Protecting my unborn child from tetanus

Mereth Clenda receiving her first tetanus toxoid shot at the Nazarene Hospital, Jiwaka Province. ©UNICEF PNG/Chambers/2017

Phain Kumul’s excitement at becoming a grandmother for the first time in a few months’ time is matched by her desire to have a healthy grandchild and she is going out of her way to ensure this.

Her daughter, 19-year-old Mereth Clenda, is five months pregnant and has just received a tetanus toxoid (TT) shot at the Nazarene Hospital, in Jiwaka Province where she is attending her first antenatal clinic session.

“I came with my daughter for her first appointment because I want to make sure she receives the care and support she needs to have a healthy baby. Mereth is my second child. I have five children. I received TT immunisation for all my pregnancies and all my children were born healthy. I want the same for my daughter, we just want a healthy child,” Phain says with a broad smile.

Mereth (centre) and her mother (left) at the antenatal clinic. ©UNICEF PNG/Chambers/2017

Tetanus is a deadly but highly preventable bacterial disease that causes muscles to become tight, often causing a person’s neck and jaw muscles to lock, making it hard to open the mouth or swallow. The bacteria that causes tetanus is found in soil and enters the body through a puncture or wound where it grows. This puts both the mother and her infant child at risk of getting tetanus.

In Papua New Guinea, tetanus is potentially fatal for new-borns and their mothers especially where thousands of mothers deliver their babies in unhygienic conditions because they are unable to access antenatal care, as well as getting the right help from a skilled person when giving birth.

PNG has one of the highest under five and newborn mortality rates in the Pacific region. Some 57 children under five die from every 1,000 live births [1] and many of them die from easily preventable diseases during the first year of life. The average country coverage for most vaccines has stagnated at around 60 per cent, but there are districts, like in Jiwaka province, that only reached 20 per cent coverage for three doses of the Pentavalent vaccine in 2016. The number of children not vaccinated and at risk of infectious diseases is very high.

©UNICEF PNG/Chambers/2017

UNICEF is supporting the Government of PNG, in efforts to eliminate maternal and neonatal tetanus through by providing technical trainings for health workers, supplying TT vaccinations, improving cold chain and helping provinces roll out Supplementary Immunisation Activities (SIA) — special vaccination campaigns that boost immunisation. The SIA targets women of child bearing age (15–45) including pregnant women and children under five. TT vaccination prevents mothers and new born babies from getting infected with tetanus if unclean delivery practices are used. A minimum of two doses of TT vaccine is required to ensure adequate protection against tetanus.

Mothers waiting to receive tetanus toxoid shots at the Nazarene Hospital, Jiwaka Province. ©UNICEF PNG/Chambers/2017

In 2016, UNICEF supported Jiwaka Province roll out its SIA in three districts. Prior to the SIA, TT coverage in Jiwaka Province was only 40 per cent. After the SIA ended in September 2016, Jiwaka achieved a remarkable 86 per cent coverage.

Jiwaka’s Family Health Services Coordinator, Sr. Priscilla Pius, is proud of her team’s hard work, commitment and determination that has increased coverage.

“Our challenges are many. Our health facilities are poorly staffed so we aren’t able to conduct regular outreach services. Many rural communities are inaccessible by road, we walk for two days to reach them, and by the time we reach them, the vaccines can lose their potency due to the lack of ice packs to keep them at the right temperature. Despite these challenges, we managed to increase our coverage to 86 per cent and I am very proud of that achievement,” Priscilla explains.

There are many young mothers like Mereth in rural communities who cannot access proper antenatal care.

Mereth is very aware of this and is grateful she is able to get the antenatal care she needs not only from the health facility but also with support from her mother.

Immunization is amongst the most equitable and most cost effective health interventions that can be offered to women and children. Diseases such as tetanus are a major cause of childhood and maternal illnesses and deaths that can be easily prevented by vaccines.

Phain Kumul and her daughter, Mereth Clenda. ©UNICEF PNG/Chambers/2017

[1] UNDP 2015 Human development Index