Afghanistan Mortality Survey 2010 - Measure DHS

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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
Table 6.1 Recent levels of adult mortality (sibling deaths)Direct estimates of age-specific mortality rates and probabilities of dying forfemales and males age 15-49 and 15-59 based on the survivorship of sistersand brothers of female respondents for the period 0-6 years prior to thesurvey, Afghanistan 2010DeathsFEMALEExposureMortality rates(per 1,000)Age15-19 122.8 110,187 1.120-24 117.6 98,458 1.225-29 95.1 81,164 1.230-34 92.6 61,521 1.535-39 68.6 43,903 1.640-44 79.8 25,599 3.145-49 44.4 13,713 3.250-54 30.7 4,442 (6.9)55-59 9.6 1,400 (6.8)Probability of dyingAll Afghanistan15-49 ( 35 q 15 ) 6315-59 ( 45 q 15 ) 125Afghanistan (excluding the South zone)15-49 ( 35 q 15 ) 6215-59 ( 45 q 15 ) 122MALEAge15-19 151.9 121,531 1.220-24 245.5 116,781 2.125-29 169.4 95,976 1.830-34 151.6 71,740 2.135-39 105.7 51,790 2.040-44 78.2 30,603 2.645-49 50.4 17,348 2.950-54 55.7 6,331 (8.8)55-59 20.2 1,938 (10.4)Probability of dyingAll Afghanistan15-49 ( 35 q 15 ) 7115-59 ( 45 q 15 ) 156Afghanistan (excluding the South zone)15-49 ( 35 q 15 ) 6715-59 ( 45 q 15 ) 153Note: A figure in parentheses indicates a less reliable estimate, with arelative error of 20 percent or more.The sibling history based on respondents up to age 49 can provide estimates of trend in mortalityfor a few years prior to the survey. In Table 6.2 age-specific mortality rates for adults age 15-59 years areshown for three five-year periods preceding the survey. The decline in adult mortality is noticeable acrossall age groups but is especially marked among older age groups (age 40 and above) of adults. Theestimates for older age groups, however, must be interpreted with caution since they are less reliable dueto larger sample variations. There is a decreasing trend in mortality for both sexes over the three five-yearperiods. For women of reproductive age 15-49 ( 35 q 15 ), mortality rates for Afghanistan have fallen bynearly half, dropping from 103 deaths per 1,000 in the 10-14 years before the survey to 52 per 1,000 inthe 0-4 years before the survey (Figure 6.1). Similarly, male adult mortality for the same age group hasAdult Mortality | 107
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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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more problematic for the estimates
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Table 3.2 Fertility by background c
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Another frequently used approach to
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3.2.6 Birth IntervalsA birth interv
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3.2.7 Age at First BirthThe onset o
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Table 3.9 Teenage pregnancy and mot
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Table 3.11 Age at first marriagePer
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the community level by utilizing al
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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 and 112: INFANT AND CHILD MORTALITY 5Early c
Page 113 and 114: first seven days of life, to estima
Page 115 and 116: In considering the mortality trends
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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
Page 125: problem for areas outside the South
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
Page 140 and 141: 6.4.2 Household ReportingIn the Hou
Page 142 and 143: The unexpectedly low crude death ra
Page 144 and 145: Figure 6.8.2 Estimates of Female Ad
Page 146 and 147: The third panel estimates life expe
Page 148 and 149: Maternal mortality in Afghanistan i
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Page 158 and 159: The VA interview started by checkin
Page 160 and 161: Figure 8.1 Causes of Female and Mal
Page 162 and 163: Table 8.4 Causes of deaths among ch
Page 164 and 165: Global Agricultural Information Net
Page 166 and 167: Streatfield, P.K., S.E. Arifeen, A.
Page 168 and 169: • The Cluster Level Questionnaire
Page 170 and 171: A.3 STRUCTURE OF THE SAMPLE AND THE
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Page 175 and 176: ESTIMATES OF SAMPLING ERRORSAppendi
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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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Afghanistan Mortality Survey 2010 - Measure DHS

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