China eliminated neonatal tetanus: WHO

China has eliminated maternal and neonatal tetanus as part of efforts to improve the health of mothers and children, the World Health Organization has confirmed.

The elimination has been confirmed via a two-step process.

First, a comprehensive risk-assessment exercise in all prefectures was conducted in July. Next, community-based validation surveys were conducted this month by China's health authorities, with support from the WHO and the United Nations Children's Fund, in the two highest-risk areas — Hechi in the Guangxi Zhuang autonomous region and Jiangmen in Guangdong province — according to the WHO Beijing Office.

"The achievement came as a result of a number of different programs by the Ministry of Health, other government sectors and partners working together for a joint goal to better improve the health of mothers and children and enhance the well-being of families and communities," said Michael O'Leary, WHO Representative in China.

The primary strategies for eliminating maternal and neonatal tetanus on the mainland were implemented through the Health Ministry's maternal and child health program through improvement of antenatal care and the promotion of clean and institutional deliveries.

This approach was supported by upgrading infrastructure and equipment in county and township hospitals, improving skills of obstetric staff, subsidizing hospital deliveries in poor areas, and providing transportation to hospitals in remote areas, as well as through health education and social mobilization.

For the WHO confirmation process, 103 survey teams, comprising interviewers and local guides and supported by 27 supervisors and 12 national and international monitors, visited 45,088 households and investigated 2,306 live births.

No neonatal tetanus cases or death from tetanus was observed in either survey, confirming that maternal and neonatal tetanus has been eliminated.

Also, the hospital-delivery rates among the 1,441 women surveyed reached 99 percent. Increased hospital deliveries decrease the risk of neonatal tetanus.

The global initiative to eliminate maternal and neonatal tetanus is led by the WHO, UNICEF and the United Nations Population Fund.

The WHO considers neonatal tetanus to have been eliminated when the incidence is less than one case per 1,000 live births in every district in a country. Maternal tetanus is considered to be eliminated when neonatal tetanus has been eliminated.

"The elimination does not mean that activities can stop; rather, it is the start of a new phase to sustain elimination through continued strong government commitment to the leadership of the maternal and child health program," O'Leary said.