Afghanistan Mortality Survey 2010 - Measure DHS

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the number who had died. Each woman was also asked if she ever had a stillbirth, that is, a baby that wasnot born alive, and, if so, how many stillbirths she had had in her lifetime.A detailed history of the woman’s births was then recorded in chronological order, starting withthe first birth. To obtain that history, the mother was asked if the baby had been born alive or dead foreach birth she reported. In the case of live births, information was then obtained on whether the birth wassingle or multiple, the date of birth (month and year), sex and survival status. If the child was still alive atthe time of the interview, the age of the child on the date of interview was obtained. If the child was nolonger alive, the child’s age at death was obtained. In the case of stillbirths, i.e., when the baby did notbreathe or show other signs of life at birth, the mother was asked about how long the pregnancy hadlasted.In this chapter, child mortality rates are also derived from data on deaths of usual householdmembers that occurred during the five-year period prior to the survey. The information on householddeaths was obtained by asking the household respondent 1 about any deaths of usual household membersthat had occurred since 21 March 2005 (1 Hammal 1384). Because the Household Questionnaire did notcollect information on children’s birth dates, the exposure time used for calculating the child mortalityrates had to be taken from other sources. For living children, it was calculated from information obtainedin the household schedule. For dead children, the information on the child’s birth date and age at the timeof death was obtained from the Verbal Autopsy Questionnaire. 25.1.2 Child Mortality Rate DefinitionsThe primary causes of childhood mortality shift from biological to environmental factors aschildren age. Thus, the information obtained in the pregnancy history about the age at death of childrenwho were born alive but later died is used to calculate childhood mortality rates according to thefollowing customarily defined age categories:• Neonatal mortality (NN): the probability of dying within the first month of life• Postneonatal mortality (PNN): the difference between infant and neonatal mortality• Infant mortality ( 1 q 0 ): the probability of dying between birth and the first birthday• Child mortality ( 4 q 1 ): the probability of dying between exact ages 1 and 5• Under-5 mortality ( 5 q 0 ): the probability of dying between birth and the fifth birthday.These rates are expressed as deaths per 1,000 live births except for the child mortality rate, whichis expressed as deaths per 1,000 children surviving to age 1.The data obtained on household deaths can be used to calculate infant and under-5 mortality ratesbut not neonatal and postneonatal mortality rates. This is because adequately detailed exposure time isavailable only for the dead neonates and not for the survivors since date of birth information was notcollected for living children in the Household Questionnaire.Finally, in addition to child mortality rates, the information on stillbirths from the pregnancyhistories is combined with information on deaths that occurred during the early neonatal period, i.e., the1 In the AMS 2010, 97 percent of the household respondents were male. In contrast, all respondents to the Woman’sQuestionnaire were women.2 Two different versions of the questionnaires were used according to the age of the child at the time of death: Form1 for infants aged 0-28 days and Form 2 for children aged 29 days to 11 years.90 | Infant and Child Mortality
first seven days of life, to estimate perinatal mortality. Perinatal mortality is the number of stillbirths andearly neonatal deaths per 1,000 stillbirths and live births.5.2 LEVELS AND TRENDS IN INFANT AND CHILD MORTALITYTable 5.1.1 presents neonatal, postneonatal, infant, child, and under-5 mortality rates for threefive-year periods before the survey for Afghanistan. Because of the coverage issues described in Chapter2 as well as other issues with the quality of the mortality data for the South zone (discussed in more detailbelow), rates are also presented for Afghanistan excluding the South zone. The direct estimates from datain the birth history for Afghanistan show an infant mortality rate in the five years immediately precedingthe survey of 55 deaths per 1,000 live births, and an under-5 mortality rate of 71 deaths. Estimates ofchildhood mortality from the household death roster and the verbal autopsy data for the five yearspreceding the survey show a somewhat higher under-5 mortality rate of 84 per 1,000 live births (Table5.1). The infant mortality rate derived from the household data is 65 deaths per 1,000 births.Table 5.1.1 Early childhood mortality rates for AfghanistanNeonatal, postneonatal, infant, child, and under-5 mortality rates for five-year periods preceding the survey,Afghanistan 2010Years precedingthe surveyApproximatecalendar yearNeonatalmortality(NN)Postneonatalmortality(PNN) 1Infantmortality( 1 q 0 )Childmortality( 4 q 1 )Under-5mortality( 5 q 0 )Birth history data0-4 2006-2010 25 29 55 17 715-9 2001-2005 25 28 53 20 7210-14 1996-2000 25 32 57 24 80Household data 20-4 2006-2010 65 20 84Note: The years 1996-2010 in the Gregorian calendar roughly corresponds to the years 1375-1389 in theAfghan calendar.1Computed as the difference between the infant and neonatal mortality rates2Neonatal and postneonatal mortality rates are not calculated from the household data. This is becauseadequately detailed exposure time is available only for the dead neonates and not for the survivors since dateof birth information was not collected in the Household Questionnaire. Data on the movement of youngchildren into and out of the household during the five-year period prior to the survey was used to adjust theexposure time used in calculating the infant and under-5 rates.As Table 5.1.2 shows, the rates observed for Afghanistan excluding the South zone derived fromthe pregnancy history data—an infant mortality of 64 deaths per 1,000 births and an under-5 mortalityrate of 83 per 1,000 births—are higher than the national rates. Similarly, the rates for Afghanistanexcluding the South zone derived from the household death roster—an infant mortality rate of 76 deathsper 1,000 and an under-5 mortality rate of 97 deaths per 1,000—are higher than the national ratescalculated from the household data.Infant and Child Mortality | 91
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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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emoteness, and the scores were summ
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The analysis also suggests that amo
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Central zone (56 percent) has the h
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The data also show that more than h
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2.10 CONCLUSIONThe AMS 2010 enumera
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3.1.2 Data Quality AssessmentThe pr
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Page 64 and 65: Table 3.2 Fertility by background c
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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
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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 and 100: Table 4.8 Reasons for not deliverin
Page 101 and 102: Table 4.9 Assistance during deliver
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: INFANT AND CHILD MORTALITY 5Early c
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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 130 and 131: fallen from 118 deaths to 71 deaths
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
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Page 142 and 143: The unexpectedly low crude death ra
Page 144 and 145: Figure 6.8.2 Estimates of Female Ad
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Page 150 and 151: other words, about two in five deat
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Page 160 and 161: 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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