Determinants of Tetanus Toxoid Vaccination Among Women of Reproductive Age in Somaliland: A Cross‐Sectional Study

Background and Aims: Understanding the predictors of Tetanus Toxoid (TT) protection among women of reproductive age is essential for designing effective interventions to eliminate Maternal and Neonatal Tetanus (MNT) in Somaliland. This study aims to identify the sociodemographic, economic, and geographic determinants of TT protection. Methods: A cross-sectional study was conducted using the 2020 Somaliland Demographic and Health Survey (SLDHS). Binary and multivariate logistic regression models, accounting for the complex survey design, were applied to identify determinants of TT protection (receipt of ≥ 2 doses) among 2630 women. Results: Significant predictors included Antenatal Care (ANC) attendance, education, wealth, and region. The adjusted odds of protection were over 8 times higher for women with 4 + ANC visits (AOR = 8.52; 95% CI: 6.31-11.51), nearly 3 times higher for the wealthiest women (AOR = 2.83; 95% CI: 1.98-4.05), and over 3 times higher for women with secondary or higher education (AOR = 3.48; 95% CI: 2.11-5.74). Conclusion: Findings highlight the importance of strengthening ANC services as the primary platform for TT delivery. Tailored interventions are recommended to target the identified risk factors, including uneducated, poor, and rural women, particularly in underserved regions.