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Maternal and Neonatal Tetanus (MNT) elimination:
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1,2,3,4,5,6,7
Programmatic update
As a first step, countries are encouraged to develop a 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 1999-2008:
- 97.24 m CBAW targeted with TT-SIAs
- 84.89 m CBAW reached with 2 doses of TT
- 12 countries (and 15 States and Union Territories in India) eliminated MNTE
This update has been consolidated with WHO/UNICEF MNT collected data, as of March 2009

Immplementation of Supplementary Immunization Activities (SIAs)
TT-SIAs is one strategy to achieve MNT elimination. Three doses of TT vaccine are given to all women of child bearing 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, 47 countries initiated or expanded TT-SIAs between 1999 and 2008
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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 2008, 47 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, Ghana, Guinea, Guinea-Bissau, Haiti, India, Indonesia, Iraq, Kenya, Lao People's Democratic Republic (the), Liberia, Madagascar, Mali, Mauritania, Mozambique, Myanmar, Nepal*, Niger (the), Pakistan, Senegal, Sierra Leone, Somalia, Sudan (the), Togo*, Timor-Leste, Turkey, Uganda, United Republic of Tanzania (the), Viet Nam*, Yemen, Zambia*
*indicates the country has been validated as having eliminated MNT
full size map [jpg 96kb]

During 2009, 26 countries are planning to implement TT-SIAs
During 2009, 26 countries are planning to implement TT-SIAs: Afghanistan, Angola, Burkina Faso, Camodia, Cameroon, Central African Republic (the), Chad, Côte d'Ivoire, Democratic Republic of Congo (the), Ethiopia, Gabon, Guinea, Haiti, Indonesia, Kenya, Lao People's Democratic Republic (the), Mali, Mauritania, Myanmar, Niger (the), Pakistan, Somalia, Sudan (the), United Republic of Tanzania (the), Timor-Leste, and Yemen
full size map [jpg 69kb]


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MNT-related publications and useful links
Maternal and Neonatal Tetanus (MNT) elimination:
1,2,3,4,5,6,7
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