Afghanistan Mortality Survey 2010 - Measure DHS

More documents

Recommendations

Info

about 80 percent of agricultural production. Livestock production contributes 14 percent of agriculturalGDP while fruit and nut production, which is widely expected to be the impetus for agricultural growth inthe future, contributes 6 percent. Growth in the agricultural sector is highly dependent on erratic wintersnows and spring rains for water. In 2009/10 the agricultural sector rebounded sharply from the severedrought in the previous year and grew by more than 20 percent. Growth is expected to be at about thesame pace in the current year. Agricultural products, including carpets and rugs, contribute to 80 percentof the total licit exports. Dried fruits and nuts such as raisins, figs, almonds and pistachios are majorexports. Raisins accounted for 21 percent of the total value of all agricultural exports, with almonds,pistachios and walnuts together representing 32 percent. The carpet and rug industry contributes another36 percent to total agricultural exports. Major export destinations are Pakistan, India, Iran, Russia andCentral Asian countries. The major agricultural imports into Afghanistan are food commodities, such aswheat and wheat flour, rice, sugar, vegetable oils, chicken and beef, and tea, which accounted for18 percent of total imports. Other imports include motor vehicles, petroleum products and textiles.Growth in imports continues to outpace the growth in agricultural exports.Afghanistan trades US$5 billion a year with other countries. In 1996, legal exports (excludingopium) were estimated at US$80 million, and imports were estimated at US$150 million per year. Sincethe collapse of the Taliban government in 2001, new trade relationships are emerging with the UnitedStates, Pakistan, Iran, Turkmenistan, the European Union, Japan, Uzbekistan, and India. Trade betweenAfghanistan and the United States is beginning to grow at a fast pace, currently reaching approximatelyUS$500 million per year. Afghan rugs are one of the most popular exports from the country. Otherproducts include hand-crafted antique replicas, precious and semiprecious stones, leather and furs(Dupree et al, 2011).Afghanistan is endowed with a wealth of natural resources, including extensive deposits ofnatural gas, petroleum, coal, marble, gold, copper, barites, talc, sulfur, lead, zinc, iron ore, salt, andprecious and semiprecious stones. According to a 2007 assessment, Afghanistan likely has significantamounts of undiscovered, nonfuel mineral resources. Geologists also found indications of abundantdeposits of colored stones and gemstones, including emerald, ruby, sapphire, garnet, lapis, kunzite,tourmaline, and peridot. In 2010, US Pentagon officials working with American geologists discoverednearly $1 trillion in untapped mineral deposits in Afghanistan (Risen, 2010).1.2 POPULATIONThe Afghan government, with the support of the State University of New York (SUNY) andUSAID, carried out in 1972-74 a demographic survey that used the most modern methods available(Country Studies, 2011). The survey reported a settled population of 10.2 million but was notrepresentative of the entire country. The last official census of Afghanistan, carried out in 1979, registereda total population of 15,551,358. There is no other comprehensive population-based information that iscollected systematically and scientifically in Afghanistan. Most population statistics rely on estimates andsamples.The 1979 Census estimated that more than 85 percent of the population lived in the rural areasand about 15 percent lived in the urban areas of the country (CSO, 1979). About half of the urbanpopulation lived in Kabul, the capital city. The nomadic population was estimated to be about 2.5 million.Due to the fragility of security, large-scale migration out of the country has been common. The majorityof migrants have settled in Pakistan and Iran.Afghanistan has an annual population growth rate of about 2.6 percent. The growth rate is2.3 percent in rural areas and 4.7 percent in urban areas, reflecting migration to urban centers. Thepopulation of Afghanistan in 2010 was estimated at 29.7 million (IMF, 2011). The government of4 | Introduction
