Afghanistan Mortality Survey 2010 - Measure DHS

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The unexpectedly low crude death rates, on the order of 5 and 7 per 1,000, suggest that there maystill be some level of underreporting of deaths in the household (Table 6.3). Despite this low rate, thelevel of adult mortality computed from household information is higher than that from the sibling historyby about one-fourth for women and one-tenth for men.Figure 6.7 Number of Deaths from Verbal Autopsies byCalendar Year, Afghanistan 20101,2581,3091,400 Number of deaths *1,2001,0008009278311,05475660040020002005 2006 2007 2008 2009 2010 Don’t know,missingYear28Note: The years 2005-2010 roughly corresponds to 1384-1389 in the Afghan calendar.* Indicates incomplete yearAMS 2010Despite the higher estimates from thehousehold source compared with the sibling history,there is still underreporting of deaths in the household.This is due in part to recall bias that occurs in anyretrospective survey. However, there may also beother factors at work that prevented completereporting, especially in the South zone. Table 6.10shows results of a preliminary assessment of theTable 6.10 Completeness of household death reportingEstimated percentage of completeness of reported householddeaths for age 5 and above in the 0-4 years preceding thesurvey, Afghanistan 2010Central North South TotalMale 119 125 75 105Female 82 63 49 66completeness of reporting of household deaths for age 5 and above in the 0-4 years prior to the survey,using the Brass Growth Balance Method (see for example, Brass, 1975; Bennett and Horiuchi, 1984; Hill,1987). 2 First, the completeness of reporting of female deaths is consistently lower than that of male deaths;and second, the completeness of reporting is lowest in the South zone for both sexes compared with otherzones. For males in the Central and North zones, more deaths than expected are reported, resulting in over100 percent completeness perhaps because household members reported on deaths that occurred outsidethe reference period. However, this method assumes a population with no migration and with constantfertility and mortality rates, which is not the case in Afghanistan. It is important not to attribute whatmight be real changes in the population structure to undercounting and overcounting of deaths.2 The Brass Growth Balance Analysis is a death distribution method for estimating the percentage of deaths that areregistered relative to the household population distribution. In this assessment, for each age group the exposure timefrom the household and the deaths in the past five years were used to compute partial birth rates and partial deathrates. These were plotted and the slope of the fitted line indicates the proportion of deaths relative to the population.120 | Adult Mortality
6.4.3 Internal and External Comparison of Adult Mortality RatesComparison between the various mortality rates between ages 15-59 from the sibling history, thehousehold death roster, and the indirect orphanhood method are shown in Figures 6.8.1 for men and 6.8.2for women, respectively. Both the male and female mortality rates are somewhat consistent in the figures.A preliminary conclusion that may be drawn from these results is that, for both sexes, there is goodinternal consistency among the estimates from the various AMS 2010 sources in more recent years. Formen, there is a divergence in the trends indicated by indirect orphanhood levels and the direct siblingmortality levels such that there is a much stronger decline in the former; however, the rates are about thesame around 2003 and 2004 (1382 and 1383 in the Afghan calendar). For women the estimates comparewell in the mid-2000s. If indirect orphanhood estimates were extrapolated to more recent years, it appearsthat they would be lower than the 2008 (circa 1387) direct estimate from household deaths and from thesibling history.400Figure 6.8.1 Estimates of Male Adult Mortality BetweenAges 15 and 59 from the Various Sources in the Survey,Afghanistan 2010350Probability of dying per 1,000300250200150100502010 AMS Orphanhood method2010 AMS Sibling history2010 AMS Household deaths01994 1996 1998 2000 2002 2004 2006 2008 2010Note: The years 1994-2010 corresponds roughly to theyears 1373-1389 in the Afghan calendar.Calendar yearAMSInternal consistency of estimates between sources, however, does not necessarily represent robustmeasures of adult mortality. The challenging question that remains, therefore, is to investigate furtherwhy levels of recent mortality from all three sources—indirect, sibling, and household death—are lowerthan estimates for neighboring countries, including Pakistan, Bangladesh, and India (see next section).Preliminary evidence on data quality points to substantial underreporting of deaths to females, generallyin the South zone. Although further analysis is beyond the scope of the present report, a closerexamination is necessary to quantify the potential effects of skewed sex ratios, low completeness ofreported deaths, and lack of coverage of adult mortality in the rural areas of the South zone.Adult Mortality | 121
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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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difference may be due to difference
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There are substantial differences i
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Table 3.17 Total fertility rate and
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MATERNAL HEALTH 4Afghanistan is com
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Table 4.1 Antenatal carePercent dis
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Figure 4.2 Trends in Antenatal Care
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Page 109 and 110: Table 4.13 Problems in accessing he
Page 111 and 112: INFANT AND CHILD MORTALITY 5Early c
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Page 115 and 116: In considering the mortality trends
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Page 121 and 122: Table 5.4 Early childhood mortality
Page 123 and 124: The patterns of perinatal mortality
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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 144 and 145: Figure 6.8.2 Estimates of Female Ad
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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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Page 179 and 180: Table B.3 Sampling errors for Urban
Page 181 and 182: Table B.5 Sampling errors for North
Page 183 and 184: Table B.7 Sampling errors for South
Page 185 and 186: Table B.9 Sampling errors for North
Page 187 and 188: Table B.11 Sampling errors for Cent
Page 189 and 190: Table B.13 Sampling errors for East
Page 191: 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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