Tetanus

By: Emily Tarnacki

A trisector engagement approach is a collaborative strategy among business, government and civil society that combines their unique strategies to solve a common issue. Currently, third world countries such as Indonesia, Uganda, and Nepal somewhat have a trisector engagement approach in progress to solve the issue of vaccine preventable diseases (4). However, in most cases, the nonprofit sector is more heavily utilized than the other two sectors. If each of the three sectors truly work in conjunction with each other, it is possible for vaccine preventable diseases like tetanus to be eradicated.

The World Health Organization (WHO), a specialized agency within the United Nations that is concerned with international public health, stepped in as an advisor to Indonesia (5). The first action that they took in Indonesia is to make immunizations mandatory for children under the age of 5 (2). However, this did not make a monumental difference for tetanus because the goal is to immunize women of reproductive age. Tetanus is most commonly spread by nonsterile birthing conditions, therefore if the mother has tetanus antibodies, so will their child (2). WHO is purchasing these vaccines almost exclusively from the private organization PT Bio Farma, a global vaccine producer located in Indonesia (1). Not only is this stimulating the Indonesian economy, but it is also benefitting its citizens by providing immunizations.

Since 2006, UNICEF has also been active in providing tetanus-toxoid vaccinations to Indonesians. Their campaign was far more organized than WHO however. UNICEF identified high risk areas and targeted women of reproductive age during its distribution (2). Also, UNICEF provided additional services to train midwives on hygienic delivery techniques (2).

Although this trisector engagement strategy is in place in Indonesia, I think there are still improvements that can be made. For example, I think the Indonesian government should be responsible for surveying the population and providing data on high risk areas. Currently, UNICEF and other non-profits are spending their energy and resources researching rather than simply providing (2). Then, I suggest that private vaccination producers should be more active in the distribution of their product. They should also advertise the need for this immunization and who should be receiving it so that they are providing information about tetanus, its symptoms, and about where to go to get the vaccine. In terms of organization however, Indonesia is better than Uganda and Nepal at utilizing a trisector approach. Both are relying heavily on nonprofits such as UNICEF and Tetanus Elimination Initiatives to provide vaccinations (3). This approach is not viable as a long-term solution.

References

Hitipeuw, J. (2011, March 10). Indonesian Company Exports Vaccines to 110 Countries Retrieved March 15, 2017, from https://web.archive.org/web/20110713164325/http://english.kompas.com/read/2011/03/10/06253496/Indonesian.Company.Exports.Vaccines.to.110.Countries
Ministry of Health of the Republic Indonesia with WHO, UNICEF and UNFPA. (2016, May 19). Indonesia has eliminated maternal and neonatal tetanus [Press release]. Retrieved February 27, 2017, from http://indonesia.unfpa.org/news/2016/07/indonesia-has-eliminated-maternal-and-neonatal-tetanus
UNICEF. (2011, July 13). Uganda announces elimination of Maternal and Neonatal Tetanus. Retrieved March 15, 2017, from https://www.unicef.org/media/media_59210.html
World Health Organization. (2016, December 1). [Tetanus (total) reported cases]. Unpublished raw data.
World Health Organization. (2017). Who we are, what we do. Retrieved March 13, 2017, from http://www.who.int/about/en/

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