This systematic review assessed the progress and barriers towards maternal and neonatal tetanus elimination in the 12 countries that are yet to achieve elimination, globally. Coverage of at least 80% (the coverage level required for elimination) was assessed among women of reproductive age for five factors: (1) at least two doses of tetanus toxoid-containing vaccine, (2) protection at birth, (3) skilled birth attendance, (4) antenatal care visits, and (5) health facility delivery. A scoping review of the literature and data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys provided insights into the barriers to attaining maternal and neonatal tetanus elimination. Findings showed that none of the 12 countries attained at least 80% coverage for women of reproductive age receiving at least two doses of tetanus toxoid-containing vaccine or protection at birth according to the data from Demographic and Health Surveys or Multiple Indicator Cluster Surveys. Barriers to maternal and neonatal tetanus elimination were mostly related to health systems and socioeconomic factors. Modification to existing maternal and neonatal tetanus elimination strategies, including innovations, will be required to accelerate maternal and neonatal tetanus elimination in these countries.

这项系统回顾评估了全球 12 个尚未实现消除孕产妇和新生儿破伤风的国家在消除孕产妇和新生儿破伤风方面的进展和障碍。在育龄妇女中评估了至少 80% 的覆盖率（消除所需的覆盖水平），评估了五个因素：(1) 至少两剂含破伤风类毒素的疫苗，(2) 出生时的保护，(3) 熟练的分娩护理，(4) 产前护理就诊，以及 (5) 医疗机构分娩。对人口统计和健康调查以及多指标类集调查的文献和数据进行范围界定审查，深入了解消除孕产妇和新生儿破伤风的障碍。调查结果显示，根据人口与健康调查或多指标类集调查的数据，12 个国家中没有一个国家的育龄妇女在出生时接受至少两剂含破伤风类毒素疫苗或保护的覆盖率达到至少 80%。消除孕产妇和新生儿破伤风的障碍主要与卫生系统和社会经济因素有关。需要修改现有的孕产妇和新生儿破伤风消除战略，包括创新，以加快这些国家消除孕产妇和新生儿破伤风的速度。