Over the decades the burden of tetanus has shifted to most disadvantaged, poorer population who has limited access to standard healthcare. In global context, 88% reduction of death from tetanus was observed over past three decades. Today majority of the cases are confined to Sub-Saharan Africa and South-east Asia region. These two regions account for 82% of all tetanus cases globally. Similarly, 77% of all deaths from tetanus occur in South Asia and Sub-Saharan Africa. However, even though South Asia still sees more cases of tetanus than any other region, in just three decades the incidence rate in the region has fallen 14-fold, from close to half a million cases in 1990 to 33,000 in 2017.1 According to WHO, Bangladesh reported total 226 cases of confirmed tetanus including 84 cases of neonatal tetanus.2,3 Under reporting of tetanus cases has been a challenge in curbing the disease burden.