Maternal vaccination has proven to protect newborns from neonatal tetanus, which has a mortality rate of about 30% to 70% in developing countries. This public engagement project led by Agnes Msoka aimed to improve maternal vaccination services uptake in pregnant women and postnatal mothers in Tanzania.

The project was implemented in three steps: baseline assessment, training and evaluation. Participants included health care workers (HCWs), mothers and community members from 10 villages, who were selected on basis of their interest in participating in the project and their availability. For assessing problems related to maternal vaccination experienced in the communities, in-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with 58 HCWs, mothers and other community members. In the training phase, 10 HCWs were educated as 'trainer of trainers' to teach community leaders, who in turn trained the communities including mothers during routine community meetings. In a third phase, FGDs and IDIs were conducted to evaluate the acquired knowledge among HCWs, mothers and other community members.

The baseline assessment revealed a shortage of human resources among HCWs, a shortage of tetanus vaccines, a lack of awareness of maternal vaccination among mothers, who were often not able to visit vaccination services because of household responsibilities, and litte interest in antenatal care among the women's husbands. While the baseline findings helped to enrich training content, the results from the evaluation phase helped to assess the impact of the project. The data generated in the evaluation phase suggests that the project resulted in an increased vaccine awareness in the communities and that more mothers visited clinics for antenatal examinations at an earlier stage. Also more men supported their wives in receiving vaccination services.

It can be concluded that knowledge gaps and lack of awareness were the major reasons for inadequate use of vaccination services. The availability of service providers and proper timing of vaccination provision are additional keys for the accessibility of vaccination services. The project demonstrated that vaccine awareness creation through community meetings is a low-cost measure for a sustainable promotion of maternal vaccination services.