Tanzania’s human papillomavirus (HPV) vaccination program: Community awareness, feasibility, and acceptability of a national HPV vaccination program, 2019

Li, Anyie J.; Manzi, Fatuma; Kyesi, Furaha; Makame, Yusuf; Mwengee, William; Fleming, Monica; Mkopi, Abdallah; Mmbaga, Selemani; Lyimo, Dafrossa; Loharikar, Anagha

doi:10.1016/j.vaccine.2021.06.047

Cited by 12 publications

(12 citation statements)

References 33 publications

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“…As expected, service delivery was also a substantial portion of financial costs (38 %), given the upfront investments necessary to scale the HPV vaccination program nationally to an age group that was previously not routinely targeted for vaccination. Further, given the age cohort targeted, additional resources had to be allocated to reach both primary and secondary schools (given that girls aged 14 years may be in either setting) [36] .…”

Section: Discussionmentioning

confidence: 99%

“…Further, community leaders were found to have low basic knowledge of HPV vaccination, which points to the need for additional investments in community engagement and outreach that are not included in our modelling. The reality is that at age 14, 36 % of Tanzanian girls are already out-of-school, and 45 % at age 15 (compared with only 4 % of girls aged 9 years in the Kilimanjaro demonstration project) [36] . The poorest children and those living in rural areas face additional disparities in primary school attendance.…”

Section: Discussionmentioning

confidence: 99%

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Costs of delivering human papillomavirus vaccination using a one- or two-dose strategy in Tanzania

Hsiao

Struckmann

Stephani

et al. 2023

Vaccine

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Costs of delivering human papillomavirus vaccination using a one- or two-dose strategy in Tanzania

Hsiao

Struckmann

Stephani

et al. 2023

Vaccine

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“…However, Senegal and other countries with lower rates of school enrollment should consider PLOS GLOBAL PUBLIC HEALTH innovative ways of community outreach to access out-of-school girls that might be missed during school vaccinations, including mobilizing these girls to schools on vaccination days, encouraging health facility-based vaccination, or integrating outreach efforts [22][23][24]. A comprehensive approach of utilizing all routine delivery strategies is needed to achieve equitable high HPV vaccination coverage and has been shown to be successful in other countries [25,26]. Overall, Senegal's HPV introduction was successful, with high-level political engagement, knowledgeable health staff, and high vaccine demand in communities.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and acceptability of nationwide HPV vaccine introduction in Senegal: Findings from community-level cross-sectional surveys, 2020

Doshi

Casey

Adrien

et al. 2022

PLOS Glob Public Health

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In Senegal, cervical cancer is the most common cancer among women and the leading cause of morbidity and mortality from all cancers. In 2018, Senegal launched a national human papillomavirus (HPV) vaccination program with Gavi, the Vaccine Alliance (Gavi), support. HPV vaccination was incorporated into the national immunization program as a two-dose schedule, with a 6-12-month interval, to nine-year-old girls via routine immunization (RI) services at health facilities, schools and community outreach services throughout the year. During February to March 2020, we conducted interviews to assess the awareness, feasibility, and acceptability of the HPV vaccination program with a cross-sectional convenience sample of healthcare workers (HCWs), school personnel, community healthcare workers (cHCWs), parents, and community leaders from 77 rural and urban health facility catchment areas. Participants were asked questions on HPV vaccine knowledge, delivery, training, and community acceptability of the program. We conducted a descriptive analysis stratified by respondent type. Data were collected from 465 individuals: 77 HCW, 78 school personnel, 78 cHCWs, 152 parents, and community leaders. The majority of HCWs (83.1%) and cHCWs (74.4%) and school personnel (57.7%) attended a training on HPV vaccine before program launch. Of all respondents, most (52.5–87.2%) were able to correctly identify the target population. The majority of respondents (60.2–77.5%) felt that the vaccine was very accepted or accepted in the community. Senegal’s HPV vaccine introduction program, among the first national programs in the African region, was accepted by community stakeholders. Training rates were high, and most respondents identified the target population correctly. However, continued technical support is needed for the integration of HPV vaccination as a RI activity for this non-traditional age group. The Senegal experience can be a useful resource for countries planning to introduce the HPV vaccine.

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“…However, HCPs were sometimes found to have little knowledge of disease etiology and vaccine, with some reports indicating that HCPs were unaware of the disease they were vaccinating against or the MoH-recommended target age group eligible for vaccination. In addition, in Uganda and Tanzania, only a few HCPs reported attending a condensed one-day training vaccine a few weeks before the introduction (36,41). In specific instances (such as Cote d'Ivoire) the planning process and trainings were rushed or missed.…”

Section: Multi-sectoral Coordinationmentioning

confidence: 99%

“…Routine mode might work better for countries with sub-optimal school attendance with intensified social mobilization and communication outreach activities. These program experiences have demonstrated that providing vaccination at school is both feasible and acceptable (20,36,62). Using a schoolbased vaccine delivery platform with a six-month or annual dose schedule is an effective strategy, but it requires careful microplanning between health and education officials (17,46), and at times the information forwarded from MoH to school administration did not reach the school teachers (63) (KIIs).…”

Section: Deliverymentioning

confidence: 99%

Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries?

Waheed

Bolio

Guillaume

et al. 2023

Front. Public Health

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Cervical cancer due to human papillomavirus (HPV) infection is a leading cause of mortality among women in low-resource settings. Many Sub-Saharan African countries have introduced HPV vaccination programs at the national level in the last few years. However, countries are struggling to maintain sustainable coverage. This study focuses on the introduction and sustainability challenges, context-specific key lessons learned, and mechanisms of action to achieve high sustainable coverage from low and lower-middle-income countries (LLMICs) that have introduced HPV vaccination programs by collating evidence from a literature review and key informant interviews. Local data availability was a challenge across countries, with the lack or absence of registries, data collection and reporting mechanisms. Multi-sectoral coordination and early involvement of key stakeholders were cited as an integral part of HPV programs and facilitators for sustainable coverage. Key informants identified periodic sensitization and training as critical due to high staff turnover. Health workforce mobilization was fundamental to ensure that the health workforce is aware of the disease etiology, eligibility requirements, and can dispel misinformation. Schools were reported to be an ideal sustainable platform for vaccination. However, this required teachers to be trained, which was often not considered in the programs. District-level staff were often poorly informed and lacked the technical and logistic capacity to support vaccination rounds and data collection. To improve the sustainability of HPV vaccination programs, there is a need for timely microplanning, efficient preparedness assessment, assessing training approaches, periodic training, finding innovative ways to achieve equity and adoption of a bottom-up approach to ensure that processes between districts and central level are well-connected and resources are distributed efficiently.

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Tanzania’s human papillomavirus (HPV) vaccination program: Community awareness, feasibility, and acceptability of a national HPV vaccination program, 2019

Cited by 12 publications

References 33 publications

Costs of delivering human papillomavirus vaccination using a one- or two-dose strategy in Tanzania

Costs of delivering human papillomavirus vaccination using a one- or two-dose strategy in Tanzania

Feasibility and acceptability of nationwide HPV vaccine introduction in Senegal: Findings from community-level cross-sectional surveys, 2020

Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries?

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