Challenges Experienced by Healthcare Workers on Maternal Tetanus Toxoid Vaccination in Kilimanjaro Region Tanzania

Sweetness Naftal Laizer1,2,3, Asia Hemed1,2, Perry M. Cyril1, Zuhura Lintu1,2, Sanjura Mandela Biswaro1 ,Blandina Theophil Mmbaga1,2,3, and Agnes Cyril Msoka1,3,4
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Healthcare Workers (HCWs) are the first part of call for healthcare enquirers and have a key role in providing appropriate information and evidence-based healthcare recommendations to pregnant and postnatal mothers in order to ensure that they are well informed regarding maternal vaccinations. The World Health Organization (WHO) recommends that five doses are needed in order to acquire lifelong immunity against tetanus. A pregnant mother is considered to be more than 80% protected once she receives at least two doses of the vaccine. This study aimed to identify challenges experienced by the healthcare workers on maternal Tetanus Toxoid (TT) vaccination in Kilimanjaro region, Tanzania.


A qualitative approach comprising of In-Depth Interviews (IDIs) and focus group discussion (FGD) was conducted with 10 healthcare workers selected from 10 health facilities in remote villages of Hai district. The healthcare workers were selected purposively based on their availability and convenience; thematic analysis guided the data process.


Majority of the Healthcare workers were female, enrolled nurses with college education; their age ranged between 26-59 years with experience of work between 1 to 31 years. Main themes were extracted from the analysis namely: unreliable storage of vaccines, shortage of vaccines, shortage of healthcare workers, behavior of the healthcare workers and spousal influence on maternal vaccinations.


The shortage and unreliable storage of TT vaccine has led to mothers missing their required doses, the spousal support and good mother-provider relationship is essential to ensure that the pregnant and post-natal mothers receive all the required doses. The regional and district health officials should ensure constant supply of TT vaccine with the recommended standards of vaccine storage facilities.