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
Diphtheria 4,000 1,000
Measles 540,000 71,000
Poliomyelitis .. ..
Tetanus (excluding NT) 18,000 15,000
Neonatal Tetanus 180,000 ..
Pertussis 294,000
Yellow Fever 15,000 15,000
Haemophilus Influenzae B 413,000
Total
1,464,000 102,000
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
1997 2000 2002
248,000
200,000
180,000
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)
Numerator Number of mothers of live births in the
previous year with at least two doses of
TT within appropriate interval prior to
infants birth
Denominator Total number of women surveyed aged
15-49 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)