Afghanistan Mortality Survey 2010 - Measure DHS

Central zone and 32 percent in the North zone (Table 2.8). On the other hand, female education levels arelower in the South than in the other zones; 87 percent of women age 12-49 years surveyed in the AMS inthe South zone never attended school compared to 67 percent and 75 percent in the Central and Northzones, respectively (Table 2.13). Other factors external to the immediate household situation alsoobviously have potential to influence early childhood mortality levels in the South as well as the otherzones including the availability of health care services and the extent to which the security situation limitsaccess to existing services.A full evaluation of the various factors that are likely to influence mortality levels in the Southzone is beyond the scope of this report and, thus, it is not possible to provide national child mortalityestimates for Afghanistan as a whole. However, the results for Afghanistan excluding the South zoneprovide a basis for considering the implications of various assumptions with respect to child mortalitylevels within the South. For example, if we assumed that the under-5 mortality in the South zone is 15percent higher (112 deaths per 1,000) than the under-5 mortality for Afghanistan excluding the Southzone (97 deaths per 1,000), than the under-5 mortality rate for Afghanistan as a whole would be anestimated 102 deaths per 1,000. Similarly, assuming the rate for the South zone is 121 deaths per 1,000,i.e., 25 percent higher than the adjusted level for Afghanistan excluding the South zone, the national ratewould be 105 deaths per 1,000. Given that the South zone includes only around one-third of the country’spopulation, an assumption of even substantial excess mortality in the South zone only results in acomparatively modest potential effect on the national rate.In any mortality estimation process adjustments have to be made for known biases to obtain thebest estimate. The Government of Afghanistan together with the UN and other partners may consider thefull array of survey data and methods to come up with ‘best estimates’ of the trend in child mortality inAfghanistan.5.4 DIFFERENTIALS IN CHILDHOOD MORTALITYBecause the national rates are so clearly downwardly biased by the problems with the mortalitydata for the South zone, the following discussion of the trends and differentials in mortality levels willfocus on the patterns observed in the results for Afghanistan excluding the South zone.5.4.1 Socioeconomic DifferentialsTable 5.3 shows differentials in childhood mortality for Afghanistan excluding the South zone bykey socioeconomic variables including residence, mother’s education, and the wealth and remotenessquintiles.Infant and child survival are clearly associated with the socioeconomic characteristics of thehousehold and of mothers. Mortality rates are consistently lower in urban areas than in rural areas. Ratesin the Capital region also are consistently lower than the rates in other regions. Infant and under-5mortality rates are higher in the Western region than in other areas.As expected, mother’s education inversely relates to a child’s risk of dying. The relationshipbetween under-5 mortality and wealth is also as expected: children born to mothers in the highest wealthquintile have half the risk of those born to mothers in the poorest wealth quintile (49 and 106 per 1,000live births, respectively). Although not uniform, under-5 mortality levels decreased with the remotenessquintile from 93 per 1,000 births in the most remote quintile to 60-69 per 1,000 in the two least remotequintiles. This indicates that as expected better access to service centers improves the probability that achild will survive.Infant and Child Mortality | 97