Background Although neonatal tetanus (NNT) has been eliminated in most countries, it remains prevalent in settings where poor hygiene during delivery and low maternal tetanus immunisation coverage persist. Protection against NNT requires at least two doses of tetanus–diphtheria vaccine (Td2+) during pregnancy. In Ghana, despite ongoing elimination efforts, 82 cases of NNT were reported in 2023, highlighting the need to address emerging gaps in surveillance and coverage. This study aimed to determine the prevalence and factors associated with Td2+ uptake among pregnant women in Pru East Municipality. Methods A hospital-based cross-sectional study was conducted among 456 pregnant women from 22nd January to 15th April 2024. Data were collected using structured questionnaires, with Td2+ uptake verified from ANC cards. Descriptive statistics, chi-square tests, and logistic regression were performed in STATA 14. Variables with p ≤ 0.25 were adjusted in the multivariate model with 95% confidence intervals (CIs). Adjusted odds ratios (AORs) were calculated to estimate the strength of association between explanatory variables and Td2+ uptake after controlling for potential confounders. Results Overall, uptake of Td2+ was 70.2% (95% CI: 66.01–74.4). Uptake was linked to early ANC visits 1st (AOR = 2.95) and 2nd (AOR = 2.54), listening to the radio daily (AOR = 9.23) or weekly (AOR = 4.65), watching television daily (AOR = 1.71) or once a day (AOR = 17.13), frequent internet use (AOR = 1.47), long distance to health facility (AOR = 1.57), high (AOR = 2.47) or moderate (AOR = 3.44) knowledge, good (AOR = 2.26) or fair (AOR = 3.37) attitude, rural residence (AOR = 1.85), being married (AOR = 2.85), formal education (AOR = 2.23), and employment (AOR = 4.27). Conclusion The 70.2% uptake of Td2+ was below the 80% target for every district. Achieving the recommended coverage target requires strengthening community outreach, improving health education and improving maternal service accessibility.
Bardoe et al. (Tue,) studied this question.