Health System Factors Influencing Uptake of Human Papilloma Virus (Hpv) Vaccine Among Adolescent Girls 9-15 Years in Mbale District, Uganda

Abstract

Introduction Globally, cervical cancer is the fourth most common cancer in women with more than 85% of the burden in developing countries. In Uganda, cervical cancer has shown an increase of 1.8% per annum over the last twenty years. The availability of the Human Papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. Understanding how the health system influences uptake of the vaccine is critical to improve it. This study aimed to assess how the health systems is influencing uptake of HPV vaccine so as to inform policy for vaccine implementation and uptake in Mbale district, Eastern Uganda. Methods We conducted a cross sectional study of 407 respondents, selected from 56 villages. Six key informant interviews were conducted with District Health Officials involved in implementation of the HPV vaccine. Quantitative data was analyzed using Stata V.13. Prevalence ratios with their confidence intervals were reported. Qualitative data was audio recorded, transcribed verbatim and analyzed using MAXQDA V.12, using the six steps of thematic analysis developed by Braun and Clarke. Results 56 (14%) of 407 adolescents self-reported vaccine uptake. 182 (52.3%) of 348 reported lack of awareness about the HPV vaccine as the major reason for not having received it. Receiving vaccines from outreach clinics (p=0.02), having many options from which to receive the vaccine (p=0.02), getting an explanation on possible side-effects (p=0.024), and receiving the vaccine alongside other services (p=0.024) were positively associated with uptake. Key informants reported inconsistency in vaccine supply, inadequate training on HPV vaccine, and the lack of a clear target for HPV vaccine coverage as the factors that contribute to low uptake. Recommendation We recommend training of health workers to provide adequate information on HPV vaccine, raising awareness of the vaccine in markets, schools, and radio talk shows, and communicating the target to health workers. Conclusion Uptake of the HPV vaccine was lower than the Ministry of health target of 80%. We recommend more training of health workers to clearly provide adequate information on HPV vaccine, increasing awareness about the vaccine to the adolescents and reaching out to adolescents in and out of school for vaccination..

Gaps in measles vaccination coverage in Kasese district, Western Uganda: results of a qualitative evaluation

“…This is a common phenomenon in low-and middle-income countries which have limited budget allocation for vaccines but also low technological access that limits the planning and prediction of such supplies [17]. This study findings are in line with other studies conducted at Mulago National Referral Hospital, Uganda that showed that majority of the new borns miss immunization due to vaccine stock outs [18,19]. This calls for budget increase for EPI activities at the district health offices, and proper planning by stakeholders like national medical stores (NMS), ministry of health and district health department to minimise the occurrence of stock outs [17].…”

Human papillomavirus vaccination uptake and its associated factors among adolescent school girls in Ambo town, Oromia region, Ethiopia, 2020

“…To explore these reasons, studies have looked at hindering factors at the community level (social group values and norms, media coverage around the HPV vaccine), at the organizational level (allocated resources, information provision, consent process, immunization setting, and environment) and the policy level (HPV vaccine program) [3,4,[17][18][19][20]. Additionally, poor knowledge about cervical cancer, HPV infection, HPV vaccine, negative attitude towards the HPV vaccine, poorly perceived susceptibility and severity of cervical cancer age, residence, level of education, parental educational status, and low socioeconomic status, significantly affects the vaccine uptake [3,4,11,13,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Hubungan tingkat pengetahuan dengan sikap terhadap imunisasi vaksin Human Papilloma Virus sebagai pencegahan primer kanker serviks pada mahasiswi fakultas keperawatan Unsyiah

“…(10) Penelitian Juliet Nabirye, et al tahun 2020 tentang faktor sistem kesehatan yang mempengaruhi pemberian vaksin HPV remaja perempuan berusia 9-15 tahun di daerah Mbale, Uganda menyatakan bahwa sebanyak 182 responden (52,3%) dari 348 responden memiliki kesadaran dan pengetahuan rendah terhadap vaksin HPV yang diakibatkan oleh informasi dan penyuluhan yang kurang dan terbatas. (11) Berdasarkan latar belakang diatas, kurangnya penerimaan masyarakat terhadap imunisasi vaksin HPV dikarenakan tingkat pengetahuan yang rendah tentang kanker serviks dan vaksin HPV. Oleh karena itu, penulis tertarik untuk meneliti mengenai "Hubungan Tingkat Pengetahuan dengan Sikap Terhadap Imunisasi Vaksin HPV Sebagai Pencegahan Primer Kanker Serviks Pada Mahasiswi Fakultas Keperawatan Universitas Syiah Kuala".…”