Validation of the criteria used to determine protection at birth as applied to neonatal tetanus elimination in Vietnam

To determine the validity of the following simple criteria used to determine protection of the infant from neonatal tetanus, we carried out an analysis of 646 neonatal tetanus cases that were reported in Vietnam from 1994 to 1998. 93% (602) of the 646 cases did not fit the criteria set for “protection at birth”. It was concluded that the criteria used to define “protection at birth” are valid and reliable. It's enough to be used by health workers as a simple management tool to monitor the neonatal tetanus elimination program, and assess the eligibility of women for further tetanus toxoid doses, according to the EPI schedule.

Investigation of 265 neonatal tetanus cases from 1994 to 1996

The analysis showed that 207 mothers (78% of the cases) had never received tetanus toxiod. 96% (254) of the cases did not meet the criteria set for "protection at birth", 73.8% of the mothers did not seek antenatal care. The rate of delivery at home was 71%. The rate of delivery by traditional birth attendants (TBA) was 50%.