BARIYAPUR , 3 January (IRIN) - It is hoped that more than one million children have now been vaccinated against tetanus as a joint UN-Nepalese Government immunisation programme draws to an end.

The three-week-long campaign – targeting six- to eight-year-olds - saw the United Nations Children's Fund (UNICEF) join Nepal's national immunisation programme to help combat the disease that continues to pose a serious threat to newborns and their mothers.

Tetanus infection is quite common in Nepal during birth deliveries due to a lack of skilled attendants in the remote villages of the Himalayas. Nearly 90 per cent of births take place at home and without specialist care, leading to high infant mortality rates, according to the Ministry of Health (MOH). Maternal mortality rates are amongst the worst in the world outside Afghanistan and several countries in sub-Saharan Africa.

"All it takes to prevent death is by improving hygienic conditions of the birth delivery and immunising the mothers," said Bishnu Poudel, UNICEF's assistant project officer for the immunisation programme.

"The only way to protect the mothers and their newborns, throughout their childbearing years, is for them to receive five doses of the tetanus toxoid [tetanus vaccination]," Poudel explained.

The five doses, received over less than three years, offer a woman lifetime protection from tetanus.

Nepal was identified in 2001 by the World Health Organization, UNICEF and the United Nations Population Fund as one of the top 58 high-risk countries for tetanus. Since that time the Nepalese government has launched the Maternal and Neonatal Tetanus (MNT) Elimination programme.

In 2005, the country began targeting girls in schools to provide them with lifelong protection before reaching reproductive age. Ensuring the health of children is viewed as a priority in Nepal where almost half the population is aged under 16 years.

It is not known exactly how many children and mothers die every year in Nepal due to tetanus as the country does not have an accurate reporting system, admitted the MOH. The latest data, dating back to a 2001 report by the government's Health Management Information System (HMIS), claimed that there were 2.3 deaths per 1,000 live births.

The disease is particularly insidious as it kills mothers and newborns before it can be identified and treated.

According to Nepal's 2004 National Neonatal Strategy, nearly 30,000 children die each year during their first month, with two-thirds dying in the first week, marking one of the highest neonatal mortality rates in the world.

"There is now awareness even among the children that vaccinations help to prevent infections - especially tetanus," said schoolteacher Sabita Adhikari, admitting that the government-UNICEF joint initiative in schools was a valuable weapons in fighting tetanus infection.

NN/JM/DS

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