Afghanistan Mortality Survey 2010 - Measure DHS

the probabilities of death for each age interval and region. Looking at the ratios for the South zone, thereis a high sex ratio of births in the under-1 age group, and uniformly high sex ratios of deaths. Moreover,the sex ratios of the mortality rates do not compare well with those of the model life tables. For example,the sex ratios for infant mortality are below those of any of the Coale-Demeny West Model Life Tables,and the sex ratio for under-5 mortality compares to level 12 (female life expectancy of 47.5), indicatingpoor data quality and varying levels of omission of both living and dead children for each sex althoughwith a tendency for omission to be greater for girls than boys.In the patterns for Afghanistan excluding the South zone, the ratios of surviving children aresomewhat too high at around 108, indicating a small relative undercount of living girls. The sex ratios ofthe mortality rates for infant and under-5 mortality (119 and 114, respectively) are just about those of theCoale-Demeny West Model Life Tables at level 15 (female life expectancy of 55.0). At this level, under-5mortality is 157 for boys and 139 for girls. This level of mortality is too high and the sex ratios of themortality rates are too low. It is more likely that there is a relative undercount of male deaths (and of theirbirths) in the 0-4 year period of the pregnancy history. Separating the North from the Central zone andcomparing with the West Model Life Tables, it appears that the undercount of males is concentrated in theNorth zone (not shown in the table). The sex ratio of mortality in the preceding five years of 122 (134deaths/110 births) for the Central zone is between those of levels 17 and 18 (female life expectancies of60.0 and 62.5 years) and thus quite acceptable. The North zone sex ratio of mortality in this time period is108 (116 deaths/107 births), and is too low, indicating an undercount of dead boys in this zone. However,because of the relatively small number of deaths by zone, the confidence intervals overlap and are quitewide so that the differences between zones and with the model life tables may just be due to samplingvariation.With respect to the household data, the final three columns in Table D.3 show the sex ratios ofexposure and deaths and of the probabilities of death for each age interval and region. The sex ratios forexposure for the South zone appear to be high at 129 for infant mortality and 134 for under-5 mortality,probably due to an omission of living girls relative to boys. However, the sex ratios of the mortality ratesare too low compared with the model life tables, indeed indicating mortality below level 1 (lifeexpectancy of 20.0). The sex ratios of the mortality rates therefore indicate an omission of boy deathsrelative to that of girls. That is not to say that girl deaths are not omitted but rather that they have not beenomitted to the extent of those of boys. However, adjusting for the sex ratios so that they are within normallimits as indicated by the model life tables only raises the South zone under-5 mortality rate from 58 to62, clearly not sufficient to correct for under-reporting.For Afghanistan excluding the South zone, the sex ratios for exposure are within an acceptablerange of 103 to 107. The sex ratio for deaths is high for infant deaths, perhaps indicating a possibleomission of girl deaths under age 12 months. Looking at the sex ratios of the rates for Afghanistanexcluding the South zone, they are consistent with the model life table values at level 18 (female lifeexpectancy of 62.5 years). At that level, the infant mortality rate is 60 for girls and 74 for boys and under-5 mortality rate is 84 for girls and 100 for boys, compared with the calculated infant mortality rates of 68for girls and 84 for boys and under-5 rates of 89 for girls and 105 for boys. Thus the level of the mortalityrates and the sex ratios of the rates are generally consistent for Afghanistan excluding the South zone butsuggest the level of mortality may be about 5 to 10 percent too high. From the model life tables, both sexrates are consistent with a level of 67 for infant mortality and 92 for under-5 mortality.Finally, the sex ratios of the rates calculated using indirect techniques can be compared to thoseratios in the model life tables. The sex ratio of the under-5 mortality rates are 117 for all Afghanistan, 116for Afghanistan excluding the South zone, and 109 for the South zone. At the estimated life expectancies,the model life table sex ratios are 119 for all Afghanistan, 116 for Afghanistan excluding the South zone,and 127 for the South zone. Thus, the sex ratio for Afghanistan without the South zone is, therefore,Appendix D | 187