Assessing the Environment for Introduction of Human Papillomavirus Vaccine in India~!2009-10-20~!2010-02-02~!2010-04-06~!

Abstract

This paper presents findings from a study conducted in 2007 and 2008 in two states in India: Andhra Pradesh and Gujarat. The objectives of the study were to: (i) design effective and appropriate HPV vaccine delivery systems for 10-to 14-year-old girls; (ii) design a communication strategy for HPV vaccine delivery; and (iii) devise an HPV vaccine advocacy strategy.The study populations included girls, parents, and local-, district-, and national-level stakeholders. A mixture of group discussions, visual representation techniques, face-to-face interviews, desk and health facility record reviews, field observations, and consultative workshops were used to collect the data.Study findings showed that the policymakers, health care providers, parents, and adolescents were aware and concerned about cervical cancer; would welcome vaccination if safe, effective, affordable, and accessible. Health systems did not require large infrastructure investments to introduce HPV vaccine; basic cold chain and logistic equipment were available. New outreach systems for adolescent girls need to be tested through demonstration projects. No policies would compromise the introduction of HPV vaccination.An HPV vaccine program, requiring public education and provider training, could be delivered. Policymakers' safety and vaccine efficacy concerns can be addressed through targeted advocacy efforts. Three broad approaches were suggested: (i) merge HPV vaccination with already established immunization services; (ii) package HPV immunization with adolescent health services or as a part of a cancer control service; and (iii) deliver HPV vaccinations through either routine immunization services or a campaign using schools as sites for school-going girls and anganwadi or village health centers for non-school-going girls.

Delivery cost of human papillomavirus vaccination of young adolescent girls in Peru, Uganda and Viet Nam

“…32 In addition, the variation in cost reflects several key contextual factors, such as national income level, which affects public health service costs and personnel salaries, and health system policies and programmes, which influence country-specific implementation plans and lead to variations in resource use. [6][7][8][9][10]12 For example, countries used a variety of approaches and materials for microplanning, community sensitization, raising awareness and staff training. In Peru, Uganda and Viet Nam, national immunization programmes scheduled separate microplanning and training activities for HPV vaccination at multiple tiers of the health system rather than integrating …”

“…The results of formative research 5 were used to design demonstration projects of different types of vaccine delivery in partnership with each country's ministry of health, subnational health and education sectors and other key stakeholders. [6][7][8][9][10] Three delivery strategies were investigated: school-based outreach, health-centre-based outreach and integrated outreach, which made use of existing health services. The eligible population was selected by either school grade or age.…”

Advancing Cervical Cancer Prevention in India: Implementation Science Priorities

“…First is the need for systems to monitor, report, and respond to postvaccination adverse events. The Gujarat and Andhra Pradesh study found that although guidelines were available for postimmunization adverse event management, often they were not followed [4]. Additionally, the widely differing interpretations of the data on HPV vaccine safety among health activists, clinicians, public health practitioners, and journalists suggests that a more robust communication strategy is needed to disseminate evidence in support of vaccination.…”

“…Moreover, although primary prevention through human papilloma virus (HPV) vaccination is gaining acceptance in high-income countries and has been endorsed by the World Health Organization (WHO), vaccine awareness, access, and use are very low [4,5]. However, cervical cancer prevention efforts appear to be gathering momentum.…”

Knowledge of Cervical Cancer and HPV Vaccine Post-Vaccination among Mothers and Daughters in Vietnam

“…Availability of human papillomavirus (HPV) vaccine offers a method of primary prevention and has the potential to significantly reduce cervical cancer incidence and deaths (Brotherton et al, 2011). Prior to initiating an HPV vaccination program, assessing the levels of knowledge and awareness in a community has been suggested as a means to develop appropriate educational materials for vaccine recipients and decision-makers (Bingham et al, 2009;Jacob et al, 2010). A number of studies in Vietnam and other Asian countries have reported low levels of knowledge about cervical cancer, HPV, and HPV vaccines (Loi & Nhung, 2004;Dinh et al, 2007;Nghi et al, 2010;Young et al, 2010;Charakorn et al, 2011).…”