Maternal and Neonatal Tetanus (MNT) elimination
The initiative and challenges
Why Maternal and Neonatal Tetanus elimination?
In many countries, deliveries take place in unhygienic circumstances, putting mothers and their newborns at risk for a variety of life-threatening infections
Maternal and neonatal tetanus have been among the most common lethal consequences of unclean deliveries and umbilical cord care practices. When tetanus develops, mortality rates are extremely high, especially when appropriate medical care is not available
And yet, maternal and neonatal tetanus deaths can be easily prevented by hygienic delivery and cord care practices, and/or by immunizing mothers with tetanus vaccine
The MNT Elimination Initiative aims to reduce the number of maternal and neonatal tetanus cases to such low levels that MNT is no longer a major public health problem. Unlike polio and smallpox, tetanus cannot be eradicated (tetanus spores are present in the environment worldwide), but through immunization of pregnant and child bearing age women (CBAW) and promotion of more hygienic deliveries, MNT can be eliminated (defined as less than one case of neonatal tetanus per 1000 live births in every district)
A challenge
In 1988, WHO estimated that 787,000 newborns died of neonatal tetanus (NT). Thus, in the late 1980s, the estimated annual global NT mortality rate was approximately 6.7 NT deaths per 1000 live births - clearly a substantial public health problem
In 1989, the 42nd World Health Assembly called for elimination of neonatal tetanus by 1995
The following year, the 1990 World Summit for Children listed neonatal tetanus elimination as one of its goals, and the goal was again endorsed by the 44th World Health Assembly in 1991
Due to slow implementation of the recommended MNT elimination strategies, the target date for MNT elimination was postponed to 2000. In 2000, when the global elimination goal had still not been reached, the Initiative was re-constituted (see below) and elimination of maternal tetanus was added to the goal with a 2005 target date
WHO estimates that in 2010 (the latest year for which estimates are available), 58,000 newborns died from NT, a 93% reduction from the situation in the late 1980s.
While progress continues to be made, by November 2012, 31 countries have not reached MNT elimination status. Activities to achieve the goal are on-going in these countries, with many likely to achieve MNT elimination in the near future