Table 6.

Summary of Current Key Findings on the Status of Maternal and Neonatal Tetanus Elimination (MNTE) Strategies in the WHO African Region

Programmatic areas	Key Findings
Tetanus Vaccination	Only 5/47 (11%) countries include the WHO-recommended 3 tetanus booster doses in their immunization schedules
	Regional average DTP3/Penta3 coverage has increased from 52% in 2000 to 76% in 2015
	Among countries that have achieved MNTE, average TT2+ coverage among pregnant women and PAB have increased from 49% and 69% in 2000 to 84% and 86% in 2015, respectively
	Among countries that have not achieved MNTE average TT2+ coverage among pregnant women and PAB have increased from 19% and 54% in 2000 to 64% and 69% in 2015, respectively
	By the end of 2016, over 79 million WRA still need to be reached with at least 2 TTCVs
Clean Delivery and Cord Care	In 2013, the average percentage of births attended by SBAs was 54%
	Among countries that have achieved MNTE, 17/37 (46%) have >70% SBA coverage
	Among countries that have not achieved MNTE, 1/10 (10%) have >70% SBA coverage
Neonatal Tetanus Surveillance	NT surveillance is weak in most countries leading to underreporting of cases, with the efficiency of notification for NT cases globally estimated at less than 11%
	NT surveillance could be strengthened with case investigations, standardized performance indicators, and better integration with active surveillance for measles and acute flaccid paralysis
	Serosurveys can help monitor progress towards achieving or maintaining MNTE

WHO=World Health Organization; MNTE= Maternal and Neonatal Tetanus Elimination; WRA = Women of Reproductive Age; TTCV = Tetanus Toxoid Containing Vaccines; SAB = Skilled Birth Attendants; NT= Neonatal Tetanus

Sources and calculations for averages are described in the methods section