Afghanistan Mortality Survey 2010 - Measure DHS

totally consistent with the estimated under-5 mortality level, while the sex ratio for the South zone is veryinconsistent.D.3.2.2 Distribution of Deaths by Years Since BirthFigure D.4 1 compares the distribution of deaths from the pregnancy history 2 according to thenumber of years since the child’s birth for the South zone and for Afghanistan excluding the South zone.The patterns of the numbers of dead children are completely different. In Afghanistan without the Southzone, the numbers of death rise with time since birth, which is to be expected, as exposure time is longer.In contrast, in the South zone the pattern is contrary to that expected, implying omission of dead childrenthat becomes increasingly severe with time since birth, especially for those born two or more years priorto the survey.450Figure D.4 Dead Children by Number of Years Since the Child'sBirth by Zone, Afghanistan 2010400200Number of deaths without South zone35030025020015010015010050Number of deaths in South zone50Dead children-Afghanistanexcluding the South zoneDead children-South zone00 1 2 3 4 5 6 7 8 9 100Years of birth prior to surveyAMS 2010D.3.2.3 Omission of Neonatal DeathsThe pregnancy history results were also examined for evidence of omission of neonatal deaths.There are several factors that may lead to higher underreporting of children who die in the neonatal periodthan of those who die subsequently. First, there is a fine line between a stillbirth and a live birth of a childwho soon dies, and survey respondents may not be aware of the characteristics that demographers andepidemiologists use to distinguish one from the other. Also, respondents may be reluctance to talk aboutsad and painful experiences, and cultural norms may discourage mention of early deaths.1 The vertical axes have been adjusted to represent equivalent sample sizes2 Evaluation of omission of dead children by year of birth prior to the survey using the household death rosters is notpossible. This is because the cumulative risk of death increases with age and the household death roster provides thedate of birth only for household members who died in the three years preceding the survey.188 | Appendix D