Factors Affecting Uptake of Tetanus Toxoid Vaccine among Women of Childbearing Age in Low-And-Middle-Income Countries: A Systematic Review

Abstract

Tetanus is a life-threatening infection caused by Clostridium tetani, particularly affecting high-risk groups in low- and middle-income countries in sub-Saharan Africa, Africa, and Asia. This is often due to unhygienic birth practices. Vaccination with tetanus toxoid-containing vaccine during and around pregnancy provides protection. A literature review from 1995 to 2024 was conducted in PubMed/MEDLINE, African Journals Online, and Google Scholar following PRISMA guidelines to identify relevant publications. Thirteen studies met the inclusion criteria and were assessed for evidence quality using an expanded PRISMA checklist. The studies identified key factors influencing poor vaccination uptake among women of childbearing age, including age(25-35years: AOR; 0.510-0.925), marital status (Married: AOR; 0.400-1.038), parity (3-4 Children: AOR; 0.200-5.050), antenatal care visits (Four or more: AOR; 0.048-1.710), place of delivery (Health facility: AOR; 1.130-23.380), distance to health facilities (<30 minutes: AOR;1.050-4.600), media exposure (Yes: AOR;1.968-2.820), wealth index (Rich: AOR; 0.630-7.230 or poor), educational level (Secondary: AOR; 0.600-6.200), and knowledge of tetanus and the vaccine (Yes: AOR; 0.900-3.450). Health education, engagement of women, and targeted vaccination of high-risk groups are essential strategies to improve vaccination rates.