTION 6. DELIVERY HISTORYNO. QUES
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AFGHANISTAN MORTALITY SURVEYVERBAL
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DEATH OF A CHILD AGED 29 DAYS TO 11
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401 Could you tell me about the ill
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DEATH OF A PERSON AGED 12 YEARS AND
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Afghanistan Mortality Survey 2010 - Measure DHS

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