Afghanistan Mortality Survey 2010 - Measure DHS

Figure D.6 Neonatal and Postneonatal Mortality Rates for AfghanistanExcluding the South Zone and For Other South Asian Countries, by Percentage ofDeliveries Taking Place in FacilitiesNeonatal MortalityPostneonatal MortalityNeonatal Mortality Rate60504030South Asia without Afghanistan20 Afghanistan excluding south zoneAll Afghanistan10Linear (South Asia without Afghanistan)0Postneonatal Mortality Rate45403530252015South Asia without Afghanistan10Afghanistan excluding south zoneAll Afghanistan5Linear (South Asia without Afghanistan)00 5 10 15 20 25 30 35 40 45 0 5 10 15 20 25 30 35 40 45Percent of Births in Past 5 years Delivered in a Health FacilityPercent of Births in Past 5 years Delivered in a Health FacilityD.4 CONCLUSIONThe quality of the mortality results forthe South zone from all three data sources isseverely compromised, and, thus, the data areunusable for producing mortality estimates. Anyoverall estimate of the levels of infant and childmortality needs to be based on the results forAfghanistan excluding the South zone—abouttwo-thirds of country’s population. Table D.8gives the range of estimates for infant andunder-5 mortality rates in Afghanistan excludingthe South zone from the three data sources,without and with adjustments. Using theadjusted pregnancy history rates, the “best”estimate for the infant mortality rate, that is, therate that is closest to the true mortality based onall relevant evidence, is 77 deaths per 1,000births and the under-5 mortality rate is 97 per1,000 births.Table D.8 Measured and adjusted infant and under-5 mortalityrates, Afghanistan excluding the South zoneData source and adjustmentInfantmortalityrateUnder-5mortalityratePregnancy historyMeasured (0-4 years prior to survey) 64 83Adjusted for omission of neonataldeaths ( by NN/PNN ratio of 1.09) 71 90Adjusted for omission at 0-1 years(rates for 2-6 years prior to survey) 67 87Adjusted for both omission at 0-1years and neonatal deaths (ratio of 1.09) 77 97Household deaths and exposureMeasured 76 97Adjusted for sex ratio of deaths andexposure using Coale-Demeny WestModel Life Table at level 18 67 92Indirect children ever born-childrensurvivingMeasured 71 98“Best” estimate 77 97Given that estimates of mortality should not be produced directly for the South zone, the best thatcan be done to estimate the mortality rates for all of Afghanistan is to calculate a range based on assumedexcess mortality in the South zone relative to that in the rest of Afghanistan. The results of this calculationare given in Table D.9, which uses the proportion of women 15-49 in the South zone sample (34.7percent) to produce the results. For all of Afghanistan the rates would vary from a level of 77 to 84 forinfant mortality and from 97 to 105 for under-5 mortality, depending on the assumption that is made withrespect to the mortality pattern in the South zone.192 | Appendix D