Maternal and Neonatal Tetanus Elimination in India to Spare Thousands of Deaths

India is one of the most populous countries in the world, with 327 million women of childbearing age and 26 million children born every year.

In 1988, tetanus killed as many as 160,000 young children in India. The drop ever since has been extraordinary. The elimination of MNT as a public health problem means that the annual rate is less than 1 per 1000 live births.  

“India has shown strong leadership in overcoming two major threats to the prosperity and future of the nation: polio and now maternal and neonatal tetanus,” said Louis Arsenault, UNICEF Representative. “India’s remarkable achievement in eliminating maternal and neonatal tetanus shows that by making a strong commitment to investing in public health their youngest citizens and mothers will enjoy their right to health, thereby making us all stronger.”

In contrast to other countries, India did not carry out massive tetanus vaccination campaigns. The Government, instead, applied a mix of strategies which included a state by state and system approach starting in 2003 in Andhra Pradesh, with the technical support of UNICEF, WHO and other stakeholders. Successful measures included providing cash incentives to families for delivering the baby in a health facility, training more skilled birth attendants and strengthening the institutional health delivery systems including the National Rural Health Mission (NRHM). In addition, there was a systematic vaccination of pregnant women attending antenatal care with Tetanus Toxoid (TT); and intensive behaviour change communication targeting communities to reduce harmful cord care practices.

These crucial steps have played a key role in eliminating the disease, contributing significantly to progress in the effort to save the lives of children under the age of five, most of whom die from preventable causes.

“Recent initiatives to strengthen the health systems and improve access to immunisation services such as Mission Indradhanush will no doubt contribute to the country’s ability to sustain this achievement,” explained Mr. Arsenault.

Maternal and neonatal tetanus is a disease that strikes down the poorest and most vulnerable, especially singling out women and their newborns living in areas with limited access to health services and poor hygiene. The disease, which is often transmitted when the umbilical cord is cut under unsanitary conditions, is characterized by wrenching muscle spasms, initially in the jaw. In remote rural areas of developing countries, with limited or no access to treatment facilities, almost all newborns infected with tetanus die. 

With India’s announcement, the list of validated countries grows to 37, but there are 22 countries that still must eliminate this disease, including:  Afghanistan, Angola, Cambodia, Central African Republic, Chad, Democratic Republic of the Congo, Equatorial Guinea, Ethiopia (partial), Haiti, Indonesia (partial), Iraq, Kenya, Mali, Niger, Nigeria, Pakistan, Papua New Guinea, Philippines (partial), Somalia, Sudan, South Sudan and Yemen.

About the Maternal Neonatal Elimination Initiative

The MNT Elimination Initiative is an international private-public partnership that includes National Governments, UNICEF, WHO, UNFPA, GAVI, USAID/Immunization Basics, CDC, UNICEF National Committees, the Government of Japan, Save the Children, PATH, RMHC, the Bill and Melinda Gates Foundation, Kiwanas International, Pampers – a division of Proctor and Gamble, and BD.

About UNICEF

UNICEF works in more than 190 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. For more information about UNICEF and its work visit: www.unicef.org and www.unicef.org/india

For more information, please contact:

• Caroline den Dulk,  Chief Advocacy and Communication,  UNICEF India

Tel: +91-9818106093, Email: cdendulk@unicef.org

• Geetanjali Master, Communication Specialist, UNICEF India 

Tel: 91-981 810 5861, E-mail: gmaster@unicef.org

• Sonia Sarkar, Communication Officer- Media, UNICEF India

Tel: +91-981 017 0289, E-mail: ssarkar@unicef.org