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J Res Med Sci 2016,  21:77

Successful elimination of maternal and neonatal tetanus in India: Ray of hope for other nations

Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Date of Web Publication28-Jan-2016

Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kanchipuram - 603 108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1735-1995.189694

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How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Successful elimination of maternal and neonatal tetanus in India: Ray of hope for other nations. J Res Med Sci 2016;21:77

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Successful elimination of maternal and neonatal tetanus in India: Ray of hope for other nations. J Res Med Sci [serial online] 2016 [cited 2020 Sep 24];21:77. Available from: http://www.jmsjournal.net/text.asp?2016/21/1/77/189694


Maternal and neonatal tetanus (MNT) continues to remain a significant public health concern even after the passage of more than two decades since the World Health Organization (WHO) called for its global elimination in the late 1980s. [1] In fact, MNT has been acknowledged as one of the key indicators to assess the extent of inequity in the provision of health-care services, as it is extremely common in remote areas with poor health care delivery and among the poor and illiterate sections of the community. [1]

The recent estimates suggest that almost 21 nations have not yet achieved the target of elimination of MNT disease, and many more are at the risk of relapse due to an interruption in the routine health services. [1] A wide range of challenges, such as the extent of political commitment to sustain efforts, monetary constraints, questionable effectiveness of the awareness campaigns, lack of access to the tetanus vaccine, inadequate sensitization of the health professionals to immunize pregnant females, conduction of home deliveries under septic conditions, and myths associated with vaccines in the society, have seriously hampered the accomplishment of the global target to ensure elimination of MNT by the year 2015. [2],[3]

India has successfully achieved the elimination of MNT by ensuring the incidence of MNT to less than one case per thousand births in all the districts of the nation. [4] The WHO validated this achievement and appreciated the program managers for their remarkable achievement, primarily because the nation alone accounted for 0.15-0.2 million cases of neonatal tetanus. [4] Further, it is a big achievement for the Southeast Asia Region, which has completely eliminated the disease, except some parts of Indonesia. [4]

This historical achievement has been attributed to the strong commitment from the policy-makers, strengthening of the primary health care, including antenatal package of services, ensuring presence of skilled birth attendants at the time of delivery, capacity building, and intensive efforts by the millions of health professionals. [4],[5] In addition, some of the targeted interventions, such as the strengthening of the various aspects of the national immunization program, launching of the "Mission Indradhanush" (scheme to immunize all children against seven vaccine-preventable diseases), and promotion of institutional deliveries. [4],[5]

However, owing to the ubiquitous presence of tetanus spores in the environment, there is a definitive risk of relapse and thus there is an immense need to sustain the efforts. [3] In order to globally achieve the target of MNT elimination at the earliest, it is time that experts should critically assess the existing challenges in the nations that have failed to achieve the target, devise a systematic plan with appropriate indicators to implement the elimination activities in a sustainable manner, strengthen routine antenatal services, explore the option of assistance from the private sector, and implement successful strategies from other nations in appropriate settings. [1],[2],[5]

To conclude, in the global mission to prevent the death of millions of infants due to MNT disease, it is time to strengthen not only the antenatal services, but even the routine immunization and institutional deliveries, especially in the low-resource settings.

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Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. Call for nominations for experts to serve on a SAGE working group on maternal and neonatal tetanus elimination - Beyond 2015; 2015. Available from: . [Last accessed on 2015 Sep 8].  Back to cited text no. 1
Khan R, Vandelaer J, Yakubu A, Raza AA, Zulu F. Maternal and neonatal tetanus elimination: From protecting women and newborns to protecting all. Int J Womens Health 2015;7:171-80.  Back to cited text no. 2
Thwaites CL, Beeching NJ, Newton CR. Maternal and neonatal tetanus. Lancet 2015;385:362-70.  Back to cited text no. 3
World Health Organization. WHO congratulates India on maternal and neonatal tetanus elimination; 2015. Available from: . [Last accessed on 2015 Sep 5].  Back to cited text no. 4
Bairwa M, Sk S, Rajput M, Khanna P, Malik JS, Nagar M. India is on the way forward to maternal and neonatal tetanus elimination! Hum Vaccin Immunother 2012;8:1129-31.  Back to cited text no. 5


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