Launched in 1999 by UNICEF, WHO, UNFPA and partners the MNT Elimination initiative has led to protection of more than 90 million women against tetanus in more than 45 countries through Supplemental Immunization Activities (SIAs). The initiative raised over $ 186 million for the SIAs to target women of reproductive age living in high risk areas in 58 countries that had not eliminated MNT by 1999. Since then 14 countries have been validated as having eliminated MNT and validation process is underway in another 11 countries. Monthly updates on country activities for achieving MNT elimination will be posted on TechNet. Monthly updates for May and June 2009 are pasted below. Global MNTE Update- as of 1st May 2009: Country over view and update on Jan- April 2009: Countries validated to have eliminated MNT in 2009: 1. Republic of the Congo 2. Turkey Countries that have started the process for MNTE validation in 2009: 1. Benin 2. Burundi 3. Comoros 4. Ghana 5. Guinea-Bissau 6. Liberia 7. Sierra Leone Countries that have completed planned activities and are being evaluated whether elimination can be claimed: 1. Madagascar 2. Mozambique 3. Equatorial Guinea Countries that have not eliminated MNT and do not have TT-SIAs planned in 2009: 1. China 2. India 3. Iraq 4. Nigeria 5. Papua New Guinea 6. Philippines Countries that have TT-SIAs planned in 2009: 1. Afghanistan 2. Angola 3. Burkina Faso 4. Cambodia 5. Cameroon 6. Central African Republic 7. Chad 8. Cote d'Ivoire 9. DR Congo 10. Ethiopia 11. Gabon 12. Guinea 13. Haiti 14. Indonesia 15. Kenya 16. Laos PDR 17. Mali 18. Mauritania 19. Myanmar 20. Niger 21. Pakistan 22. Senegal 23. Somalia 24. Sudan 25. Tanzania 26. Timor Leste 27. Uganda 28. Yemen Afghanistan: • A joint WHO-UNICEF review in August 2008 identified the remaining high risk districts (HRDs) in need of 1, 2 or 3 rounds of TT-Supplemental Immunization Activities (SIAs). • All activities are expected to be completed by May 2010. Validation of MNT Elimination is currently scheduled in 2011. 2009 update: • Preparations have begunfor the first round of TT-SIAs in 203 HRDs targeting 2.59 million women of reproductive age (WRA). The round is scheduled from 15th to 21st June 2009. • Of the 203 HRDs that will conduct TT-SIAs in June 2009, 89 will conduct one more round and 12 will need two more rounds later in 2009 and 2010. Angola: • A joint WHO-UNICEF review in May 2008 identified 164 HRDs to be targeted in two overlapping phases in 2008 to 2010. • First round of 1st phase was implemented in November 2008 and province wise data shows that all but 2 regions (Banguela 67% and Huambo 75%) reached 80% or more WRA. • After completion of SIAs in February 2010, a few poor performing districts may require an additional round. Validation of MNT Elimination is currently scheduled in 2011. 2009 update: • Second round of TT-SIAs was conducted in end February/early March 2009 to target 2.9 million WRA in 81 HRDs. Coverage data is not yet available. • A review of districts' performance, to identify the causes of relatively poor performance and corrective actions to be implemented before the next rounds, is planned in 4 - 6 May 2009. Burkina Faso: • Last phase of TT-SIAs in 15 HRDs in scheduled in 2009. • Some districts may require an additional round after completion of this phase but all activities are expected to be completed in 2009. Validation of MNT Elimination is expected in 2010. 2009 update: • The first round of TT-SIAs in 15 HRDs was implemented on 20-24 February 2009 targeting 879,598 WRA. Coverage data is awaited. • The second round was delayed due to Polio NIDs and conducted from 17 to 21 April 2009. • The third round will be held in November 2009. Cambodia: • Last phase of TT-SIAs is being conducted now. Activities will be completed by August 2009. • Validation of MNT Elimination is scheduled in 2010. 2009 update: • First round of TT-SIAs targeting 200,114 WRA in 301 factories around the country was implemented in a phased manner beginning in October 2008 and finishing in March 2009. • Second round was begun in November 2008 and completed in April 2009. Complete coverage data for both rounds is awaited. • Third round is scheduled in August 2009. Cameroon: • Last phase of activities being conducted and will be completed by October 2009. Additional corrective round in a few districts will also be implemented in 2009. • Validation of MNT Elimination scheduled in 2010. Q1 2009 update: • No activities conducted in Q1 2009. Third/ last round scheduled in October 2009 to target 1.2 million WRA in 50 HRDs. Central African Republic: • Nation wide TT-SIAs conducted in one phase in 2008 and 2009. An additional corrective round in some poor performing districts will be completed during 2009. • Validation of MNT Elimination is scheduled in 2010. 2009 update: • The third and last round of the nation wide TT-SIAs targeting more than 1 million WRA was completed in February 2009 • A joint WHO/ UNICEF country mission for in-depth districts MNTE risk assessment is being planned in Q2 of 2009. Chad: • Current 4 year plan for MNT elimination proposes implementation of three rounds of TT-SIAs in a subset of HRDs every year between 2008 & 2011. • Two rounds of the first phase conducted in 2008 and the third round is planned in mid 2009. 2009 update; • No activities conducted in Q1 2009. (The Republic of) Congo: • Following country's claim of MNT Elimination last year an LQA was conducted in the country in March 2009 which validated MNT Elimination in Congo Brazzaville. Cote d'Ivoire: • All needed TT-SIAs were conducted in 2 overlapping phases between December 2007 and March 2009. • A few districts will require an additional round which will be completed in 2009. • Validation is scheduled in 2010. 2009 update: • Third round of TT-SIAs targeting 4.98 million WRA in 72 HRDs was implemented in March 2009. • A review of districts’ MNT risk status and performance is planned in Q2/Q3 2009 to assess if the country is ready for validation of if some rounds need an additional round of TT-SIAs. DR Congo: • All needed TT-SIAs were planned in 3 overlapping phases between 2007 & 2009. • All activities including a corrective round in a few districts will be completed in 2009, provided funding needs are met. • Validation is currently expected in 2010. 2009 update: • Third and last round of TT-SIAs targeting 4.34 million WRA was scheduled for April/ May 200. Fund raising efforts are underway but the TT-SIAs will likely be postponed for a few months due to non-availability of funds. Ethiopia: • Since 2007 TT-SIAs have been integrated with the biannual Enhanced Outreach Strategy (EOS). •
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