Success in reducing maternal and child mortality in Afghanistan

Abstract

After the collapse of the Taliban regime in 2002, Afghanistan adopted a new development path and billions of dollars were invested in rebuilding the country's economy and health systems with the help of donors. These investments have led to substantial improvements in maternal and child health in recent years and ultimately to a decrease in maternal and child mortality. The 2010 Afghanistan Mortality Survey (AMS) provides important new information on the levels and trends in these indicators. The AMS estimated that there are 327 maternal deaths for every 100,000 live births (95% confidence interval = 260–394) and 97 deaths before the age of five years for every 1000 children born. Decreases in these mortality rates are consistent with changes in key determinants of mortality, including an increasing age at marriage, higher contraceptive use, lower fertility, better immunisation coverage, improvements in the percentage of women delivering in health facilities and receiving antenatal and postnatal care, involvement of community health workers and increasing access to the Basic Package of Health Services. Despite the impressive gains in these areas, many challenges remain. Further improvements in health services in Afghanistan will require sustained efforts on the part of both the Government of Afghanistan and international donors.

Keywords:

• maternal mortality
• infant
• child
• mortality
• Afghanistan survey

Notes

1. The MMRatio is based on deaths during pregnancy, at delivery, or within two months of delivery. This ratio is sometimes called the pregnancy-related mortality ratio. The 2010 AMS report also includes an alternative measure of maternal mortality based on deaths of women while pregnant or within 42 days of the termination of a pregnancy, excluding deaths from accidental or incidental causes (APHI et al., 2011).

2. The 2010–11 MICS does not provide information for calculating the TFR.

3. Badakhshan, Bamyan, Baghlan, Faryab, Ghazni, Hirat, Jawzjan, Khost, Kabul, Kandahar, Paktika, Paktya, and Takhar

4. Neonatal, infant and under-five mortality rates discussed here have been adjusted to reflect the ‘best’ estimates, as described in APHI et al. (2011).