Joint press release of the Ministry of Health of the Republic Indonesia

with WHO, UNICEF and UNFPA

Indonesia has eliminated maternal and neonatal tetanus

UN declares that Indonesia’s has eliminated

maternal and neonatal tetanus

JAKARTA, 19 May 2016 – Today, Indonesia is declared as having eliminated maternal and neonatal tetanus (MNT) by the World Health Organization (WHO). WHO, UNICEF and UNFPA congratulate the Government of Indonesia for this major achieve as the country has significantly reduced this unacceptable inequity in immunization despite the challenges the country has in providing services in thousands of its islands.

“Indonesia is geographically challenging. We are glad and relieved that Indonesia had eliminated tetanus, even in the most challenging areas such as Papua and West Papua. We need to maintain this status by continuously giving anti-tetanus immunization to pregnant women. This could be achieved when good quality health care is available throughout Indonesia,” said Dr Nila Moeloek, Minister of Health of the Republic of Indonesia. 

Over the past few years, provinces have been categorized into four regions, three of which were declared as having MNT eliminated in 2010 and 2011. Today, the fourth region, which encompasses  Papua, West Papua, Maluku and North Maluku provinces has joined them, bringing MNT elimination status to whole country. With this elimination of maternal and neonatal tetanus in Indonesia, South East Asia Region is now  the second region in the world where MNT has been eliminated.

Neonatal Tetanus is called the “silent killer” because so many newborns who contract it die quickly and painfully at home and both the births and the deaths go unreported. Yet the disease is fully preventable, if enough focus is given to the provision of timely vaccination with tetanus toxoid vaccines and hygienic birth practices. In 1988, there were 780,000 deaths of neonatal tetanus recorded globally. In spite of progress made by 2000, Indonesia was still one of 59 countries where the risk was highest. Today, the MNT elimination status means that less than one case of neonatal tetanus per 1,000 live births is occurring in each district.

“Elimination status achieved is a snapshot of the existing neonatal tetanus situation.  Occurrence of neonatal tetanus is a marker of health and immunization inequity. It most likely affects the poorest and the least educated part of the population. MNT elimination means that Indonesia has been able to provide better access to immunization for its population,” said Dr Jihane Tawilah, WHO Representative to Indonesia.   

WHO has been a committed supporter of immunization programme in Indonesia since the 1950s, and within the last decade has provided additional technical support in high risk areas to ensure that immunization services are efficiently implemented.

Since 1977, the Government has been steadily working towards immunization using the tetanus containing vaccine for all infants in Indonesia, which contributes to elimination of MNT. Since 2006, UNICEF has supported Indonesia with the tetanus-toxoid (TT) vaccination campaign in more than 70 high risk districts, targeting women of reproductive age, to increase immunity against tetanus among women of child bearing age in high risk provinces. In turn this immunization protects their babies during pregnancy. UNICEF has also provided other related services and trained midwives to ensure that babies are delivered in a hygienic way and are protected against neonatal tetanus.

According to Gunilla Olsson, UNICEF Indonesia’s Representative, “Once neonatal tetanus is eliminated, maternal tetanus is also eliminated. So as long as we ensure that women of reproductive age have proper and complete access to tetanus toxoid vaccine and follow hygienic birth practices, neonatal tetanus becomes a disease of the past.”

A newborn can be infected with tetanus due to unhygienic birthing practices, such as cutting the umbilical cord with unsterile instruments or applying it with contaminated dressings. If the spores enter, the infection can spread, causing complications that lead to a quick and painful death of the baby. Mothers can also be infected with tetanus during unsafe or unhygienic delivery if there are unsanitary conditions where the tetanus spores are present.

“Clean delivery practices can be attained through skilled birth attendants during all deliveries, complementing immunization efforts to eliminate MNT. So the fact that Indonesia has now eliminated maternal and neonatal tetanus, is a great achievement in reaching women in all parts of the country with protective measures,” said Dr. Annette Sachs Robertson, UNFPA Representative to Indonesia.

This MNTE validation success indicates the beginning of the new era. Now, all efforts should focus in ensuring that MNT will continue to be extremely rare in Indonesia, particularly in areas where elimination has been achieved through supplementary tetanus toxoid (TT) immunization. The focus must be on identifying high risk areas and prioritized them in routine immunization and antenatal care. Periodic focal supplementary immunization activities may still be needed in the high risk areas where the health systems are still unable to reach majority of women.

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About WHO:  The primary role of WHO is to direct and coordinate international health within the United Nations’ system. We support countries as they coordinate the efforts of multiple sectors of the government and partners, to attain their health objectives and support their national health policies and strategies. Follow us on Twitter @WHOIndonesia.

For further information, please contact:

Nursila Dewi, Communication Officer, WHO Country Office for Indonesia, +62 21 520 4349, dewin@who.int

About UNICEF:  UNICEF promotes the rights and wellbeing of every child, in everything we do.  Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere. Follow us on Twitter and Facebook

For further information, please contact:

Kinanti Pinta Karana, Communications Specialist, UNICEF Indonesia, +62 815 8805842, kpkarana@unicef.org

Kate Rose, Communications Specialist, UNICEF Indonesia, HP: + 62 811 8714894, krose@unicef.org

About UNFPA: UNFPA is the lead UN agency for delivering a world where every pregnancy is wanted, every childbirth is safe and every young person's potential is fulfilled. UNFPA works in over 150 countries and territories to expand the possibilities for women and young people to lead healthy and productive lives. Follow us on Twitter and Facebook.  For more information about UNFPA and its work visit: www.unfpa.org

For further information, please contact:

Dr. Melania Hidayat, National Programme Officer for Reproductive Health, +6221 2980 2300 , hidayat@unfpa.org

Tags: reproductive health