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    Health

    Life expectancy in Afghanistan rises past 60 years

    KABUL (PAN): The estimated life expectancy both for women and men in Afghanistan has increased considerably to 62-64 years, finds the first comprehensive national mortality survey.

    In 2009, the US Central Investigation Agency put the average life expectancy for the people in Afghanistan at 44.21 years. A man's life expectancy was 44.04 years and a woman's 44.39 years.

    But the Afghanistan Mortality Survey (AMS) 2010, which estimated adult mortality based on three different sources of information, noted a major boost.

    The sources included listing of deaths in households during the five years before the survey, women's reports of deaths of their brothers and sisters and survival at the time of the assessment of household members' parents. 

    All three methods yielded similar results with men and women living past age 60, according to the survey conducted by the Afghan Public Health Institute (APHI) at the Ministry of Public Health and the Central Statistics Organisation (CSO).

    Technical assistance for the survey was provided by ICF Macro, the Indian Institute of Health Management Research (IIHMR) and the World Health Organisation's Regional Office for the Eastern Mediterranean (WHO/EMRO).

    Funded by the USAID and UNICEF, the study estimates infant mortality in the country, excluding the south zone, at 77 deaths per 1,000 live births.  Under-five mortality is 97 deaths per 1,000 live births, meaning that every 10th child dies before celebrating his/her fifth birthday.

    Although falling, infant and under-five mortality rates in Afghanistan are still higher than in other regional countries, such as Pakistan, India, Bangladesh and Nepal.

    Children are at a higher risk of death because they are born to mothers under 20 or over 40, or less than two years after a sibling. Living in a rural area, a poor household or having a mothers with little or no education are other risk factors.

    About half of child deaths under five years of age are caused by respiratory infections or parasitic diseases; another 30 percent are due to prenatal conditions.

    Coming to women's mortality, the study links more than 50 percent of deaths to females between 15 to 59 years of age to non-communicable diseases, especially cardiovascular ailments and cancer.  One in five women's deaths in the age group is due to natal causes.

    Injuries – accidents, falls, violence and war -- are the leading cause of death among men aged 15-59, accounting for half of deaths in this age group. 

    Importantly, cardiovascular disease is the overwhelming cause of death both for men and women over 60, adds the survey, which also provides data on fertility, knowledge and use of family planning methods.

    With a nationally representative sample of 22,351 households, 47,848 women aged 12-49, the survey could not cover Kandahar, Helmand and Zabul provinces for security reasons.

    The AMS 2010 covered 87 percent of the population of the country, 98 percent urban and 84 percent rural. A total of 32 teams of 102 males and 82 females collected information from respondents in all 34 provinces from April 20-December 31, 2010.

    According to AMS, 60 percent of women received antenatal care from skilled doctors, nurses and midwives during their most recent pregnancy.  This represents a big increase over earlier statistics. 

    Sixty-seven percent of Afghan women delivered their last children at homes, almost all assisted by a relative or traditional birth attendant.

    Although still low, the number of women receiving skilled delivery care is increasing.  In 2003 only 14 percent of deliveries were assisted by medically trained providers; in 2010, this more than doubled to 34 percent. 

    The maternal mortality ratio estimated from household and sibling history data is below 500 deaths per 100,000 live births. The decline is consistent with the level of antenatal care from a skilled provider, skilled birth attendance, and delivery in a health facility, which have increased rapidly in recent years.

    Hemorrhage is listed as the main cause of maternal deaths in Afghanistan, where high blood pressure during pregnancy accounted for 20 percent of deaths. About 40 percent of the maternal deaths occurred during pregnancy; 40 percent during childbirth and the remaining 20 percent within two months after delivery.

    More than 20 percent of married women, a substantial increase over the last seven years, are using family planning methods. Injectables are the most commonly used methods, followed by oral contraceptives and the lactation amenorrhea method.

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