28 February 2025, Karachi/Islamabad, Pakistan – The elimination of maternal and neonatal tetanus (MNT) in Sindh province, recently validated by the World Health Organization (WHO), marks a crucial milestone towards interrupting transmission across Pakistan. Following its elimination in Punjab in 2016, 183 million Pakistanis from Sindh and Punjab (75% of the total population of Pakistan) now live in areas where the transmission of this life-threatening disease affecting newborns remains under controlled limits.
This achievement is the result of a transformation led by the national and provincial governments, in partnership with WHO, to eliminate the disease through combined efforts such as improved immunization for pregnant women and women of childbearing age – one of the most efficient ways of preventing MNT –, safer delivery practices, improved skilled birth attendance, cord care and enhanced access to other maternal, newborn and child health services. In 2024 alone, WHO supported the vaccination of 5.44 million pregnant women and women of childbearing age across Pakistan, more than 0.9 million of them (18%) in Sindh.
Despite progress, Pakistan remains among the 10 countries worldwide that have yet to eliminate MNT, which is primarily caused by unclean deliveries and umbilical cord care practices and inequity
in access to immunization and other maternal, newborn and child health services. In 2024, a total of 322 cases and 6 deaths were reported across the country, although WHO experts estimate that only 30% of cases are notified to the authorities.
This week, WHO Representative in Pakistan Dr Dapeng Luo handed over a letter of appreciation confirming this validation to Sindh’s Minister of Health and Population Dr Azra Fazal Pechuho.
"The elimination of maternal and neonatal tetanus in Sindh is a testament to the commitment of the government, health care workers and communities to improving maternal and child health," said Dr Luo.
"This achievement demonstrates the power of collaborative action and serves as an example for other provinces and countries to follow. WHO will continue partnering with Pakistan to eliminate transmission across the country. Achieving sustainable development requires healthy mothers and newborns. A single child affected by this disease is already 1 too many."
This validation for Sindh, officially confirmed by WHO in December, was the result of a comprehensive assessment by WHO experts, in partnership with national and provincial authorities, which included extensive data analysis of the previous 3 years, pre-validation field visits in high risk districts, sample collection in the 2 most vulnerable districts – Tharparker and Thatta – and a thorough review of immunization coverage, antenatal care services and community health practices across the province. Over 80 health workers (including doctors, nurses, midwives and Lady Health Workers) and 10 international and national experts were involved in the validation process, and more than 50 000 health workers have been part of the overall response that led to MNT elimination in the province.
While MNT elimination in Sindh is a major achievement, continued vigilance is crucial to sustain the hard-fought gains. Sustained efforts will be necessary to maintain high immunization coverage, strengthen antenatal care services and promote safe delivery practices. To retain Sindh’s status as an MNT-free province, regular surveillance and monitoring will be implemented to certify that the province registers less than 1 neonatal tetanus case per 1000 live births in every district.
WHO remains committed to continuing its partnership with Pakistan to eliminate maternal and neonatal tetanus transmission nationwide and protect future generations from this preventable disease, leaving no child behind.
For additional information, please contact:
Maryam Yunus
National Professional Officer
Communications
WHO Pakistan
[email protected] (copying [email protected])
José Ignacio Martín Galán
Head of Communications
WHO Pakistan
[email protected]
