Afghanistan Mortality Survey 2010 - Measure DHS

INFANT AND CHILD MORTALITY 5Early childhood mortality and infant mortality, in particular, are widely used indicators of anation’s development and well-being. They improve understanding of a country’s socioeconomiccondition, and they shed light on the quality of life of its population. Most important, childhood mortalitystatistics reveal the health status of children and are thus useful for informing the development of policyand health interventions that will promote child survival. Disaggregation of this information bysocioeconomic and demographic characteristics further identifies subgroups at high risk and helps totailor programs to serve these populations.One of the targets of Millennium Development Goal 4, which aims to improve child health, is atwo-thirds reduction in under-5 mortality between 1990 and 2015. In line with this goal, and addressed inthe 2008 National Development Strategy (GIRoA, 2008), the MoPH has developed several relevantstrategies: the National Health and Nutrition Sector Strategy 2008-2013 (MoPH and MAIL, 2008), theNational Child and Adolescent Health Strategy 2009-2013 (MoPH, 2009a), and the Basic Package ofHealth Services 2009-2013 (MoPH, 2009b). These strategies outline health programs and service deliverypackages in facilities and target them at the community level, which focuses on cost-effectiveinterventions. In particular, maternal interventions are implemented through improving services forwomen during pregnancy, delivery, and the post-partum period. Early childhood interventions promotebirth spacing, neonatal care, breastfeeding and complementary feeding, immunization of mothers andchildren, micronutrient supplementation, integrated management of sick children, and use of long-lastinginsecticidal bednets (LLINs) in areas with high transmission of malaria. A number of these interventionshave shown impressive gains in recent years. For example, measles coverage rates have improved rapidly,with two-thirds of 1-year old children reported to have been immunized against measles in the 2008assessment of the country’s progress toward the achievement of MDG 4 (GIRoA, 2008). In turn, theimprovements in the output indicators are believed to have resulted in a steady reduction in childmortality.The AMS 2010 data can be used to examine the progress that Afghanistan is making in reducingchild mortality. This chapter first reviews the ways in which the data on child mortality were collected inthe survey, defines the childhood mortality rates discussed in the chapter, and presents the AMS 2010findings with respect to current levels of mortality among children under age five. The chapter thendiscusses a number of problems that commonly affect the quality of mortality data obtained in surveysand assesses their impact on the AMS child mortality estimates. The chapter concludes with a discussionof socio-economic and demographic differentials in the mortality rates and explores how the patterns ofchildbearing are associated with child mortality risks.5.1 AMS 2010 CHILD MORTALITY DATA5.1.1 Data Collection ProceduresThe principal source of the data used to explore the level, trends and differentials in earlychildhood mortality in this chapter is the pregnancy history included in the AMS 2010 Woman’sQuestionnaire. As described earlier in Chapter 3, the pregnancy history data were collected by askingeach of the ever-married women age 12-49 eligible for the woman’s interview if she had ever given birth,and if she had, how many sons and daughters she had living with her, the number living elsewhere, andInfant and Child Mortality | 89