Residence Educational attainment - Household shocks and community preferences 109

Health 82 Table 8.7 Percentage of 6-9-month-olds receiving complementary feeding, by a residence, b highest educational attainment of mother Residence and education of mother Complementary feeding

a. Residence

Urban 46 Rural 39 Kuchi 45

b. Educational attainment of mother

No education 40 Primary school 45 Secondary school 47 College or more 24 Total 41 The breastfeeding indicators should be interpreted with caution. The exclusive breastfeeding indicator varies considerably depending on whether or not feeding patterns during the first three days are included in calculation of the indicator. In addition, mothers were not directly asked what liquids the child was given in the past 24 hours, which may more accurately capture exclusive breastfeeding patterns. Regarding complementary feeding, the NRVA 20078 does not contain specific questions about the types of food that children were given in the last 24 hours, and therefore no information is available about the nutritional content and benefit of the complementary foods children are receiving. This is extremely important in the context of Afghanistan, where dietary diversity can be extremely limited in certain areas of the country.

8.4 Reproductive health

6 Reproductive health implies that women and men are informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. Although there are no reliable national data on mortality available in Afghanistan, the latest estimate of the maternal mortality ratio in Afghanistan is 1,600 per 100,000 live births Government of Afghanistan 2009, which would be the third highest in the world UNFPA 2008. The survival of mothers has enormous socio-economic ramifications and is a crucial development priority in Afghanistan and internationally. The Afghanistan National Development Strategy aims for a 50 percent reduction of the maternal mortality ratio MMR from 1,600 in 2002 to 800 in 2015, and a further decrease to 400 by 2020 Government of Afghanistan 2009. Key strategies to reduce Afghanistan’s maternal mortality ratio are access to contraception to avoid unintended pregnancies, access to skilled care at the time of birth and timely access to quality emergency obstetric care. In addition, early pregnancies, narrowly spaced births and high fertility exacerbate maternal mortality. The NRVA 20078 provides information on most of these issues, which are the subject of the following sub-sections. All MDG indicators mentioned in this section refer to Goal 5 – improve maternal health. _________________________________________________________ 6 Methodological considerations underlying the analysis of various reproductive health issues are provided in Annex VI.B.