Afghanistan
Eastern Mediterranean Region
Maternal and Perinatal Health Profile
Department of Maternal, Newborn, Child and Adolescent Health (MCA/WHO)
Demographics and Information System Health status indicators - Maternal and Perinatal mortality
Total population (2013) [1] Maternal mortality ratio (2013) [3]
Total women aged 15-49 years (2013) [1] Annual number of maternal deaths (2013) [3]
Annual number of births (2013) [1] Perinatal moratlity rate (2010-11)[4]
Sex ratio at births (2005-10) [1] Stillbirth rate (2009)[3]
Birth registration coverage [2] Neonatal mortality rate per 1000 live births (2013) [5]
Total fertility rate (2013) [1] Annual number of neonatal deaths (2013) [5]
Adolescent fertility rate [per 1000 woman] (2005-2010) [1]
Under five population (2013) [1]
Coverage of vital registration of deaths [2]
Maternal nutrition Pregnancy involving risks
Prevalence of anaemia among pregnant women Birth interval <24 months and birth order >3 Night blindness (adjusted) Total age <18 and birth interval <24 months Iron tablets taken during pregnancy (any tablets)
Source: Special Mortality Survey 2010
Maternal mortality
Maternal mortality ratio (MMR): maternal mortality per 100 000 live births
% change in MMR between 1990-2013 Average annual % change in MMR 1990-2013
No Data Available
MDG 5 target by 2015
Sources: [1] Population Division, Department of Economic and Social Affairs, United Nations, World Population Prospects: The 2012 Revision.
[2] WHO, World Health Statistics 2014 . [3] WHO, UNICEF, UNFPA and The World Bank estimates. Trends in maternal mortality: 1990 to 2013.
[4] Demographic Health Survey.
[5] UNICEF/WHO/The World Bank/UN Pop Div. Levels and Trends in Child Mortality. Report 2014 .
1.3 15.2
- - 21.4
36,777 4,904,773
4.9
- 117
36 29 4,200 400 42 37
1.06 1,047,942 6,792,818 30,551,674
One of the eight Millennium Development Goals (MDGs) that has made some progress, albeit slow, is MDG 5: Improve maternal health. The two targets for assessing MDG 5 are reducing the maternal mortality ratio (MMR) by three quarters between 1990 and 2015, and achieving universal access to reproductive health by 2015.
Note: Consultations with countries were carried out following the development of the MMR estimates. The purposes of the consultations were primarily:
to give countries the opportunity to review the country estimates, data sources and methods; to obtain additional primary data sources that may not Progress towards improving maternal health
-5.5 -4.7
300 making progress
-3.9 -67
Range of uncertainly on annual % change in MMR (lower estimate)
Range of uncertainly on annual % change in MMR (upper estimate)
1200 1200 1100
730 400
MDG5 Target, 300
0
500 1000 1500
1990 1995 2000 2005 2010 2015
Per 100 000 LB
Perinatal mortality
Perinatal mortality rate (PMR): Trend Perinatal mortality by background characteristics
No Data Available No Data Available
Source: Special Mortality Survey 2010
Perinatal mortality by region
No Data Available
Source: Special Mortality Survey 2010
The perinatal mortality rate expressed per 1000 pregnancies of seven or more months' duration, is used as an indicator of the quality of antenatal and perinatal care. Perinatal deaths include pregnancy losses of at least seven months’ gestation (stillbirths) and deaths to live births within the first seven days of life (early neonatal deaths).
Note: information on stillbirths and deaths to infants within the first week of life are highly susceptible to omission and misreporting.
42 53 62
34 39 42 42 38 50 31
0 20 40 60 80
Total First pregnancy <15 39+ Urban Rural No education ≥ Secondary lowest highest
Previous pregnancy interval in months
Place of residence
Mother's education
Wealth quintile
Per 1000 births
42 45
74
35
40 43
0 10 20 30 40 50 60 70 80
Total Central Central Highlands North North-East West
Per 1000 births
Place of birth and type of provider
Place of Births - Where are babies born? Type of postnatal care provider - who provides the postnatal care?
No Data Available No Data Available
Source: Multiple Indicator Cluster Survey (2010-11) Source: Multiple Indicator Cluster Survey (2010-11)
Intervention coverage across continuum of care by geographical areas
No Data Available
Source: Multiple Indicator Cluster Survey (2010-11) and post natal care data from special mortality survey (2010) Home
64.8%
Public hospital
28.0%
Private hospital 4.9%
Not known 2.1%
Others 0.2%
No checkup
71.5%
Qualified doctor 15.3%
Nurse/mid wife/auxill ary nurse 12.4%
Non- trained providers
0.6%
Health/
Communit y-health workers 0.2%
0%
20%
40%
60%
80%
100%
Central Central Highlands
East North North-East South South East West
% of births assisted by skilled birth attendant % of births received post-natal care within 48 h
% of births delivered by C-section % of births in health facilities
Equity across continuum of care
No Data Available
Note:
If more than one source of ANC was mentioned, only the provider with highest qualification is conserved in this tabulation.
