China eliminates maternal and neonatal tetanus
BEIJING, 30 October 2012 - The World Health Organization (WHO) today confirmed that China has eliminated maternal and neonatal tetanus—a major achievement to improve the health of mothers and children.
“The achievement came as a result of a number of different programmes in the Ministry of Health, other government sectors and partners working together for a joint goal to better improve the health of mothers and children and enhance the well-being of families and communities,” says Dr Michael O’Leary, WHO Representative in China.
The primary strategies for eliminating maternal and neonatal tetanus in China are implemented through the Ministry's Maternal and Child Health (MCH) programme through improvement of antenatal care and promotion of clean and institutional deliveries. This approach is supported by upgrading infrastructure and equipment in county and township hospitals, improving skills of obstetric staff, subsidizing hospital delivery in poor areas and providing transportation to hospitals in remote areas, as well as through health education and social mobilization.
The elimination was confirmed through a two-step process. First, a comprehensive risk assessment exercise for all prefectures was conducted in July 2012. Next, community-based validation surveys were conducted this month by China's health authorities, with support from WHO and the United Nations Children's Fund (UNICEF), in two highest-risk prefectures: Hechi (Guangxi Zhuang Autonomous Region) and Jiangmen (Guangdong Province). (These two survey locations represent the two different epidemiologic contexts in which neonatal tetanus occurs in China.)
A total of 103 survey teams, composed of interviewers and local guides and supported by 27 supervisors and 12 national and international monitors, visited 45 088 households and investigated 2306 live births.
No neonatal tetanus case or death from tetanus was observed in either survey, confirming that maternal and neonatal tetanus has been eliminated as a public health problem in the country.
The survey findings also show that hospital delivery rates among 1441 women interviewed was 99%. Increasing hospital deliveries decreases the risk of neonatal tetanus.
The global initiative to eliminate maternal and neonatal tetanus is led by WHO, UNICEF and the United Nations Population Fund. WHO considers neonatal tetanus to have been eliminated when the incidence is less than one case per 1000 live births in every district in a country. Maternal tetanus is considered to be eliminated when neonatal tetanus has been eliminated.
"The elimination does not mean that activities can stop; rather, it is the start of a new phase to sustain elimination through continued strong government commitment to the leadership of the Maternal and Child Health programme,” says Dr O'Leary.
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