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TETANUS TOXOID VACCINATION

UPTAKE AND ASSOCIATED
FACTORS AMONG PREGNANT
MOTHERS AT SELECTED
HOSPITALS IN MOGADISHU
SOMALIA.

Supervisor: Dr. Abdul Karem Ahmed Mohamud

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Meet Our Team

Meet Our Team

Abdirahman Ibrahim Nor Abdirahman Ahmed Abdulle Abukar Abdi Osman

Ebyan Mohamed Nor Mohamed Ibrahim Hussein Najma Osman Jimale

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BACKGROUND
• Tetanus toxoid is an FDA-approved
immunization given either alone or in
conjunction with other vaccines used
against tetanus. It defends against the
effects of the gram-positive bacterium
Clostridium tetani. (Ogden, et al, 2022)

• Annually, 3.3 million neonatal deaths

occur, of which neonatal tetanus shares
a high proportion, particularly in
developing countries. (Nigussie, et al
2021).

• WHO reported 14,230 neonatal tetanus

death cases in 2020. (Kanu, et al 2022)
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BACKGROUND
• Research done in Ethiopia showed that
at least two doses of tetanus toxoid
immunization coverage 52.4%,
(Nigussie, et al 2021).

• Report of studies conducted in Kenya

61.4 % had sufficient TT
immunization. (Haile, et al 2013).

• According to WHO Somalia (the

number of women who got (≥2tetanus
toxoid-containing vaccine TTCV doses
in 2020 was 66%
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The Problem
• Tetanus is highly prevalent in women and newborns
in Somalia due to antenatal mothers' extremely poor
health-seeking behavior, socioeconomic conditions,
unfavorable cultural attitudes, & inaccessible health
facilities in the country.

• In a three-year examination of cases, Turkey-Somalia

Hospital (Erdoğan Hospital) and the Mogadishu
Training and Research Hospital sought to determine the
death rate and prognostic factors in neonatal tetanus.
They concluded that most cases of neonatal tetanus in
Somalia did not receive maternal tetanus prophylaxis.
35 newborns diagnosed with neonatal tetanus, 22
(62.9%) of them died. (Güdeloğlu, 2020).
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The Objectives

• To assess the uptake of tetanus toxoid

vaccine and its associated factors in
selected hospitals in Mogadishu
Somalia.
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The Objectives

• To determine socio-demographic 2
factors associated with tetanus
• To describe obstetric factors
toxoid vaccination uptake among 3
associated with tetanus toxoid
pregnant mothers in selected
vaccination uptake among • To evaluate health facility factors
hospitals in Mogadishu Somalia
pregnant mothers in selected associated with tetanus toxoid

hospitals in Mogadishu Somalia. vaccination uptake among

pregnant mothers in selected
hospitals in Mogadishu Somalia.
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Literature review

AUTHOR location Study method Data tool result year

HAILE Kenya Cros-sectional survey 61.4% 2013

Gebremedhin Ethiopia Cros-sectional interview 51.8% 2020

Abuwa Nigeria Cros-sectional interview 37.1% 2019

Ahmed Egypt Cros-sectional interview 63.2% 2019

Mesert Ethiopia Cros-sectional interview 39.2% 2016

Our Somalia Cros-sectional questionnaire 49.1% 2023

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The Study design

• This study was a descriptive

hospital-based cross-sectional study
design. with the aim of to asses TT
vaccination uptake and associated
factors among pregnant mothers.
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The study area

• This study was conducted at 2
Banadir Hospital in the Wedajir
District and SOS Hospital in the • The Banadir Maternity and Children's
Heliwaa District of Somalia. Hospital, located in the Wadajir area of
1 Mogadishu, the capital of Somalia, was
founded in 1977. The maternity, pediatric,
• One of the largest pediatric and maternal
emergency, and HIV wards are just a few of
hospitals, SOS Hospital accepts many
the departments that make up this hospital,
moms and kids with various illnesses. The
which is run by Somalia's Ministry of Health.
SOS hospital in Mogadishu was founded
by SOS Children's Villages in 1989.
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The sampling
procedure
• The sampling procedure of this study was a non-
probability sampling procedure.

• The study time is December 2022 to June 2023.

• This study population was targeted and consist of

pregnant women attending antenatal care at Banadir
and SOS hospital during the timeframe of the study
period and meeting the criteria for inclusion.
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Sample size descriptions

n = sample size

Z = standard normal deviate corresponding to a 95% level of

• The Sample size for this study will be confidence
calculated using the Kish Lisle formula.
P = The proportion of the total number of mothers who received
two or more tetanus toxoid injections was 66% in 2020
𝟐
𝒛 𝒑 (𝟏 − 𝒑)
𝒏= 𝟐
d = level of precision (set) = 0.05
𝒅

n
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The inclusion The exclusion

• Pregnant women of any • Pregnant women who have a history of severe allergic
age with any trimester reactions to previous TT dose
who are willing to • Pregnant women do not attend Banadir and SOS
participate in the study. hospitals.
• Pregnant women who are not physically and mentally
able to answer the questions of the study.
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The data tool

• The data was collected through a structured

questionnaire which will be given to participants in
hard copies. Informed consent was obtained from
the participants before the interview.

• The collected data was checked and exported to

SPSS version 28 for analysis Descriptive statistics
will be used to summarize the data. Then chi-square
was used to identify the association between the
variables.
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Ethical consideration

• The respondents' privacy and confidentiality will be the

study's main ethical issues. When asking questions and
stepping into the respondent's personal space, the
researcher was required to respect their privacy.

• Participants will be made aware of their freedom to

participate. Additionally, they will also be informed that
they have the right to withdraw.
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Limitations

• our limitation in this study is a

generalization, as we conducted it from only
two hospitals. Also, there was a barrier in the
evidence of vaccination, because most
mothers did not keep their cards.
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The result
• Overall TT vaccination uptake in our study reported
women who received ≥2 doses is 49.1%.

• Urban residence, older age, and employment status

were correlated with higher TT vaccination uptake.

• Multipara women, regular ANC visits, ANC at a

hospital, hospital delivery in the previous pregnancy,
and a higher number of ANC visits were associated
with a higher TT vaccination uptake.

• The results suggest that the availability of a health

facility near the district plays a significant role in TT
vaccination uptake among pregnant women.
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The conclusion

• In conclusion, the research indicates that there is a low uptake of

tetanus toxoid vaccination among pregnant mothers. Furthermore,
the study found that the most common reason for not being
vaccinated was a lack of awareness about the need for the vaccine.

• These findings highlight the importance of increasing awareness and

education about the benefits of tetanus toxoid vaccination during
pregnancy
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Recommendation

• The healthcare providers should plan for daily basis health education provisions to

increase awareness

• Improve access to healthcare services and vaccines:

• increase maternal awareness of the importance of ANC service utilization.

• Address cultural and social barriers:

• Regular monitoring and evaluation of vaccination programs

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THANK
YOU