By Sharon Atieno

Though tetanus continues to be a substantial cause of maternal and neonatal mortality in many Sub-Saharan African (SSA) countries, the rate of vaccine uptake among pregnant mothers remains low.

This is according to a research study published in the PLOS One titled “Prevalence and correlates of tetanus toxoid uptake among women in sub-Saharan Africa: Multilevel analysis of demographic and health survey data.”

Despite antenatal tetanus vaccination reducing neonatal mortality by 94% if the majority of childbearing-age women are immunized, the study found that the prevalence uptake of tetanus toxoid- a vaccine that is given during pregnancy to protect women and newborns from tetanus during delivery- is at 51.54% in the region.

The study analyzed pooled data from the Demographic and Health Surveys (DHS) of 32 countries in SSA conducted from 2010 to 2020 and included about 223,594 women with a history of childbirth before the survey.

The countries sampled include Kenya, Tanzania, Sierra Leone, Zambia, Liberia, Congo, Angola, Burkina Faso, Nigeria, Niger, Ghana, Malawi, Mali, Ethiopia, South Africa, Zimbabwe, Benin, Togo, Chad, Burundi, Democratic Republic of Congo, Cote d’ Ivoire, Cameroon, Gabon, Gambia, Guinea, Comoros, Lesotho, Namibia, Rwanda, Uganda and Senegal.

According to Dr. Robert Dowou, epidemiologist, University of Health and Allied Science, Ghana, the performance across countries varied with Liberia having the best uptake at 79.2% while Zambia performed the poorest at 27.5%.

He noted that this difference is brought about by the country’s initiative to make the tetanus vaccine available and accessible to women as well as health education to create awareness amongst women about the importance of the vaccine among other health factors.

The study also found that women aged 20 years and above were more likely to receive the tetanus vaccine as opposed to teenage girls aged 15-19 years.

Dr. Dowou notes that pregnant teenagers are more likely to have a fear of seeking care due to the possible stigma they could face from the care providers and other women receiving care.

He adds that they could be feeling shy about seeking vaccination care or even antenatal care (ANC) and therefore will surely be less likely to receive all the doses of the tetanus vaccines.

Also, finance could be another hindrance to seeking care in case the services are not covered by health insurance.

Additionally, the study found that women who had never been in a union were more likely to uptake the vaccine than those who were married, cohabiting, divorced, widowed, and separated.

Further, women who were educated and those who were working were likely to take the vaccine as opposed to their counterparts who were not educated or not working.

According to Dr. Dowou, the study serves as evidence that informs the health sector stakeholders in SSA to implement interventions that ensure availability and accessibility to vaccines, especially in Zambia or other countries with poor coverage.

He notes that there should be health system reform that makes it easier for pregnant women to seek ANC, more investment in vaccine development and production research, as well as education of women to inform them and encourage them to have at least four ANC visits and by doing so, receive the tetanus vaccine.

“Also, health policymakers in SSA must ensure that the tetanus toxoid vaccine is free or covered under national health insurance to make it easier for women from poorer households to have access to it when necessary,” he said.