Coverage and determinants of protective dose tetanus toxoid vaccine among postnatal women delivered at university of Gondar comprehensive specialized hospital, northwest Ethiopia, 2019

Abstract

Background: Even though there have been tremendous strides globally in reducing the burden of tetanus, neonatal deaths due to tetanus have reported annually, and most deaths occur in sub-Saharan Africa which accounts for nearly half of the global neonatal mortality by tetanus. Immunization of pregnant women or women of childbearing age with at least two doses of tetanus toxoid is estimated to reduce mortality from neonatal tetanus by 94%. Despite its importance, immunization programs are suboptimal in Ethiopia, where more than 85% of the population have resides in rural districts. Therefore, this study has been used to determine the coverage and determinants of protective dose tetanus vaccine among postnatal women and design a strategy to maximize the service. Methods: Institution-based cross-sectional study was conducted from December 20-June 20, 2019. The sample was taken using a systematic random sampling method. To collect data from the study participants, a semistructured interviewer-administered and pre-tested questionnaire was used. The data were entered into Epi info version 7.0 and then exported to SPSS version 20.0 for analysis. Logistic regressions analysis was conducted and the level of statistical significance was determined by a p-value of less than 0.05. Results: The proportion of immunization with Tetanus toxoid protective dose was 69.8% (95% CI: 65.2-74.0). Urban residence (AOR = 3.626, 95%CI: 1.510-8.707), husband's having secondary education (AOR = 7.397, 95%CI: 1.873-29.211), husband's having tertiary education (AOR = 9.539, 95%CI: 2.277-39.969), women stated that the provision of TT vaccine service was good (AOR = 3.978,) and mother stated health care workers who provide TT vaccine were good in their behavior (AOR = 4.259, 95%CI: 1.913-9.484) were factors influencing utilization of TT protective dose immunization. Conclusion:The proportion of TT protective dose immunization in the study area was found to be low. Being Urban residence, secondary and tertiary levels of the husband's educational status, women who stated that 'the provision of TT vaccine service was good' and "health care workers who provide TT vaccine were good in their behavior were statistically significant factors influencing TT protective dose immunization. Thus, it is better to strengthening education and empowering women to enhance vaccine utilization. Besides, promoting husband's education and creating community awareness particularly rural residents are better options to increase utilization of TT protective dose vaccine.

Spatial distribution and determinants of tetanus toxoid immunization among pregnant women in Ethiopia using data from Ethiopian demographic and health survey 2016

“…The overall TT vaccination coverage among pregnant women in Ethiopia was 42.4% which is lower than the study conducted at the University of Gondar Comprehensive Specialized Hospital, Ethiopia 69.8% [ 17 ], in Southern Ethiopia 51.8 [ 13 ], 72.5% [ 14 ], India 68% [ 2 ], Sudan 60% [ 18 ] and Sera Leon 82.12% [ 19 ]. The finding from this study is also far below the WHO recommendation, which states 80% immunization coverage to achieve neonatal tetanus elimination [ 7 ].…”

Maternal Tetanus Toxoid Vaccination in Benin: Evidence from the Demographic and Health Survey

“…Specifically, urban women in Benin and the rest of SSA enjoy improved access to health information and health care facilities and personnel. This urban bias in access to health care resources may work to increase their chances of receiving the range of vaccinations including TT before and during pregnancy and after birth relative to their rural counterparts where such health care facilities and personnel are mostly lacking [ 25 , 26 , 27 ].…”

Protective doses of tetanus toxoid immunization and its associated factors among mothers in southern Ethiopia

“…Of the socio-demographic factors, maternal literacy, 12–14 young age, 12–15 higher family income, 14 and dwelling in an urban area 16 , 17 were factors that positively influenced the uptake of TT immunization. Higher numbers of antenatal care (ANC) visits, 12–15 , 18 multiparty, 12 , 16 giving birth in a health facility, 12 having a postnatal care (PNC) visit, 18 and having a plan for childbirth were obstetric factors that positively influenced the uptake of TT immunization. 15 In addition, maternal knowledge about TT immunization, 17 , 19 , 20 being exposed to information about TT immunization, 13 , 15 and long distances to a health facility 13 , 16 were also found to be factors predicting the utilization of TT immunization.…”