Celebrating the elimination of maternal and neonatal tetanus
The dedicated staff at the Bernay-Fotoba health centre helped eliminate MNT in Guinea
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If you see it from a distance, it peeks out like a pop of hope with its yellow walls. The Bernay-Fotoba health centre in the vibrant Matoto commune of Conakry, Guinea, moves to its own rhythm. The hustle and bustle might seem like a routine dance—patients arriving, consultations in progress, vaccinations administered. However, the current atmosphere carries extraordinary significance, that perfectly encapsules the steadfast work and dedication of this corner of health: after years of relentless efforts, Guinea has officially eliminated maternal and neonatal tetanus (MNT), becoming in May the 49th out of 59 priority countries globally to achieve this remarkable milestone.
Guinea is facing significant challenges in maintaining its health services consistent and effective, particularly since the pandemic. Nevertheless, the mango season, which between February and June suggestively colors the streets and markets throughout the country, is sweeter this year. It is a historic moment, a milestone that marks the beginning of a healthier future for countless mothers and their newborns in Guinea.
From the bright yellow mangoes displayed at local market stands to the yellow walls of the health centre. Dressed in her blue scrubs and matching cap, Sambou Bayo, immunisation worker for the Expanded Programme on Immunisation, is sitting at her desk, carefully handling the paperwork and ensuring that every entry is accurate and up-to-date. Her workday has just started. Next to her, the vaccination cooler and various medical supplies are neatly arranged, highlighting her organized and methodical work approach.
"I've been a section head at the Bernay-Fotoba health centre for eight years," she tells. "It is usually very busy. Every day, from Monday to Saturday, we vaccinate more than 20 women and 30 children. On Mondays and Thursdays, we see more patients. For pregnant women, we give two doses of the tetanus vaccine, one month apart, and continue the vaccination after delivery."
The morning stretches ahead with a long line of mothers and their babies, some as young as one week old, waiting patiently under Sambou’s quiet and understanding gaze to receive their vaccinations. A melting pot of stories and a mosaic of life in Conakry.
"I'm currently seven months pregnant," says Assiatou, who is expecting her third child. "I came to get vaccinated today to protect myself from diseases and to ensure the health of my future baby. I've had regular vaccinations and antenatal check-ups since I started having children."
Sambou is tireless. She assesses the health of the mothers, exchanges quick anecdotes to put them at ease. She takes a look at the babies, and a smile can’t help but come to her face. Then, with the help of Aissatou, a trainee at the health centre, she administers the vaccines.
"The main causes of neonatal tetanus are related to unsanitary delivery practices. Pregnant women who do not receive adequate antenatal care, who give birth at home using unsterilized instruments, or who are not fully vaccinated are at greater risk," says Sambou. "By systematically vaccinating pregnant women, we have been able to significantly contribute to maternal and neonatal tetanus elimination in Guinea. I encourage all women of childbearing age to be vaccinated regularly. The vaccine is free and available at all health centres."
In a corner, with shy eyes and a bright smile, Habigoulo is waiting for her turn. She is a 20-year-old high school student, a year away from graduation, and is pregnant with her first child. She has received information about the importance of vaccination at school. Her actions betray some nervousness, but her resolve is strong. "I'm four months pregnant and this is my first pregnancy. Today I had my first tetanus vaccination to protect me and my baby. We have learned a lot at school about the importance of vaccinations for good health," she says.
Between 2020 and 2022, when the entire world was profoundly affected by the COVID-19 pandemic, coverage of vaccinations against vaccine-preventable diseases, including tetanus and diphtheria vaccine vaccination for women of reproductive age (WRA), saw a significant decline. However, despite facing substantial challenges, Guinea Conakry persevered in its efforts to maintain immunization activities. These challenges included the suspension of supplementary immunization activities and a decrease in the demand for immunization services driven by fears of potential COVID-19 infection during vaccination sessions at health centers.
The MNT elimination in Guinea is the fruit of efforts made over a long period. With the contribution of donors such as Kiwanis, P&G, The Church of Jesus Christ of Latter-day Saints, and the CDC, UNICEF has been able to support the implementation of vaccination campaigns and assist the government in making vaccines available on a large scale. A crucial role was also played by community awareness campaigns and catch-up sessions carried out by professionals like Sambou. "We run community awareness campaigns to encourage women to be vaccinated. As a result, there is less and less reluctance to vaccinate, and most people understand the importance of protecting themselves and their children," she says.
Djenné, a young mother who is pregnant with her second child and is waiting for her vaccine, echoes Sambou’s sentiments. "Before, I wasn't very well informed, but now, thanks to the awareness campaigns in my neighbourhood, I know that it's essential to consult a doctor and follow the advice of health professionals, especially during pregnancy."
With Guinea achieving elimination status, there are globally only 10 countries with a suspended path in their fight against MNT. Some of them face major implementation challenges in their vaccination campaigns. UNICEF, with the support of partners and donors, is working to help reach this meaningful goal and pave the road for a healthier future for every mother and every child.
