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  • Title: [Prevention of neonatal tetanus in developing countries hampered by local organization and limited knowledge of health personnel and traditional midwives; North Sulawesi (Indonesia)].
    Author: de Haas I, Moes N, Wolffers I.
    Journal: Ned Tijdschr Geneeskd; 1994 May 14; 138(20):1032-5. PubMed ID: 8196802.
    Abstract:
    OBJECTIVE: Evaluation of the policy to prevent neonatal tetanus in North-Sulawesi (Indonesia). DESIGN: Descriptive and questionnaire study. SETTING: Twelve villages in the district of Minahassa, Sulawesi, Indonesia. METHOD: The policy aimed at preventing neonatal tetanus was studied during the period April-June 1992. The relevant knowledge was tested of the community health workers (CHWs, n = 142) and traditional birth attendants (TBAs, n = 37) active in the 12 villages. To this purpose, 54 and 27 workers, respectively, were interviewed using a standard questionnaire. RESULTS: Not all women were vaccinated sufficiently to prevent their unborn children from tetanus; mostly, adequate vaccination records were lacking. 33% of the TBAs were unaware that neonatal tetanus can be prevented by hygienic delivery; in this respect there was no difference between trained and untrained TBAs. Of the CHWs, 39% were familiar with the correct vaccination policy and 26% did not know that pregnant women have to be vaccinated. 70% of the CHWs and TBAs wrongly believed that neonatal tetanus no longer occurred in their village. CONCLUSION: CHWs and TBAs showed little interest in neonatal tetanus, so that they were lacking in motivation regarding hygienic delivery procedures and preventive tetanus toxoid vaccination. Implementation of a good preventive programme in developing countries mostly requires organizatory rather than biomedical improvement.
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