Abstract:
Background: Literatures revealed that protection of births against tetanus is low with significant urban
rural differentials in Tigray region. To solve this problem researching TT utilization among mothers is
very crucial.
Objective: To determine and compare utilization status of tetanus toxoid vaccination among urban and
rural child bearing women during their index pregnancy and identify the predictors in Gulemekeda
Woreda, Tigray region, Northern Ethiopia 2011.
Methods and materials: A community based cross-sectional study design was carried out from
March 16 -April 10, 2011 in Gulemekeda Woreda, Tigray region, Northern Ethiopia on 264 mothers
of 0–11 month old children. Multi stage stratified random sampling was used to select study subjects.
Quantitative data were collected by interviewing mothers and reviewing their vaccination cards
whereas qualitative data were collected through in-depth interview and focussed group discussion.
Finally quantitative data were analysed using SPSS version 16 through descriptive statistics, univariate
(X2, logistic regression, T-test) and multiple logistic regression methods and qualitative data were
analysed by thematic framework analysis.
Results: TT2+ (full TT vaccination) coverage assessed by card plus history was 81.2 %, 86.4% in
urban and 75.5% in rural (P=0.040) where as protection against tetanus at birth assessed by card plus
history was 71.2% in both urban and rural. Being fully vaccinated were less likely among respondents
who were illiterate (AOR=0.326, 95%CI.0.14, 0.78), infrequently mass media exposed (AOR=0.163,
95%CI.0.05, 0.55), not visited at their home by HEWs (AOR=0.254, 95% CI.0.09, 0.76) and among
mothers who had no ANC during their index pregnancy (AOR=0.331, 95% CI.0.14, 0.79). Besides to
this mothers whose index pregnancy were planned were almost three times more likely to be fully
vaccinated with TT than those whose index pregnancy were unplanned (AOR=2.926, 95% CI: 1.177-
7.272).
Conclusions: TT2+ coverage were 9.9% higher in urban mothers compared to rural mothers (p<0.05).
Maternal education, media exposure, proximity to EPI centre, HEWs home visit, antenatal care
attendance, pregnancy plan and knowing benefits of TT were predictors of full TT vaccination status.
Thus, benefits of TT should be widely disseminated in the community and it is recommended to
mobilize the community to generate demand for use of maternal health services
