For policy makers the efforts to bring down maternal mortality figures in Afghanistan will be priority.
By 2050, Afghanistan’s projected population will be 75 million. At 6.6 live births per woman the fertility rate is the highest in Asia.
By 2050, Afghanistan’s projected population will be 75 million. At 6.6 live births per woman the fertility rate is the highest in Asia. Younus Payab, UNFPA assistant representative in Kabul, points out that the high fertility rate has pushed up maternal mortality rates. A woman dies every 20 minutes from childbirth in the country. At 1,800 maternal deaths per 100,000 live births Afghanistan is second only to Liberia, according to WHO.
Social indicators reveal a dismal picture. The sex ratio is warped; contraceptive prevalence is poor; and the infant mortality rate continues to trouble demographers. Nearly half the population is under 14 years. The only figure that has brought cheer in the past 10 years is for life expectancy. It was 43.8/43.9 for women and men respectively in 2009. Payab says the average age has risen to 49 in the last two years.
Bleak future
The rising population has set alarm bells ringing. Khair Mohammad Nairo, deputy minister of martyrs and disabled, has warned infrastructure – especially in education and agriculture – needs to be strengthened. “The majority population is young and attention needs to be paid to finding jobs for them,” the minister said.
At maternity hospitals doctors are concerned about the high mortality figures. Dr Hamaida Omar at the Estiqlal maternity hospital thinks repeated pregnancies show health centres are not reaching out to women to educate them about their health and safety. It could be because of an acute shortage of female doctors in the country.
Few women use health facilities that are staffed by male health workers. Tribal customs forbid women from leaving their homes unless accompanied by a male relative. The result is that few women in the villages deliver outside their homes.
Risky births
A high percentage of new borns are underweight. The under-five mortality rate has decreased from 257 per 1,000 births in 2000 to 161 per 1,000 in 2007-08, but is still one of the highest in the world, according to UNFPA.
In addition, according to Professor Khairudeen Khair Khwah, at the psychology department of Kabul University, “most people want more children as they think a large family will be to their economic advantage and they want to fulfil a religious duty.”
Figures for Afghanistan are projections. The last census in the country in 1979 was never completed because of conflict. The UN estimates the population is 32 million. The Central Statistics Organisation of Afghanistan (CSO) has put it at 26 million. Abdul Rehman Ghafoori, CSO director, says the figure does not include Afghan refugees.
New survey
A detailed socio-demographic and economic survey has been started. Data collection was completed on October 13 in Bamyan province under a joint project of the CSO and UNFPA with technical support from the Japanese government.
The survey will potentially be rolled out in all 34 provinces. This will provide Afghanistan with essential data on migration, as well as educational and professional characteristics of the population, including school attendance and literacy. Reliable socio-economic data can help the government provide for effective and fair governance, planning and resource distribution.
The government is struggling to provide basic education, health and housing. Policymakers have to change attitudes and customs through education. Afghanistan has much to achieve if the population boom is not to upset the stabilisation process.
