Immunization, Vaccines and Biologicals

Maternal and Neonatal Tetanus (MNT) elimination


Programmatic update

As a first step, countries are encouraged to develop an MNT plan of action (PoA), detailing how they would proceed to eliminate MNT through the implementation of the recommended strategies as normal

The PoA is then submitted to UNICEF or other partners for financial and technical support. One major component of most plans is the implementation of TT Supplementary Immunization Activities (TT-SIAs) in high risk districts (HRD). TT SIAs are then implemented as per the country's capacity and available resources

Global progress 1999-2014:

  • > 170 m Women of Reproductive Age (WRA) targeted with TT-SIAs
  • > 130 m WRA reached with 2 doses of TT
  • In 2014, 9 countries implemented TT SIAs: Angola, Cambodia, DRC, Haiti, Indonesia, Kenya, Mali, Niger, Nigeria.
  • Cumulatively, 53 countries initiated or expanded TT-SIAs between 1999 and 2014
  • 37 countries (plus Ethiopia (all except Somali region), 32/36 States and Union Territories in India, 30/34 Provinces in Indonesia and Philippines ( all except ARMM) eliminated MNTE

This update has been consolidated with WHO/UNICEF MNT collected data, as of May 2015


Implementation of Supplementary Immunization Activities (SIAs)

TT-SIAs are among the strategies to achieve MNT elimination. Three doses of TTCV are given to all women of reproductive age (usually women between 15 and 45 years of age) who live in "high risk areas", using a campaign-style approach. In practice, 3 rounds of campaigns are organized in the selected areas with at least one month interval between rounds 1 and 2, and at least six months between 2 and 3. The criteria to label districts as "high risk" are country-specific. The TT-SIAs provide protection for at least 5 years, and need to be complemented by follow-up doses, usually given as part of the antenatal care. In many countries, TT-SIAs are implemented in a phased manner, and it can therefore take several years before all high risk districts will actually have been targeted

Cumulatively, 53 countries initiated or expanded TT-SIAs between 1999 and 2014

TT-SIAs is one strategy to achieve MNT elimination. Three doses of TT vaccine are given to all women of child bearing age who live in "high risk areas". This means that 3 rounds of campaign-style activities are implemented, with at least one month interval between rounds 1 and 2, and at least six months between 2 and 3. Between 1999 and 2014, 53 countries implemented TT-SIAs in parts of the country: Afghanistan, Angola, Bangladesh*, Benin*, Burkina Faso*, Burundi*, Cambodia, Cameroon*, Central African Republic (the), Chad, Comoros (the)*, Congo (the)*, Cote d'Ivoire, Democratic Republic of the Congo (the), Egypt*, Equatorial Guinea, Ethiopia, Gabon, Ghana*, Guinea, Guinea-Bissau*, Haiti, India, Indonesia, Iraq, Kenya, Lao People's Democratic Republic (the), Liberia*, Madagascar, Mali, Malawi, Mauritania, Mozambique*, Myanmar*, Nepal*, Niger (the), Nigeria, Pakistan, Papua New Guinea, Philippines, Senegal*, Sierra Leone, Somalia, South Sudan, Sudan, Togo*, Timor-Leste*, Turkey*, Uganda*, United Republic of Tanzania (the)*, Viet Nam*, Yemen and Zambia*
*indicates the country has been validated as having eliminated MNT



During 2014, 9 countries implemented TT-SIAs

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Last update:

8 June 2015 15:46 CEST