{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T10:54:06Z","timestamp":1793876046950,"version":"4.7.0"},"reference-count":65,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Maternal immunization confers dual protection on pregnant women and their newborns through transplacental antibody transfer, yet vaccination coverage across sub\u2010Saharan Africa remains critically inadequate. Two intersecting crises drive this gap: vaccine hesitancy, rooted in historical distrust and pervasive misinformation, and vaccine scarcity, driven by supply chain fragility and infrastructural deficits. Sub\u2010Saharan Africa bears approximately 70% of global maternal deaths and 57% of neonatal deaths worldwide, with an estimated 200\u2009000 vaccine\u2010preventable neonatal deaths annually. This narrative review examines the causes and impacts of both crises and reviews the evidence base for key maternal vaccines including tetanus toxoid, Anti\u2010D immunoglobulin, influenza, Tdap (tetanus, diphtheria, and pertussis), and respiratory syncytial virus. Drawing on a conceptual pathway model, we present a six\u2010pillar framework addressing structural determinants, prenatal care integration, workforce capacity, supply chain modernization, community engagement, and equity\u2010focused monitoring. We conclude with a call to action for concerted, multi\u2010stakeholder intervention to build a resilient and equitable maternal immunization ecosystem across the region.<\/jats:p>","DOI":"10.1002\/ijgo.71286","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:53:18Z","timestamp":1785937998000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["From policy to practice: Systemic solutions to strengthen maternal immunization in sub\u2010Saharan Africa"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2089-4395","authenticated-orcid":false,"given":"Amala K.","family":"Nazareth","sequence":"first","affiliation":[{"name":"Emirates Healthcare Group Emirates Specialty Hospital DHCC  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chittaranjan N.","family":"Purandare","sequence":"additional","affiliation":[{"name":"Purandare Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne B.","family":"Kihara","sequence":"additional","affiliation":[{"name":"Kenyatta National Hospital Nairobi  Nairobi Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanthakumari","family":"Sekharan","sequence":"additional","affiliation":[{"name":"Yashoda Hospital  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Al\u2010Qedra","sequence":"additional","affiliation":[{"name":"Latifa Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulfetah Abdulkadir","family":"Abdosh","sequence":"additional","affiliation":[{"name":"St Paul's Hospital Millennium Medical College  Addis Ababa Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikhil C.","family":"Purandare","sequence":"additional","affiliation":[{"name":"University Hospital  Galway Republic of Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"Immunity Types.CDC: US Centers for Disease Control and Prevention.https:\/\/www.cdc.gov\/vaccines\/basics\/immunity\u2010types.html"},{"key":"e_1_2_14_3_1","unstructured":"Diseases that Vaccines Help Protect Against.CDC: US Centers for Disease Control and Prevention.https:\/\/www.cdc.gov\/vaccines\u2010children\/diseases\/index.html"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines13050450"},{"key":"e_1_2_14_5_1","unstructured":"How investing in maternal and child health fuels prosperity for women young people and children in Africa.World Economic Forum.https:\/\/www.weforum.org\/stories\/2024\/09"},{"key":"e_1_2_14_6_1","volume-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division","author":"World Health 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