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Review
. 2015 Feb 3:7:171-80.
doi: 10.2147/IJWH.S50539. eCollection 2015.

Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all

Rownak Khan  1 , Jos Vandelaer  1 , Ahmadu Yakubu  2 , Azhar Abid Raza  1 , Flint Zulu  1
Affiliations
Review

Maternal and neonatal tetanus elimination: from protecting women and newborns to protecting all

Rownak Khan et al. Int J Womens Health. .

Abstract

A total of 35 of the 59 countries that had not eliminated maternal and neonatal tetanus (MNT) as a public health problem in 1999 have since achieved the MNT-elimination goal. Neonatal tetanus deaths have decreased globally from 200,000 in 2000 to 49,000 in 2013. This is the result of increased immunization coverage with tetanus toxoid-containing vaccines among pregnant women, improved access to skilled birth attendance during delivery, and targeted campaigns with these vaccines for women of reproductive age in high-risk areas. In the process, inequities have been reduced, private-public partnerships fostered, and innovations triggered. However, lack of funding, poor accessibility to some areas, suboptimal surveillance, and a perceived low priority for the disease are among the main obstacles. To ensure MNT elimination is sustained, countries must build and maintain strong routine programs that reach people with vaccination and with clean deliveries. This should also be an opportunity to shift programs into preventing tetanus among all people. Regular assessments, and where needed appropriate action, are key to prevent increases in MNT incidence over time, especially in areas that are at higher risk. The main objective of the paper is to provide a detailed update on the progress toward MNT elimination between 1999 and 2014. It elaborates on the challenges and opportunities, and discusses how MNT elimination can be sustained and to shift the program to protect wider populations against tetanus.

Keywords: clean delivery; elimination; high risk; immunization; maternal; neonatal; tetanus; vaccination.

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Figures

Figure 1
Figure 1
MNT-elimination status of 59 priority countries.
Figure 2
Figure 2
Trend in reported TT2+ coverage and estimated neonatal tetanus deaths, 2000–2013. Abbreviation: TT, tetanus toxoid.
Figure 3
Figure 3
Measuring tetanus toxoid-immunization coverage.
Figure 4
Figure 4
Status of WRA at risk in 59 countries reached with TT (by years), and remaining WRA at risk in 2013.
See this image and copyright information in PMC

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