Qualitative study of knowledge and behaviours related to tetanus toxoid immunization among women of childbearing age in rural China

Abstract

Since the late 1980s neonatal tetanus (NT) has been a major public health problem in developing countries. In 1988 the World Health Organization estimated that 787 000 neonates died of NT; a rate of 6.5 cases per 1000 livebirths. In 1989 the 42nd World Health Assembly called for the elimination of NT by 1995. Due to slow implementation of the recommended strategies the target date was postponed to 2005. The focus is now on the 57 developing countries including China that have not eliminated NT in all districts. The Chinese Government declared their plan to eliminate NT by 2010 and put their main efforts towards improving clean deliveries. One study showed that the death rate due to NT was up to 34.5 per 1000 livebirths among the minority group of Bouyei in the late 1980s suggesting that the official statistics concealed the imbalance between areas and the decline in NT incidence in some areas has been very slow in the past few decades. Another study suggested that womens decision making power and autonomy were relevant to maternal and child health outcomes. In summary the results of this study demonstrated that knowledge levels and local cultures are closely related to TT immunization behaviours in women of childbearing age in rural China. All of these factors should be considered fully when developing strategies for TT immunization. (excerpt)