mnte presentation
TRANSCRIPT
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Maternal and Neonatal Tetanus Elimination
(MNTE) in Kenya
Dr Collins Tabu,National Vaccines and Immunization Program
Ministry of Health, Kenya
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Background• Caused by a bacteria, Clostridium Tetanii, Mainly found in the soil
• Affects all age groups, more common and Deadly in newborns, because of low immunity & umbilical cord wound
• Causes Painful muscles spasms & stiffness (Lock jaw disease), Fever, Sweating, inability to eat, swallow or function normaly
• 100% Die with no care, Even with hospital care 60% still die
• A case of Neonatal Tetanus represents multiple gaps in the health services to provide Routine immunization; Antenatal care and Clean delivery and umbilical cord care services
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Tetanus Disease
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MNTE Status• Globally 1 newborn dies every 9 minutes from Neonatal Tetanus• In Kenya, we lose one child every day from this Silent killer
• Less than 5% of neonatal tetanus cases are actually reported even from well-developed systems , Deaths therefore are much more than estimated- ‘It is the silent killer of Newborns’
• Goal of MNT Elimination is to reduce No of cases to less than 1 case of neonatal tetanus per 1,000 Live births, in every sub-county
• By end 2013, Kenya among 28 countries that are yet to achieve the MNT Elimination targets
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The Journey to MNTE Elimination• Kenya initiated the Maternal and Neonatal Tetanus Elimination process
in 2001• Proportion of High risk Districts/ Sub-counties reduced from 38% in 2001
to 20% in 2013 and <10% in 2015• Key Pillars:
• Improved skilled attendance at delivery through Provision of Free maternity services
• Improved ANC Attendance through adoption of Focused Antenatal Care (FANC) package
• Improved Tetanus vaccination coverage through provision of vaccines free of charge, setting up more health facilities & provision of HR
• Provision of free medical care to children under 5 years of age• Improved diagnostic and Management capacity
• Tetanus vaccination campaigns conducted 2003, 2006, 2009, 2013/2014
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The Journey to MNTE Elimination• A joint assessment by MOH/ WHO/ UNICEF and other Health
Partners in 2012 identified 60 districts at risk of NNT• These have further reduced to 24 • Determination of risk status:
– Incidence or rate of neonatal tetanus (< 1/1000 Live Births)– Clean delivery coverage rate (delivery by a physician, nurse or trained
midwife (≥ 70%)– Strength of surveillance system in detecting Neonatal Tetanus cases– Tetanus vaccine coverage rate in pregnant women & among girls and
women 14- 49 years of age (≥ 80%)
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TT SIAs• Integrated with Measles Rubella Vaccination campaign• Targeting 800,000 Women of reproductive age in 11
High risk Counties– Mombasa Meru– Garisaa Wajir– Mandera Kilifi– West Pokot Turkana– Samburu Narok– Baringo
• Validation for elimination expected end of 2016
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Thank you!