Afghanistan Mortality Survey 2010 - Measure DHS

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more problematic for the estimates for the South zone, where roughly a third of the population was notcovered in the AMS 2010.3.2 FERTILITY BEHAVIOR3.2.1 Current FertilityInformation from the pregnancy history is used in this section to assess current and completedfertility, and factors related to fertility such as age at first birth, birth intervals, and adolescentchildbearing. The level of current fertility is one of the most important demographic indicators measuredin the survey. For health and family planning policy makers, current fertility has direct relevance topopulation policy and programs. Measures of current fertility are presented in Table 3.1 for the three-yearperiod preceding the AMS 2010, corresponding approximately to the calendar period of mid-2007-2010.A three-year period was chosen because it reflects the most current information yet also allows the ratesto be calculated based on a sufficient number of cases to obtain estimates with a reasonable level ofprecision.Table 3.1 shows several measures of current fertilityfor Afghanistan at the national level and by urban-ruralresidence. Age-specific fertility rates (ASFRs), expressed asthe number of births per thousand women in a specified agegroup, are calculated by dividing the number of live births towomen in a specific age group by the number of woman-yearslived in that age group. The total fertility rate (TFR) is basedon the ASFRs and is defined as the total number of births awoman would have by the end of her childbearing period ifshe were to pass through those years bearing children at thecurrently observed age-specific fertility rates. The generalfertility rate (GFR) is the number of live births occurringduring a specified period per 1,000 women age 15-44. Thecrude birth rate (CBR) is the number of births per 1,000population during a specified period.The total fertility rate for Afghanistan for the threeyears preceding the AMS 2010 is 5.1 children per woman. Theoverall age pattern of fertility as reflected in the ASFRsindicates that fertility is low among adolescents age 15-19,increases to a peak of 262 children per 1,000 women amongthose ages 25-29, and declines rapidly thereafter.As expected, fertility is higher in rural areas (5.2children per woman) than urban areas (4.7 children perwoman). As the ASFRs show, the pattern of higher ruralfertility is particularly evident in the 15-24 and 40-49 agegroups (Figure 3.2). The urban-rural difference in fertility ismost pronounced for women in the age group 20-24.Table 3.1 Current fertilityAge-specific and total fertility rates, the generalfertility rate, and the crude birth rate for the threeyears preceding the survey, by residence,Afghanistan 2010ResidenceAge group Urban Rural Total15-19 67 84 8020-24 236 263 25725-29 260 263 26230-34 205 210 20935-39 120 130 12840-44 43 65 6045-49 13 29 26TFR 4.7 5.2 5.1CI: (5.0-5.3)GFR 154 168 165CBR 34.7 35.935.6TFR (excludingSouth zone) 4.5 5.2 5.0CI: (4.8-5.2)Note: Age-specific fertility rates are per 1,000women. Rates for the age group 45-49 may beslightly biased due to truncation. Rates are for theperiod 1-36 months prior to interview.TFR: Total fertility rate expressed per womanGFR: General fertility rate expressed per 1,000women age 15-44CBR: Crude birth rate, expressed per 1,000populationCI: Confidence interval40 | Fertility, Marriage, and Family Planning
Figure 3.2 Age-specific Fertility Rates by Urban-Rural Residence300 Births per 1,000 women Urban Rural Total25020015010050015-19 20-24 25-29 30-34 35-39 40-44 45-49Age group AMS 20103.2.2 Fertility DifferentialsTable 3.2 and Figure 3.3 present the differentials in the total fertility rate (TFR), the percentage ofwomen age 15-49 who are currently pregnant, and the mean number of children ever born (CEB) towomen age 40-49, by urban-rural residence, zone, region, education, wealth quintile and remotenessquintile. Women residing in the South zone have a higher TFR than women in the North and Centralzones. TFR varies by region, with women in the South Eastern and Eastern regions having an average ofone child more than women in the Central Highland region. The differentials in TFR across educationgroups are striking. Fertility decreases rapidly from 5.3 children per woman among women with noeducation to 2.8 children per woman among women who have a higher education. TFR is not uniformlyassociated with increasing wealth; however, women in the lowest wealth quintile have an average of 5.3children compared with women in the highest quintile who have 4.8 children. A similar pattern is seen forremoteness quintile with women in the least remote quintile having the lowest fertility.Table 3.2 also shows the percentage of women who reported being pregnant at the time of thesurvey. This percentage may be underreported since women may not be aware of a pregnancy, especiallyat the very early stages, and some women who are early in their pregnancy may not want to reveal thatthey are pregnant. Twelve percent of women reported being pregnant at the time of the survey. Ruralwomen are more likely to be pregnant than urban women. The percentage of women currently pregnantranges from a low of 9 percent among women in the Southern region to a high of 15 percent among thosein the South Eastern region. The proportion of women currently pregnant varies considerably by women’seducation, from 13 percent among women with no education to less than 6 percent among women withonly secondary education.Table 3.2 also presents a crude assessment of trends in the various subgroups by comparingcurrent fertility with a measure of completed fertility (the mean number of CEB to women age 40-49).When fertility levels have been falling, the TFR will be substantially lower than the mean number of CEBto women 40-49. The comparison suggests that fertility has fallen by nearly two births during the past fewdecades from 6.9 births per woman to 5.1. Fertility has declined in all subgroups as seen in Table 3.2 withthe difference between current and completed fertility highest among women with secondary education(2.4).Fertility, Marriage, and Family Planning | 41
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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
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 and 26: After the fall of the communist reg
Page 27 and 28: Afghanistan, in cooperation with th
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 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
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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
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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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first seven days of life, to estima
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In considering the mortality trends
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data was found in Afghanistan exclu
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Central zone and 32 percent in the
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Table 5.4 Early childhood mortality
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The patterns of perinatal mortality
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problem for areas outside the South
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information was usually reported by
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fallen from 118 deaths to 71 deaths
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Table 6.4 shows adult mortality rat
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mortality levels. The procedures us
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Table 6.6 Female and male life tabl
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Table 6.7 Mean sibship size and sex
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6.4.2 Household ReportingIn the Hou
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The unexpectedly low crude death ra
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Figure 6.8.2 Estimates of Female Ad
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The third panel estimates life expe
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Maternal mortality in Afghanistan i
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other words, about two in five deat
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It is useful to compare the seven-y
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50PercentFigure 7.1Timing of Pregna
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ased on the sibling history (270).
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The VA interview started by checkin
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Figure 8.1 Causes of Female and Mal
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Table 8.4 Causes of deaths among ch
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Global Agricultural Information Net
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Streatfield, P.K., S.E. Arifeen, A.
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• The Cluster Level Questionnaire
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A.3 STRUCTURE OF THE SAMPLE AND THE
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ased on sampling probabilities sepa
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ESTIMATES OF SAMPLING ERRORSAppendi
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For the total sample, the value of
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Table B.3 Sampling errors for Urban
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Table B.5 Sampling errors for North
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Table B.7 Sampling errors for South
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Table B.9 Sampling errors for North
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Table B.11 Sampling errors for Cent
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Table B.13 Sampling errors for East
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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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