Afghanistan Mortality Survey 2010 - Measure DHS

The patterns of perinatal mortality are in the expected directions. Mortality is higher amongwomen whose age at delivery was either under 20 years or especially 40-49 years. First pregnancies andpregnancies that end after an interval of less than 15 months are more likely than pregnancies that endafter longer intervals to end in a perinatal loss. There is little difference in perinatal loss among urban andrural women. Perinatal mortality is lowest among women in the highest wealth quintile and those in thefourth and least remote quintiles.5.6 PATTERNS OF CHILDBEARING ASSOCIATED WITH HIGH CHILD MORTALITY RISKSThe survival of infants and children depends in part on the demographic and biological characteristicsof their mothers. Typically, the probability of dying in infancy is greatest among children born tomothers who are young (under age 18) or old (over age 34); children born after a short birth interval (lessthan 24 months after the preceding birth); and children born to mothers of high parity (more than threechildren). The risk is further elevated when a child is born to a mother who has multiple riskcharacteristics.The first column in Table 5.6 shows the percentage of births (excluding the South zone) occurringin the five years before the survey that fall into the various risk categories. Seventy-two percent of birthsin Afghanistan are at an elevated but avoidable risk of dying, while 16 percent are in a “risk-free”category. First births to mothers age 18-34, which make up 12 percent of births, are in the “unavoidable”risk category. Forty-three percent of births are in a single high-risk category, and 29 percent are in amultiple high-risk category. The most common single high-risk category is births of order 4 and higher(25 percent), while the most common multiple high-risk category is births to mothers occurring less than24 months after a prior birth and of birth order 4 and above (15 percent).The risk ratios displayed in the second column of Table 5.6 denote the relationship between riskfactors and mortality. In general, risk ratios are higher for children in a multiple high-risk category thanfor children in a single high-risk category. The most vulnerable births are those to women age 34 or older,especially if they have a birth interval less than 24 months and a birth order of 3 or higher. This group ofchildren is more than twice as likely to die early as children not in any high-risk category.The last column of Table 5.6 shows by category the distribution of currently married women whohave the potential for having a high-risk birth. This column is purely hypothetical and does not take intoconsideration the protection provided by family planning, postpartum insusceptibility, and prolongedabstinence. However, the data provide insight into the magnitude of high-risk births. Eighty percent ofcurrently married women are in categories that would put them at potential high and avoidable risk werethey to get pregnant. A higher proportion of women (47 percent) have the potential for having a birth in amultiple high-risk category than in a single high-risk category (33 percent).Infant and Child Mortality | 101