Source: Multiple Indicator Cluster Survey (2010-11) and post natal care data from special mortality survey (2010)
Utilization of services by wealth quintile
% of births in health facility % of births assisted by skilled personnel
No Data Available No Data Available
Source: Multiple Indicator Cluster Survey (2010-11) Source: Multiple Indicator Cluster Survey (2010-11) 14.2
25.8
15.6
0.9
12.5
8 33
78.1 78.3
9
67.4
38 42
77.1
74.3
8.7
66.2
42.1
17.8
41.2
30.5
2.4
25.3 19.4 19
47.9
38.6
3.6
32.9
23.4
0 20 40 60 80 100
% of women currently using
modern contraceptive
% women who received any ANC by
skilled provider
% births assisted by skilled personnel
% of births by C- section
% births in health facilities
% of births received postnatal care
Percent
Poorest Richest Urban Rural Total
0 10 20 30 40 50 60 70 80 90 100
Lowest Second Middle Fourth Highest
% of birth in health facility
Wealth quintile Equity gap
0 10 20 30 40 50 60 70 80 90 100
Lowest Second Middle Fourth Highest
% of births assisted by skilled personnel
Wealth quintile
Equity gap% of births delivered by C-section % of mothers with postnatal checkup in <2 days of delivery
No Data Available No Data Available
Source: Multiple Indicator Cluster Survey (2010-11) Source: Multiple Indicator Cluster Survey (2010-11)
Quality of care indicators Reasons for not seeking medical care
No Data Available No Data Available
Source: Multiple Indicator Cluster Survey (2010-11)
Source: Multiple Indicator Cluster Survey (2010-11)
Contents of ANC can be an important indicator for accessing the quality of ANC services that pregnant women receive in order to be prepared for
complications and any danger signs associated with pregnancy and childbirth.
Many barriers can prevent women from seeking medical care in general when needed. Understanding these factors is critical to improve the accessibility and
utilization of medical care during pregnancy and childbirth.
0 10 20 30 40 50 60 70 80 90 100
Lowest Second Middle Fourth Highest
% of births delivered by C-section
Wealth quintile Equity gap
0 10 20 30 40 50 60 70 80 90 100
Lowest Second Middle Fourth Highest
% of birthts received post-natal care
Wealth quintile
Equity gap0 20 40 60
Blood pressure measured
Urine sample
taken
Blood sample
taken
Richest Poorest Total
0 20 40 60 80 100
Knowing where to go for treatment
Getting permission to
go for…
Getting money for treatment
Distance to health facility Having to take
transport Not wanting to
go alone Concern there
may not be a female provider
Total
Workforce availability
Number of nurses/ midwives/ auxilliary nurse-midwives 1 Number of physicians, generalists
Number of obstetricians and gynaecologists
If yes, how many visits
Is there a national policy on discharge of mother and the baby after normal cildbirth at facility?
What year was the policy adopted?
Does the national policy require all maternal deaths to be reviewed?
If yes, what year was the policy adopted?
Is there a facility maternal death review (audit) process in place?
Is there a community maternal death review (audit) process in place?
Is there a national panel (committee) to review maternal deaths in place?
How often does the panel meet?
Is there a subnational panel (committee) to review maternal deaths in place?
Stillbirths
Is there a policy that requires all stillbirths (fresh or macerated) to be reviewed?
What year was the policy adopted?
Is there a facility stillbirth review (audit) process in place?
Is there a policy that requires all neonatal deaths (0-28 days) to be reviewed?
What year was the policy adopted?
Is there a facility neonatal deaths review (audit) process in place?
Is there a community neonatal death review (audit) process in place?
Magnesium Sulphate Oxytocin 400
4,200 3,500
Health system and policy indicators
2013 Yes Is there a national policy or policy statement on the right of every woman to have access to skilled care at
childbirth?
Health system and policy indicators
Does the national policy/policy statement indicate the minimum ANC visits during the normal pregnancy?
Yes 4
Yes No Is there a policy recommending postnatal follow up visit/review by a trained provider for mother and newborn?
Neonatal deaths
Source: UNFPA, State of the World's Midwifery 2014 report (http://www.unfpa.org/sites/default/files/pub-pdf/EN_SoWMy2014_complete.pdf) .
1 These figures do not necessarily reflect the number of practicing midwives or the ICM definition of a midwife.
Does national policy require all maternal deaths to be notified within 24h to a central authority?
No - No 2013
Yes
Yes Monthly
Yes No Yes Yes
Maternal deaths review
Yes
Does national Essential Drugs List include the following drugs indicated for use during pregnancy, childbirth?
Yes 2013
Yes
Source: WHO: Global maternal newborn, child and adolescent health policy indicator database (2014) based on key informant surveys in 2009-10, 2011
& 2013-14
Yes Yes
