The Promise of Maternal and Neonatal Tetanus Elimination in Pakistan

Islamabad, Pakistan: Nouranda hugs her precious 7-month-old daughter Fatima, who is playfully tugging at her burqa. She and her husband, Akbar Saeed, have come to see Shazia Tabassum, the Lady Health Worker (LHW) in their community.

Shazia welcomes the community in the Health House, a dedicated room in her home in Bilal Town on the outskirts of Islamabad. Outside, life bustles with the familiar sounds of rickshaws and friendly neighborhood chatter. In Bilal Town, community bonds are strong, and every home tells a story.

Here, maternal and neonatal tetanus (MNT) has long posed a silent threat, bringing grief to the lives of many families. Nouranda has been through every mother’s worst nightmare, the heartbreak of losing a child, not once, but twice. After five healthy deliveries, she lost two sons. Furqan was only 13 days old when he passed away in 2016, followed by his brother who died in 2021 at just 7 days of age.

Her family was devastated. They had no knowledge of why they lost their babies or that their deaths could have been prevented.

“Furqan had a high fever when he was only 10 days old. The doctors told me that they couldn’t help him and all I could do was pray for him,” shares Nouranda.

Supporting maternal and infant health with timely vaccination

MNT is a painful, life-threatening disease affecting women and babies. MNT can be contracted when women give birth outside hygienic health facilities, but it is preventable through clean labor and delivery environments, proper umbilical cord care and lifesaving vaccinations.

UNICEF is supporting the Government of Pakistan’s efforts to eliminate this disease, together with the World Health Organization (WHO), steadfast collaborator The Church of Jesus Christ of Latter-day Saints and other partners.

By investing in safer delivery practices, increasing vaccination coverage and mobilizing communities, Pakistan is making significant strides towards total elimination.

The Turning Point for one mother and MNT

When Shazia learned about a case of MNT from the District Health Officer in 2021, she rushed to Nouranda’s home. She investigated the case and offered support to the bereaved mother. Her visit changed everything.

“I visited Nouranda’s home and counselled her on the importance of MNT protection through vaccination. She didn’t know about this disease or the availability of routine immunization,” explains Shazia.

“I had never heard of MNT before or that the vaccination was available so close by,” says Nouranda.  “Shazia explained that this happened because I wasn’t vaccinated and the disease could be prevented in the future.”

Shazia’s words brought hope.

“I wouldn’t have hesitated to get vaccinated if I knew. It makes me happy to know that prevention could help save my babies in the future,” adds Nouranda.

Shazia referred Nouranda to the nearby Rawal Institute of Health Sciences where a UNICEF-supported Expanded Programme on Immunization provided vaccines for pregnant and lactating mothers.

“I thanked God Fatma survived and is healthy and growing. I want other mothers to know that getting vaccinated means you can be happy instead of grieving. No one should have to go through this,” says Nouranda.

Vaccines advance progress toward full MNT elimination in Pakistan

March 2025 marked a major milestone for Pakistan, Islamabad Capital Territory (ICT) and Pakistan-Administered Kashmir (PAK) as they achieved MNT elimination, joining Sindh and Punjab in 2024 and 2016, respectively.

Now, nearly 80 percent of Pakistan’s population lives in areas where MNT is no longer a threat, with less than one case of tetanus per 1,000 live births. With support from UNICEF and WHO, 5.4 million women were vaccinated against tetanus in 2024. Pakistan is now one step closer to joining the ranks of countries that have eliminated MNT, with only 10 nations left to cross the finish line.

Pakistan is continuing to target nationwide elimination, with Balochistan, Khyber Pakhtunkhwa and Gilgit-Baltistan scaling up immunization campaigns and strengthening maternal and child health services in the coming years.

“Mothers don’t know that protection through vaccines can save them from heartbreak. Vaccines and other health services are saving and changing lives here. We need this support to continue so that everyone has access to the services they need,” said Shazia.

Progress toward a healthier, happier future for every mother and child is unfolding. Through the continued support from The Church of Jesus Christ of Latter-day Saints and other partners, targeted and routine immunization drives and the dedication of frontline health workers, families in Bilal Town and across Pakistan are seeing the power of protection against this deadly disease.

Pakistan is writing a new story of hope in which every child can survive and thrive, and communities are protected from this preventable disease.

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