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

Authors Khan R, Vandelaer J, Yakubu A, Raza A, Zulu F

Received 8 October 2014

Accepted for publication 20 November 2014

Published 3 February 2015 Volume 2015:7 Pages 171—180


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Professor Elie Al-Chaer

Rownak Khan,1 Jos Vandelaer,1 Ahmadu Yakubu,2 Azhar Abid Raza,1 Flint Zulu1

1Health Section, Programme Division, UNICEF, New York, NY, USA; 2Family, Women and Children’s Health Cluster, World Health Organization, Geneva, Switzerland

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: maternal, neonatal, tetanus, elimination, high risk, immunization, vaccination, clean delivery

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