Afghanistan, in cooperation with the international community, has tried since 2008 to initiate a populationcensus. Because of the fluid security situation within the country, this has not been possible.An anomaly in Afghanistan is the reporting of population by sex. Girls are underreported relativeto boys in the younger age groups (below age 15) (Haub, 2009). A preference for sons is prevalent. Sexselectiveabortion is not a likely cause for the underreporting of girls, especially given the lack of moderntechnology. Most likely, some girls are reported as boys because some stigma is attached to families whoraise only girls, and as a result, the families may not wish to admit to their presence (Haub, 2009).1.3 HEALTH POLICIES, STRATEGIES, AND STRUCTURE OF THE HEALTH CARE SYSTEM1.3.1 Evolution of Health Policy and StrategyThe general health of the Afghan people remained poor in the 1970s because of the war. Poorhealth was exacerbated by inadequate water supplies, poor sanitation and hygiene practices, unstablesecurity, lack of public policy on harmful products, unsafe drug use, danger in public places, uncontrolledwaste disposal, air and noise pollution, and food insecurity. The very weak foundation of the public healthsystem, threatened by constant war, made it even harder to deliver quality care to the general population.Health sector reform has flourished in Afghanistan since the 1980s in response to increasingrecognition of public sector inefficiencies in health care delivery. However, twenty years of unrest slowedimplementation of health programs. An interim National Health Policy (NHP) and National HealthStrategy (NHS) were developed during 2002-2004. This was followed by the development of the NHP2005-2009 and the NHS 2005-2006. The European Commission (EC), USAID, and the World Bank(WB), together with the Ministry of Public Health (MoPH), made efforts to rehabilitate Afghanistan’sdevastated health care system. A strategy to deliver a basic package of health services (BPHS) wasdeveloped in 2002 shortly after the establishment of the Transitional Islamic Republic of Afghanistanfollowing the departure of the Taliban, when the country recorded some of the worst health statistics inthe world (MoPH, 2005). The BPHS was adopted through various mechanisms, including performancebasedpartnership agreements (PPAs), within the framework of government health policy. This approachis premised on the notion that delivery of a BPHS to the majority of Afghans will address the majorburden of disease and mortality through a set of sustainable, cost-effective interventions (Strong et al.,2005).The BPHS includes cost-effective interventions aimed at addressing the principal health problemsof the population, especially the most vulnerable groups—women and children. Provisions are also madeto eventually incorporate interventions targeting other vulnerable groups. In 2003, the MoPH adopted astrategy of contracting out the delivery of basic health care services to nonstate providers so that it couldconcentrate fully on its role as a steward of the NHS. Under three different contracting mechanisms,underwritten by the WB, USAID, and the EC, each representing a different philosophical approach to therelationship among the host country government, donor, and population, the BPHS is currently beingdelivered by contract with nongovernmental organizations (NGOs) in 31 of the 34 provinces inAfghanistan. In the remaining three provinces, the MoPH is undertaking an experiment called the“Strengthening Mechanism,” by which it contracts with its own staff on the same terms as it contractswith NGOs. A key part of the strategic process that vastly enhanced the ability of the MoPH to managemany large NGO contracts was the establishment of the Grants and Contracts Management Unit (GCMU)in 2003. Situated within the MoPH, the GCMU has expanded rapidly with the BPHS, currently managingboth technically and financially, in conjunction with the Ministry of Finance (MoF), about US$125million worth of grants and contracts.Introduction | 5
Page 1: AfghanistanMortality Survey 2010
Page 5 and 6: CONTENTSTABLES AND FIGURES ........
Page 7 and 8: 4.3 Postnatal Care.................
Page 9 and 10: TABLES AND FIGURESCHAPTER 1INTRODUC
Page 11 and 12: Table 5.2 Early childhood mortality
Page 13: APPENDIX CDATA QUALITY TABLESTable
Page 17: AMS 2010 TECHNICAL ADVISORY GROUP M
Page 21 and 22: AMS 2010 CONTRIBUTORS TO THE REPORT
Page 23 and 24: INTRODUCTION 11.1 GEOGRAPHY, HISTOR
Page 25: After the fall of the communist reg
Page 29 and 30: workload of the BHC, up to two addi
