By Gabrielle Wade
5 August 2008 [MEDIAGLOBAL]: Although it is preventable by vaccination, tetanus, an infectious disease that occurs when wounds are contaminated by soil bacteria, is still responsible for approximately five to seven percent of all neonatal deaths worldwide.
While many countries have eliminated maternal and neonatal tetanus through required vaccine programs, Madagascar, along with nine other countries in the East and Southern African region, has yet to eradicate such cases.
Alarmed by these statistics, the United Nations Children’s Fund (UNICEF) Director Ann M. Veneman launched a tetanus campaign Wednesday in Andilamena, Madagascar. Organized primarily by the Government of Madagascar and UNICEF, the campaign targets 830,000 women of childbearing age in high-risk tetanus districts.
UNICEF External Communication Specialist Sara Johansson told MediaGlobal, “The tetanus vaccination itself is part of the routine immunization services, and the government and partners are working together to strengthen this routine vaccination in the areas with the lowest coverage.”
To make the program more effective, Veneman called for all families to register their children at birth. Currently, about 35 per cent of children in Madagascar do not have birth certificates, and as a result “many of those children will be left behind without access to basic health services and education. A child without a birth certificate is more vulnerable to sexual exploitation, early marriage and child labor,” according to Johansson.
UNICEF, along with Madagascar’s Prime Minister, first launched a national campaign, called the “EKA program,” to ensure the registration of children in June 2004. At the launch of the program, UNICEF Representative to Madagascar Barbara Bentein said, “To appreciate the realization of a child’s right in a country, it is important that at the very least that child is recognized as a human being.”
Before the EKA program, efforts to ensure child registration were unable to address all aspects of the problem. The EKA program introduced a more holistic approach by making sure birth registration as well as immunization services are offered with medically assisted birth services. It places accountability for registration on all parties, from parents to staff of civil registration offices, from communities to the national government.
The EKA program is two-fold; it aims to ensure the systematic declaration of birth within 12 days as well as offer retroactive birth registration for those citizens who never received birth certificates. In order to increase the tetanus campaign’s effectiveness, it is vital that all newborns as well as presently unregistered adults get registered.
In 2006, two years after its launch, there was a national awareness raising campaign for the EKA program to make it familiar to the population. Since the campaign, the government has reported to the parliament on the implementation of the program in 351 communes, and in June 2008 it was reported that 378,465 of a total 1,070,678 children were still unregistered at birth, according to Johansson.
The tetanus campaign launched Wednesday focuses specifically on women ages 15 to 29 in high-risk areas, which are assessed by indicators such as tetanus toxoid two coverage and clean delivery coverage. It targets women of childbearing age because, Johansson said, “Immunization of pregnant women also protects the newborn for several months against tetanus.”
To further protect children from future infection it is important they receive the vaccination, and to do so they must be registered at birth.
At the launch of the tetanus campaign, Veneman said; “Death due to tetanus is painful, but one visit to the local health center for a simple immunization can help save a baby’s life.”
While the current tetanus campaign focuses on high-risk districts only, Johansson said, “Resource mobilization and capacity building continue so that actions can be extended.”
In addition to UNICEF and the Government of Madagascar, the World Health Organization (WHO), the United States Agency for International Development (USAID), the GAVI Alliance, and multiple private sector partners, such as the Pampers Division of Procter and Gamble, support the effort to eliminate tetanus in Madagascar.