Neonatal tetanus elimination: fleld guide

Abstract

BACKGROUND In many countries neonatal tetanus is responsible for half of all neonatal deaths due to vaccine-preventable diseases and for almost 14% of al¡ infant deaths. It is estimated that in the 1970s more than 10,000 newborns died annually from neonatal tetanus in the Americas. Neonatal tetanus is prevented by immunization and/or assuring clean delivery and post-delivery practices. In 1989, the World Health Assembly adopted a resolution calling for the elimination of neonatal tetanus throughout the world by 1995 and the resolution was endorsed by the Directing Council of PAHO. Ministers of Health of PAHO Member Countries initiated specific program activities to eliminate neonatal tetanus with support from PAHO and a variety of international agencies. These activities take place within the wider context of the Expanded Program on immunization (EPI) and existing programs on family and community health and benefit from knowledge acquired in polio and measles eradication programs. It is recognized that the program to eliminate neonatal tetanus as a public health problem differs from other eradication programs, such as those for smallpox and polio, in that even after the goal of zero cases is reached, the potential for return of the disease is always present. Therefore, the issue of sustainability is of paramount importance...