Maternal and Neonatal Tetanus Elimination in Nigeria: A Review of Delivery and Cord Care Practices among Women of Child Bearing Age

Abstract

Introduction: Maternal and Neonatal Tetanus (MNT) are important causes of maternal and neonatal deaths, and this led the World Health Assembly in 1999 to launch the maternal and neonatal tetanus elimination strategy with a target of 2020 after earlier targets of 2005, 2015 were missed. Tetanus claims tens of thousands of deaths annually with majority of the deaths occurring in Sub-Saharan Africa and Asia. Safe delivery practice is one of the strategies for elimination of MNT and it can be achieved if delivery is handled by a skilled health worker that have adequate knowledge on the care of the umbilical cord. Methods: This study which is a descriptive study that covered 62 high risk Local Government Areas (LGAs) is aimed at determining the delivery practices and cord care practice of Women of Child bearing Age. (WCBA) in sixty–two Local Government Areasin the six States of Ondo, Osun, Ekiti, Imo, Enugu and Ebonyi in Nigeria that were involved in the three rounds of tetanus toxoid vaccination campaign as part of the Nigeria’s Maternal and Neonatal Tetanus Elimination program from 2014 to 2016. Results: A total of 23,860 households were visited by enumerators in all the 1,860 selected clusters surveyed across the 62 high-risk LGAs of the 6 States. Eligible respondents were found in 13,020 of these households (54.6%).Most of the respondents were wives of the household heads, Christians (83.9%), educated with majority attending secondary school (53.8%), employed with majority doing petty trading 30.9% and located in predominantly rural LGAs (74.4%). Across the 62 LGAs, 84.8% of respondents had their delivery handled by doctors, nurses/midwives and CHEW while 76.7% had their delivery handled by doctors and nurses/midwives. On cord care practices the survey results showed that on the average, only 3.1% of women used chlorhexidine with Ebonyi state recording the highest while 79.0% of respondents used methylated spirit for cord care. Conclusion: Sociocultural factors such as maternal education, financial preparedness, marital status, religion has been shown to be strong determinants of Skilled Birth Attendants (SBA) use. SBA usage has a direct effect on maternal and neonatal tetanus elimination as such government is encouraged to support the promotion of formal education for women and women empowerment and autonomy.