Pakistan has taken a significant step towards eliminating maternal and neonatal tetanus (MNT) after the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) pre-validated the disease’s elimination in Khyber Pakhtunkhwa, bringing the country closer to achieving a long-sought public health milestone.
Progress in Elimination
The development means that nearly 94 per cent of Pakistan’s estimated population of more than 265 million now lives in areas where neonatal tetanus transmission is considered under control, with fewer than one case reported per 1,000 live births. Khyber Pakhtunkhwa joins Gilgit-Baltistan, Islamabad Capital Territory, Pakistan-administered Kashmir, Punjab and Sindh in achieving elimination status. Balochistan is now the only province yet to meet the benchmark required for nationwide elimination.
Assessment and Factors
The pre-validation assessment conducted by WHO and UNICEF included visits to high-risk districts, reviews of surveillance records spanning the past three years, and audits of immunisation activities. Health experts attributed the achievement to expanded vaccination coverage, safer delivery practices, improved maternal healthcare services and the sustained efforts of frontline health workers across the province.
A central role was played by nearly 12,000 Lady Health Workers, supported by thousands of vaccinators and healthcare personnel who helped extend immunisation services to vulnerable communities, particularly in remote and underserved areas.
Vaccination Campaigns
According to health officials, WHO and UNICEF supported vaccination campaigns reaching 5.4 million pregnant women and women of childbearing age across Pakistan during 2025. Of these, more than 870,000 women were vaccinated in Khyber Pakhtunkhwa alone.
Maternal and neonatal tetanus remains a life-threatening but preventable disease, most commonly affecting newborns delivered in unhygienic conditions and mothers lacking adequate immunisation coverage. Public health experts regard its elimination as a key indicator of improvements in maternal healthcare, routine immunisation and safe childbirth practices.
Remaining Challenges
Despite the progress, Pakistan remains among only eight countries worldwide that have yet to achieve nationwide elimination of maternal and neonatal tetanus. Health authorities, with continued support from international partners, are now focusing efforts on Balochistan to secure countrywide certification and meet the targets set under the Immunization Agenda 2030.
This latest achievement marks a major advance in Pakistan’s public health journey and strengthens hopes that the country could soon join the growing list of nations that have successfully eliminated the disease.
