Afghanistan Mortality Survey 2010 - Measure DHS

information was usually reported by a male respondent to a male interviewer, and birth history and siblinginformation was reported by an eligible woman to a female interviewer) as well as other independentsources. The preliminary data quality assessment suggests omissions in reporting of deaths.Finally, because analysis and presentation of adult mortality statistics from cross-sectionalsurveys is still in its early stages compared with analysis of childhood mortality statistics, it would bebeneficial if the data from this survey could lead to further developments in standardizing methodologiesfor collecting, analyzing, and presenting results pertaining to adult mortality. There is, at present, apaucity of comparable information within and between countries, an increasingly noticeable gap ofevidence in a field of growing importance, especially in light of changing risk patterns and agingpopulations.6.1 LEVELS AND TRENDS OF ADULT MORTALITY6.1.1 Adult Mortality from Sibling DeathsOne source of direct estimates of male and female adult mortality is information collected in thesibling history from the Woman’s Questionnaire. The sibling history provides information reported byeligible women, age 12-49, on all brothers and sisters, whether alive or dead. It is possible to derivemortality trends for periods over the past 15 years because information on siblings of eligible women spanseveral decades. From this information, age-specific death rates are computed by dividing the number ofdeaths in each age group by the total number of person-years of exposure in that age group, during a timeperiod. In the chapter, reports from respondents 15-49 are used to compare with external sibling histories.In total, respondents age 15-49 enumerated 230,994 siblings, of whom 107,412 were sisters and 123,582were brothers (Appendix Table C.10).Table 6.1 shows age-specific mortality rates for adults age 15-59 years for the seven-year periodprior to the survey. For both sexes, as expected, mortality is lower among adults in the younger agegroups where death rates rarely exceed 1 to 3 per 1,000, until it starts to rise after around age 50. It isnoted that estimates from the sibling history do not provide reliable estimates for age groups 50 years andolder. This is largely because information on the exposure to risk is greatly diminished due to relativelyfewer eligible women respondents (age 15-49) in older age groups (and thus fewer siblings are recorded).There is also selection bias since the survivors are likely to have lower mortality among their siblings.Thus, while the sibling history appears to be an adequate instrument for measuring mortality during thereproductive ages, for populations with a young age distribution, such as Afghanistan and manydeveloping countries, it is not the most efficient method for measuring adult mortality beyond age 50.As a summary measure of mortality, Table 6.1 presents the probability of dying for two ageranges: 35 q 15 is the probability of a 15-year old dying during the reproductive ages, 15-49 completed years(exact ages 15-50 years); 45 q 15 is the probability of dying between 15-59 completed years (exact ages15-60 years). The probability of dying during the reproductive ages is 63 per 1,000 for women, and 71 per1,000 for men in the 0-6 years prior to the survey. Again, although results are less reliable for the olderage groups (as indicated by the parentheses around the estimates), it appears that mortality risessubstantially as adults approach age 60 years: to 125 per 1,000 for women and to 156 per 1,000 for men.Due to the coverage issues described in Chapter 1 as well as other issues with the quality of the mortalitydata for the South zone described in the earlier chapters, Table 6.1 also presents recent levels of adultmortality for Afghanistan without the South zone. For women 15-49, the probability of dying is justslightly lower for Afghanistan excluding the South zone (62) than for the country as a whole (63).Similarly, the probability of dying for women 15-59 in Afghanistan excluding the South zone is lower at122 deaths per 1,000 than for the country as a whole (125). A similar pattern is observed for men.106 | Adult Mortality