It was only when she entered the seventh month of her pregnancy that Naseema Bibi, 24, from Mansehra in Khyber Pakhtunkhwa, northern Pakistan, learned that there were vaccines that could protect her unborn child.

“I did not know [that] there was any vaccine that I needed to receive during pregnancy,” she said.

That changed when a Lady Health Worker assigned to her neighbourhood learned that Naseema was pregnant, and paid her a visit. 

Not long afterwards, the pair of them went to the district hospital together, where Naseema received a first dose of the tetanus toxoid (TT) vaccine. She received a second during her eighth month.

The vaccine was vital preparation for a safe delivery. Childbirth is an often messy and dangerous experience. Tetanus transmitted by non-sterile instruments or unclean hands is one of those risks. In most cases, especially in settings where intensive care is unavailable, it proves fatal to the newborn.

Maternal vaccination heads off the risk: WHO estimates that properly-timed maternal TT vaccination prevents well over 90% of the neonatal tetanus deaths that would otherwise occur.

Sights set on elimination of maternal and neonatal tetanus

Most countries worldwide have reduced their share of maternal and neonatal tetanus (MNT) infections to the point that the condition is considered “eliminated as a public health risk” within their borders. 

Pakistan has yet to achieve that milestone. But in June 2026, the World Health Organization (WHO), following an assessment conducted in partnership with UNICEF, announced the pre-validation of maternal and neonatal tetanus (MNT) elimination in Khyber Pakhtunkhwa province. Pre-validation is a preliminary field assessment in which WHO and UNICEF review a province’s surveillance, vaccination and delivery-care data against the elimination criteria, ahead of a formal national validation mission. It signals that Khyber Pakhtunkhwa has met the technical bar for elimination, though the final, official confirmation still requires that broader national process. In other words, it’s a sign that Pakistan is zooming down the right track.