Maternal Tetanus Toxoid Vaccination

Neonatal tetanus is estimated to kill about 200,000 newborns each year. A woman immunized with at least two doses of tetanus toxoid develops antibodies that protect her baby against tetanus during pregnancy and in the first two months of life. The indicator therefore measures the proportion of women with young children who were vaccinated against tetanus.

Collect the following data by conducting individual interviews with a representative sample of mothers of children aged 0-23.99 months:

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Q1: While pregnant with your youngest child, did you receive an injection in the arm to prevent the baby from getting tetanus, that is convulsions after birth?

A1: yes / no / does not remember

(ask the following question only if the answer to Q1 is YES)

Q2: While pregnant with your youngest child, how many times did you receive such an injection?

A2: once / twice or more / does not remember

(ask the following question only if the answer to Q1 is NO)

Q3: Did you receive any tetanus toxoid injection any time before that pregnancy, including during a previous pregnancy or between pregnancies?

A3: yes / no / does not remember

(ask the following question only if the answer to Q3 is YES)

Q4: Before the pregnancy with your youngest child, how many times did you receive a tetanus injection?

A4: once / twice or more / does not remember

The mother was vaccinated against tetanus if the answer to Q1 is YES and Q2 “twice or more” or if the answer to Q3 is YES and Q4 “twice or more”.

Calculate the indicator’s value by dividing the number of vaccinated respondents (twice or more) by the total number of respondents (exclude those with the “does not remember” answer) and multiplying the result by 100.

Disaggregate the data by location (rural/ urban), socio-economic characteristics (wealth quintile, education level) and mother’s age.

1) In some contexts, the required information can also be verified by asking the respondent: Do you have a card or other document with your own immunisations listed? and reviewing its content. Use this method only if many people have vaccination cards and it is easy to recognize whether the correct vaccination was provided. 

2) This indicator relies on accurate age assessment. Since people often do not remember the exact dates of their children’s birth, the data collectors should always verify the child’s age. This can be done by reviewing the child’s birth certificate, vaccination card or another document; however, since many caregivers do not have such documents (and since they can include mistakes), it is essential that your data collectors are able to verify the child’s age by using local events calendars. Read FAO’s Guidelines (see below) to learn how to prepare local events calendars and how to train data collectors in their correct use.