“Maternal and Neonatal Tetanus Elimination in Ethiopia is hereby validated!” That was the conclusion of the joint mission from UNICEF and WHO today at its debriefing sessions with: the Ethiopian Ministry of Health; the WHO Representative to Ethiopia; and the UNICEF Representative to Ethiopia. The Federal Democratic Republic of Ethiopia has thus become 42ndcountry in the world to have validated the elimination of Maternal and Neonatal tetanus.
Ethiopia began accelerated Maternal and Neonatal Tetanus Elimination (MNTE) efforts in 1999. In 2011, all the regions in the country except the Somali Region were validated for MNTE. The 2011 validation mission made recommendations that would see the Somali Region progress to MNTE over time. The recommendations were implemented especially corrective vaccination campaigns against tetanus in 2016. The administrative, as well as post-campaign survey data, revealed more than 85% coverage in each of the 9 zones of Ethiopia Somali Region. The Joint validation mission reviewed these and other related data during the period, 28-30 June 2017, and concluded that maternal and neonatal tetanus elimination had been achieved in the Somali Region and, by extension, in the whole of Ethiopia.
Receiving the good news of the validation of MNTE in Ethiopia, the State Minister of Health, His Excellency Dr. Kebede Worku exclaimed that “The country had worked hard on improving Maternal and Child Health services delivery with tangible results including the record attainment of MDG 4 three years ahead of the target year of 2015. Along with this, MNTE was given emphasis and hence between 1999 and 2009, over 15 million women of reproductive age (WRA) in 59 high-risk zones were immunized during three rounds of Tetanus Toxoid (TT) Supplementary Immunization Activities (SIA). Thus in April 2011, the validation survey concluded that the whole country except Somali region had been validated for MNTE, and now the whole country including Somali region has achieved MNT elimination. This was possible through the efforts and investments made to improve maternal and child health care. The ministry of health will continue to sustain this gain by integrating maternal and child health care services with other public health priorities”.
WHO Representative, Dr. Akpaka A. Kalu, congratulated the country and said that “WHO is grateful for this remarkable result. He added that WHO will continue to support the Ministry to sustain this achievement by prioritizing risk areas for public health interventions that need more support and interventions through specifically targeted strategies with active community involvement to achieve the desired results.” Dr. Kalu also revealed that the integration of vaccine preventable disease with other health programs will be also incorporated in the WHO response strategy.
“I would like to extend my warm congratulations to the Ministry of Health and its partners for this excellent achievement, which benefits the health of women and children,” said Ms. Shalini Bahuguna, Officer in Charge of UNICEF Representative to Ethiopia. “UNICEF will continue to support the government of Ethiopia to sustain this achievement and deliver results for every child” she added.
Zones were selected following an in-depth review of the risk factors for maternal and neonatal tetanus (MNT) using the high-risk approach. Clean delivery and cord care practices, reaching all women of reproductive age in high-risk districts through TT SIAs and immunization of pregnant women during routine immunization and conducting neonatal surveillance as it is a hidden disease, are some of the interventions that helped to achieve this remarkable result.
It is acknowledged that the validation of MNTE in Ethiopia is not an end in itself but the beginning of a new phase of interventions focused on sustaining the attainment of Maternal and Neonatal Tetanus elimination status, an endeavour that is possible only through: maintaining tetanus protection level at above 80 percent in every zone especially in the zones that achieved elimination through Supplementary Immunization Activities (SIAs); strengthening partnerships for improving Maternal, Newborn and Child Health (MNCH) activities; and implementing the sustainability plan of action-2014 which incorporates a switch from Tetanus Toxoid (TT) to Tetanus-diphtheria (Td) vaccine, and annual joint review of national MNT risk status to guide the interventions.