Womens Questionnaire TETANUS TOXOID MODULE

Goals and Targets MDG 5: Reduce by three quarters the maternal mortality ratio Strategy: Elimination of maternal and neonatal tetanus Target: Reduce incidence of neonatal tetanus to less than 1 case of neonatal tetanus per 1000 live births in every district

Neonatal Tetanus Definition Caused by tetanus spores, a bacteria found everywhere in the environment Transmission occurs when there is contact with broken skin such as an infants umbilical cord Poverty, poor hygiene and limited access to health services increase the risk for transmission during childbirth

Neonatal Tetanus Prevention 1. Immunization of pregnant women with at least 2 doses of tetanus toxoid vaccine (TT2+), passing protection to the newborn for up to first two months of life 2. Immunization of women of childbearing age who live in areas of high risk for transmission (delivery of immunizations usually through campaigns) 3. Promotion of clean delivery and cord care practices

Estimated Deaths from Vaccine Preventable Diseases (As of March 2004; source WHO) Cause 2002 Under 5 Over 5 Diphtheria4,0001,000 Measles540,00071,000 Poliomyelitis.. Tetanus (excluding NT)18,00015,000 Neonatal Tetanus180,000.. Pertussis294,000… Yellow Fever15,000 Haemophilus Influenzae B413,000… Total 1,464,000102,000

Note: The boundaries and the names shown and the designations used on these maps do not imply official endorsement or acceptance by the United Nations. MNT not eliminated Countries with TT campigns MNT eliminated * includes Timor-Leste 248, , ,000 Neonatal Tetanus death reduction Situation of Maternal and Neonatal Tetanus (Remains a problem in 51 countries)

Obtain country specific womens immunization card(s) for easy recognition Obtain the most recent national immunization schedule for women Find out if any tetanus toxoid campaigns were carried out in previous year (identify month) Preparation

Purpose and Eligibility Obtain information on tetanus toxoid immunizations among women with a live birth in the previous 2 years (allows estimation of indicator based on births during the last year). Womens Questionnaire TETANUS TOXOID MODULE

Neonatal tetanus protection (protection at birth against tetanus) NumeratorNumber of mothers of live births in the previous year with at least two doses of TT within appropriate interval prior to infants birth DenominatorTotal number of women surveyed aged years with a birth in the year preceding the survey Indicator

Appropriate interval 1)two TT doses during the pregnancy (TT3>=2) 2)one TT dose during the pregnancy and at least one TT dose prior to the pregnancy (TT3=1 AND TT6>=1) 3)at least two TT doses prior to the pregnancy of which the last dose was less than 3 years before the birth 4)with 3 doses within the 5 years before the pregnancy 5)with 4 doses with the last dose less than 10 years before the pregnancy 6)with 5 doses or more ever (TT6>=5).

TT Module Ask to see card (TT1) TT during last pregnancy, how many times (TT2, TT3) Filter out for women with more than 2 doses during last pregnancy (TT4) TT injections before last pregnancy, timing of last injection if any (TT5-TT8)