Conclusion
Tetanus induced neonatal mortality is still a widespread problem in LMICs. As various interventions were discussed in this review, the key intervention which remarkably lowered the neonatal mortality was the vaccination of pregnant women or women of child bearing age with tetanus toxoid. Along with this, regular antenatal checkups, safe and clean deliveries, iron and folic acid supplementations and high risk approach were also effective in reducing neonatal mortality. Community Based Behavior Change Management is a possible intervention to overcome the problem in LMICs. Strengthening of health systems towards simple cost effective interventions is a key to successfully eliminating tetanus in countries like Nepal and Bangladesh.
In Pakistan, there remains an unfinished agenda of tetanus elimination and findings from this review should be taken as a benchmark for setting future priorities in near-term efforts to reduce neonatal mortality due to tetanus.