Increasing Frequency of Antenatal Care Visits May Improve Tetanus Toxoid Vaccination Coverage in Pregnant Women in Pakistan

OBJECTIVE: Maternal and neonatal tetanus (MNT) elimination in low-income countries is a major aim of public health endeavors, due to poor vaccination status, lack of antenatal care, and unhygienic birth practices. The objective of this study, thus, was to assess the present state and factors associated with maternal tetanus toxoid (TT) vaccination in Pakistan. METHODS: Overall, 80 pregnant women (26 ± 4 y) during their last trimester were recruited from the district hospital Khanewal, Pakistan. The prevalence of vaccination was ascertained through clinical interviews and examination of health records from each participant. A questionnaire-based interview was conducted to assess the education level, antenatal visits, and sociodemographic variables related to vaccination coverage. A generalized linear model was used for statistical analyses. RESULTS: Seventy-nine percent of pregnant women were vaccinated with two doses of TT vaccine, while 16% of women were unvaccinated. Overall, 66% of pregnant women received two or more antenatal visits. Two and more than two antenatal visits during pregnancy were associated with significantly increased odds ratios for sufficient TT vaccination (OR = 1.60, CI [95%] 1.34–1.92 and OR = 1.61, CI [95%] 1.32–1.97, respectively) as compared to no or only one antenatal visit. CONCLUSION: Regular antenatal care can improve vaccination coverage during pregnancy. Hence, reducing barriers for visiting antenatal care facilities could be key to reach the goal for MNT elimination.