Effective Health Interventions for Adolescents That Could Be Integrated With Human Papillomavirus Vaccination Programs

Broutet, Nathalie; Lehnertz, Nicholas; Mehl, Garrett; Camacho, Alma Virginia; Bloem, Paul; Chandra-Mouli, Venkatraman; Ferguson, Jane; Dick, Bruce

doi:10.1016/j.jadohealth.2013.02.022

Cited by 24 publications

(16 citation statements)

References 65 publications

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“…While our cost data include staffing costs for the programs assessed, they do not provide more detailed information on other non-vaccine costs categories that could substantively impact the implementation or sustainability of the programs [42]. A review of the available data from low- and middle-income countries found that HPV vaccination is cost-effective and potentially cost saving, especially in settings without organized cervical screening programs [43].…”

Section: Discussionmentioning

confidence: 99%

Performance of 21 HPV vaccination programs implemented in low and middle-income countries, 2009–2013

Ladner

Besson²,

Rodrigues³

et al. 2014

BMC Public Health

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BackgroundCervical cancer is the third most common cancer in women worldwide, with high incidence in lowest income countries. Vaccination against Human Papilloma Virus (HPV) may help to reduce the incidence of cervical cancer. The aim of the study was to analyze HPV vaccination programs performance implemented in low and middle-income countries.MethodsThe Gardasil Access Program provides HPV vaccine at no cost to help national institutions gain experience implementing HPV vaccination. Data on vaccine delivery model, number of girls vaccinated, number of girls completing the three-dose campaign, duration of vaccination program, community involvement and sensitization strategies were collected from each program upon completion. Vaccine Uptake Rate (VUR) and Vaccine Adherence between the first and third doses (VA) rate were calculated. Multivariate linear regressions analyses were fitted.ResultsTwenty-one programs were included in 14 low and middle-income countries. Managing institutions were non-governmental organizations (NGOs) (n = 8) or Ministries of Health (n = 13). Twelve programs were school-based, five were health clinic-based and four utilized a mixed model. A total of 217,786 girls received a full course of vaccination.Mean VUR was 88.7% (SD = 10.5) and VA was 90.8% (SD = 7.3). The mean total number of girls vaccinated per program-month was 2,426.8 (SD = 2,826.6) in school model, 335.1 (SD = 202.5) in the health clinic and 544.7 (SD = 369.2) in the mixed models (p = 0.15). Community involvement in the follow-up of girls participating in the vaccination campaign was significantly associated with VUR. Multivariate analyses identified school-based (β = 13.35, p = 0.001) and health clinic (β = 13.51, p = 0.03) models, NGO management (β = 14.58, p < 10-3) and duration of program vaccination (β = -1.37, p = 0.03) as significant factors associated with VUR.ConclusionSchool and health clinic-based models appeared as predictive factors for vaccination coverage, as was management by an NGO; program duration could play a role in the program’s effectiveness. Results suggest that HPV vaccine campaigns tailored to meet the needs of communities can be effective. These results may be useful in the development of national HPV vaccination policies in low and middle-income countries.

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Section: Discussionmentioning

confidence: 99%

Performance of 21 HPV vaccination programs implemented in low and middle-income countries, 2009–2013

Ladner

Besson²,

Rodrigues³

et al. 2014

BMC Public Health

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“…New developments with the introduction of a two-dose instead of the three-dose regime will further increase cost-effectiveness as well as simplify delivery and lead to improved coverage rates (Dobson et al, 2013; WHO, 2014b). Packaging HPV vaccination programs with national adolescent health efforts targeting sexual risk behavior, substance abuse, under- and over nutrition and physical inactivity could additionally increase cost-effectiveness of the intervention (Broutet et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

Obel

McKenzie²,

Buenconsejo-Lum³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Objective To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. Materials and Methods A cross-sectional questionnaire-based survey among ministry of health officials from 21 Pacific Island countries and territories (n=21). Results Cervical cancer prevention was rated as highly important, but implementation of prevention programs were insufficient, with only two of 21 countries and territories having achieved coverage of cervical cancer screening above 40%. Ten of 21 countries and territories had included HPV vaccination in their immunization schedule, but only two countries reported coverage of HPV vaccination above 60% among the targeted population. Key barriers to the introduction and continuation of HPV vaccination were reported to be: (i) Lack of sustainable financing for HPV vaccine programs; (ii) Lack of visible government endorsement; (iii) Critical public perception of the value and safety of the HPV vaccine; and (iv) Lack of clear guidelines and policies for HPV vaccination. Conclusion Current practices to prevent cervical cancer in the Pacific Region do not match the high burden of disease from cervical cancer. A regional approach, including reducing vaccine prices by bulk purchase of vaccine, technical support for implementation of prevention programs, operational research and advocacy could strengthen political momentum for cervical cancer prevention and avoid risking the lives of many women in the Pacific.

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“…There is scope for further interventions delivered through the vehicle of school-based HPV vaccination. A range of effective health interventions that could be integrated into HPV vaccine delivery in low-and middle-income countries has been identified in recent years (24). Some of these co-delivered interventions have been shown to be welcomed by parents, young adolescents and teachers (25).…”

Section: Towards a More Integrated Service Delivery Modelmentioning

confidence: 99%

HPV vaccine introduction in Rwanda: Impacts on the broader health system

Torres-Rueda

Rulisa

Burchett

et al. 2016

Sexual & Reproductive Healthcare

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Effective Health Interventions for Adolescents That Could Be Integrated With Human Papillomavirus Vaccination Programs

Cited by 24 publications

References 65 publications

Performance of 21 HPV vaccination programs implemented in low and middle-income countries, 2009–2013

Performance of 21 HPV vaccination programs implemented in low and middle-income countries, 2009–2013

Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention

HPV vaccine introduction in Rwanda: Impacts on the broader health system

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