Page 31 and 32: complete list of names of persons i
Page 33 and 34: 1.7 QUESTIONNAIRESFour questionnair
Page 35 and 36: survey, a detailed review of the qu
Page 37 and 38: 1.10 RESPONSE RATESTable 1.2 shows
Page 39: 72 percent of the rural population
Page 42 and 43: Figure 2.1 Population Pyramid80 +75
Page 44 and 45: Table 2.3 Children’s orphanhood s
Page 46 and 47: Table 2.5 presents information on h
Page 48 and 49: Table 2.7 Household possessionsPerc
Page 50 and 51: emoteness, and the scores were summ
Page 52 and 53: The analysis also suggests that amo
Page 54 and 55: Central zone (56 percent) has the h
Page 56 and 57: The data also show that more than h
Page 58 and 59: 2.10 CONCLUSIONThe AMS 2010 enumera
Page 60 and 61: 3.1.2 Data Quality AssessmentThe pr
Page 62 and 63: more problematic for the estimates
Page 64 and 65: Table 3.2 Fertility by background c
Page 66 and 67: Another frequently used approach to
Page 68 and 69: 3.2.6 Birth IntervalsA birth interv
Page 70 and 71: 3.2.7 Age at First BirthThe onset o
Page 72 and 73: Table 3.9 Teenage pregnancy and mot
Page 74 and 75: Table 3.11 Age at first marriagePer
Page 76 and 77:
the community level by utilizing al
Page 78 and 79:
difference may be due to difference
Page 80 and 81:
There are substantial differences i
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
Page 117 and 118:
data was found in Afghanistan exclu
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 128 and 129:
information was usually reported by
Page 130 and 131:
fallen from 118 deaths to 71 deaths
Page 132 and 133:
Table 6.4 shows adult mortality rat
Page 134 and 135:
mortality levels. The procedures us
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
Page 150 and 151:
other words, about two in five deat
Page 152 and 153:
It is useful to compare the seven-y
Page 154 and 155:
50PercentFigure 7.1Timing of Pregna
Page 156 and 157:
ased on the sibling history (270).
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
Page 172 and 173:
ased on sampling probabilities sepa
Page 175 and 176:
ESTIMATES OF SAMPLING ERRORSAppendi
Page 177 and 178:
For the total sample, the value of
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
Page 194 and 195:
Table C.2 Myers’ Blended IndexPre
Page 196 and 197:
Table C.5 Births by calendar years
Page 198 and 199:
Table C.6 Reporting of age at death
Page 200 and 201:
Table C.9 Sex ratio of live birthsS
Page 202 and 203:
mother and the household. The morta
Page 204 and 205:
The estimated infant mortality rate
Page 206 and 207:
D.3.1 Evidence of Underreporting of
Page 208 and 209:
Given the apparent omission of livi
Page 210 and 211:
totally consistent with the estimat
Page 212 and 213:
Perhaps a more sensitive indicator
Page 214 and 215:
Figure D.6 Neonatal and Postneonata
Page 217 and 218:
PERSONS INVOLVED IN AMS 2010Appendi
Page 219 and 220:
Office EditorsMaleMohammad NaseemFe
Page 221 and 222:
AshiqullahAssadullah JavedAtiqullah
Page 223:
QUESTIONNAIRESAppendix FAppendix F
Page 226 and 227:
Introduction and ConsentHello. My n
Page 228 and 229:
SECTION 2. MIGRATION FROM HOUSEHOLD
Page 230 and 231:
SECTION 4. INPATIENT HEALTH EXPENDI
Page 232 and 233:
SECTION 5. OUTPATIENT HEALTH EXPEND
Page 234 and 235:
SECTION 6. HOUSEHOLD CHARACTERISTIC
Page 236 and 237:
NO. QUESTIONS AND FILTERS CODING CA
Page 238 and 239:
Page 240 and 241:
SECTION 2. MARITAL STATUSNO.201QUES
Page 242 and 243:
Now I would like to record the name
Page 244 and 245:
SECTION 4. ANTENATAL, DELIVERY AND
Page 246 and 247:
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
SECTION 6. MATERNAL MORTALITYNO. QU
Page 254 and 255:
COMMENTS ABOUT RESPONDENT:INTERVIEW
Page 256 and 257:
Page 258 and 259:
DEATH OF A CHILD AGED 0-28 DAYSSECT
Page 260 and 261:
SECTION 6. DELIVERY HISTORYNO. QUES
Page 262 and 263:
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Page 271 and 272:
AFGHANISTAN MORTALITY SURVEYVERBAL
Page 273 and 274:
DEATH OF A CHILD AGED 29 DAYS TO 11
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285:
Page 288 and 289:
Page 290 and 291:
401 Could you tell me about the ill
Page 292 and 293:
DEATH OF A PERSON AGED 12 YEARS AND
Page 294 and 295:
Page 296 and 297:
Page 298 and 299:
Page 300 and 301:
Page 302 and 303:
Page 304 and 305:
Page 306 and 307:
show all

Afghanistan Mortality Survey 2010 - Measure DHS

Create successful ePaper yourself

Delete template?

Save as template?