Infectious diseases spread through a lack of clean drinking water are to blame for many Afghan deaths [Reuters]

One Afghan child in 10 will die before their fifth birthday, while maternal mortality rates have declined, Afghanistan's ministry of public health says.

The Afghanistan Mortality Survey found the highest childhood mortality rates occurred in children born into poorer families in rural areas, the ministry announced in a presentation on Wednesday.

Around half of the deaths of under-fives were caused by respiratory infections or infectious and parasitic diseases.

These diseases are most commonly transmitted through contaminated drinking water. Nearly a quarter of Afghanistan's city dwellers and half of its rural population do not have access to clean water.

Recent data from UNICEF showed Afghanistan had the second-highest mortality rate for under-fives in the world.

Deadly infections

Average life expectancy for all Afghans was 62, but nearly half of Afghanistan's population is under the age of 15.

Among men, one-fifth of deaths were caused by injury, which caused around half of male deaths between the ages of 15 and 59.

These were equally split between accidental injuries and wounds caused by war and violence, said Suraya Dalil, acting prime minister of health.

Infections were the leading cause of death among women, causing around one-third of fatalities, the report found.

Maternal mortality rates, which three years ago the World Health Organisation (WHO) said were the world's worst, have improved, the survey found. It gave a maternal mortality ratio of 327 per 100,000 births, against a 2008 WHO figure of 1,400 per 100,000.

Survey limits

The producers of the survey of just over 22,000 households conceded that its results were biased towards urban and more secure areas, while deaths of women and children remain under-reported.

Many areas in southern provinces, which have seen heavy fighting in recent years, could not be surveyed.

"The survey shows evidence that maternal mortality can be reduced in a country like Afghanistan," Dalil said.

"It shows that our strategies on educating midwives on emergency obstetric care, on family planning have worked. However, it also tells us that there is a long way ahead of us, and we have many challenges ahead."

She said the department would continue to focus on educating midwives, particularly in rural areas.

Dalil admitted the results of the survey were less than comprehensive.
"This is the best estimate we have," she said. "We couldn't cover the whole country. We wanted to cover 24,000 households, but we could only go to 22,000. We couldn't cover a third of the population in the south."

Despite encouraging figures, Afghanistan remains one of the world's worst countries with records of early death.

Source: Agencies