It is known to claim the life of the newborn in just seven days and it can also lead to the death of the mother involved.
It led to the death of about 49,000 newborns in 2013 alone and currently, on an average basis, it leads to 110,000 deaths annually in the African region.
Though this figure cannot be relied upon as it is estimated that less than 5% of the MNT cases are actually reported. This is due to the fact that especially in Africa, most women deliver their babies at home and infections, complications or resulting loss of life is not always reported. (WHO, 2013), (WHO, 2015).
Though this condition, has no cure and can really devastating, it can be entirely prevented through proper immunization in women of child-bearing age, and by maintaining hygienic child-bearing conditions.
Maternal and Neonatal Tetanus (MNT) is caused by a bacteria that lives in the soil, Clostridium tetani. When this bacteria comes in contact with open wounds, sore or injury, and especially the umbilical cord cut that is not properly treated, it can lead to tetanus infection especially if immediate and proper medical care is not given.
Due to the unhygienic conditions that often surround the child-bearing process especially in some rural African settings, the newborn and the mother are exposed to a high risk of infection with clostridium tetani and myriads of other micro organisms that cause some other infections and can result in neonatal sepsis as well.
Adequate maternal immunization can effectively stem the tide of maternal and neonatal tetanus.
Africa is said to have the largest number of MNT cases.
This can be attributed to the non availability and scarcity of well equipped health facilities readily available for child bearing in many African settings.
One of the major causes of this disease in the region is the unstable and relatively unreliable state of the health sector. In some places, access to quality health care is limited hence, forcing pregnant women to turn to home-delivery, delivery by quacks and/or local therapists. The problem with some of these local therapy homes is that they have poor hygienic conditions, thereby exposing the mother and the child to the risk of MNT infection. Also, the delivery tools they use are often times unsterilized and the practices around the child-delivery process are often unhygienic.
UNICEF in their report on Maternal and Neonatal Tetanus stated that ‘MNT is a disease-and an indicator-of lack of access and development’. It is called the disease of the poor because it affects the poor, uneducated, and less privileged in the society. (UNICEF, 2010)
Lack of adequate infrastructure, knowledge about MNT and also indifference by the populace as regards the disease in Africa contributes also to the incidence of the infection despite the work that is being done to ensure the elimination of the disease.
As earlier stated, MNT is a very lethal disease but it can easily be prevented by adequate maternal immunization. Hence, to reduce the occurrence of MNT, work is being done by UNICEF, WHO and other health bodies by ensuring the availability and easy accessibility to anti tetanus vaccines. Work is also being done to ensure that there are suitable clinics and hospitals that can be easily accessed in difficult to reach districts and rural places.
There is also the MNT elimination goal that was initiated by the world health assembly in 1989 where they set a goal to eliminate MNT in Africa by 1995. They did not meet this target, hence the global elimination goal was extended to 2005, and this goal too was not achieved.
In response to the challenges experienced in achieving the global elimination goal, the World Health Organization (WHO), and United Nations Children Fund (UNICEF) created a strategy called Global Immunization Vision and Strategy (GIVS) whose primary goal is to reduce the deaths from vaccine-preventable disease by two-thirds by 2015 compared to 2000 and this includes vaccination against MNT.
I would say that this is quite realistic and statistics also report that with the help of GIVS, the routine immunization coverage has recently begun to rise specifically in the sub-Saharan region.(Microbewiki, 2010)
In sub-Saharan Africa and even in other parts of the world, vaccines against tetanus generally have consistently improved over the last 20 years. Despite this success, there is still more work to be done and that includes going beyond just vaccination.
As it has been noted, MNT is especially known as the disease of the poor so the focus is been shifted from just global immunization through vaccination to improving the education, and the health system.
This seems to be a holistic approach to the issue rather than the vertical which may just focus on how to protect ourselves against it through vaccinations.
Hence, though immunization and global vaccination is being pursued, work is being done to address the underlying causes such as improving the education sector especially in the sub-Saharan region. There is also work to ensure steady improvement and growth of clinics, health centers and hospitals in terms of providing adequate infrastructure, innovation and increasing the numerical and qualitative strength of the medical personnel.
Beyond just the availability of good health care, plans are in place to ensure that these facilities are made readily accessible even to the poor in the society.
There are also other organizations and collaborations working to combat MNT in Africa and also globally, however work still remains. With the influx of appropriate technology and the proper use of the social media as well as appropriate and timely interventions by health organizations and bodies, we are hopeful that MNT in Africa and even as a global issue would soon be a topic for the history class and our mothers and newborns will no longer be at risk of this devastating disease.
Written By: Paul Ozioma
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