Abstract:

BACKGROUND; Neonatal tetanus is a major cause of neonatal mortality with an 80%–100% case-fatality rate among insufficiently vaccinated mothers after unhygienic deliveries, especially in low-income countries. It is responsible for 14% of neonatal death worldwide(1) Failure of pregnant mothers to receive the recommended doses is still faced in SSA whereby in Eastern Ethiopia, 51.8% of mothers has received at least two doses in their last pregnancy and only 7% of mothers completed the recommended 5 doses and in Tanzania 88% of women recent births had received two or more TT vaccines(2,3), implying that vaccination coverage is still of necessity. Across the literatures, no health facility based study has been done in Mwanza region to assess the factors associated with low TT vaccination uptake among pregnant women

OBJECTIVE; This study aimed at determining the factors associated with low uptake of tetanus toxoid vaccine among pregnant women attending antenatal clinic at Makongoro health Centre in Mwanza- Tanzania.

METHODOLOGY; prospective cross-sectional health facility based study was conducted using a structured closed ended questionnaire involving pregnant women attending antenatal clinic at Makongoro health center in Mwanza Tanzania . Random sampling technique was used to select participants. Data obtained was recorded in Microsoft excel, cleaned and analyzed using STATA version 14. Cross tabulations were used to examine the relationship between variables. Categorical variables were compared using Chi-square test.

RESULTS; the predominant age of the respondents was 21–26 years (34.7%). About 64% of them were married, with about 44.9% having attained secondary level education being the predominant group in terms of education level. It was observed that most of the respondents (72.33%) agreed with unawareness on number of doses of TT vaccine required during pregnancy as a major factor hindering their uptake of TT vaccine, followed by unawareness on the need for immunization against tetanus (71.27% of the respondents). Only 39.16% of the respondents had knowledge on the actual aim of TT vaccine administration in a pregnant women, being able to understand that it was aimed at preventing both the mother and the unborn child. Notably; 46.48% of the respondents did not know the importance of receiving TT vaccine. With significant relationship observed between socio-demographic characteristics and the awareness on the importance of TT vaccine. The overall prevalence of uptake of TT vaccine was 84.07% and there was statistical significance with income status. It was observed that more than half of the respondents had taken 2 or more doses of TT vaccine (57.7%) while 2.6 % had taken only a single dose during reproductive time and alarmingly 39.7% could not remember the exact number of doses they had received during reproductive period. With statistical significance observed with age and level of education.

CONCLUSION; It was observed in this study that a large number of the participants had the knowledge as well as had received at least one dose of TT vaccine. With income status observed as an important predictor. Educational level and age were observed to be to be important factors influencing the uptake of TT vaccine. However; despite the large number of people who had received TT vaccine, there was a number of participants who did not remember the number of doses received. Very few participants (16.71%) had received the complete doses of TT vaccine. On the factors hindering the uptake of TT vaccine, two factors were the most stated being unawareness of the importance of TT vaccine as well as unawareness on the number of doses required. There was a gap observed with mass media having not been utilized well to disseminate knowledge on tetanus as well as tetanus toxoid vaccine.