Health systems and immunization financing for human papillomavirus vaccine introduction in low-resource settings

Feasibility of delivering HPV vaccine to girls aged 10 to 15 years in Uganda

“…This could be attributed to that fact that eligible girls were scattered across multiple classes 8 and identifying them across the entire school required enormous efforts and time by the health workers, and yet the health workforce in Uganda is limited. 12,13 In addition, the school system in Uganda is designed in such a way that pupils in primary grades 1 and 2 study half days, yet health workers work for a full day; therefore with many schools to cover in a given day, it may be probable that health workers arrive at a school after the primary grades 1 and 2 pupils have already left school.…”

“…12,13 High school enrolment, due to the institutionalization of Universal Primary Education, suggested that schools could be a viable venue for vaccinations. The research also noted that the twice-yearly CDP program was delivering vitamin A, albendazole for de-worming, and catch-up vaccinations in communities every six months, and often used schools as a venue for distribution.…”

Global Delivery of Human Papillomavirus Vaccines

“…• Health system capacity and infrastructure, including cold chain systems to transport and store the vaccine, as well as the availability of human resources for cold chain and logistics management; 41,79 • Financial costs to introduce and sustain HPV programs; 37 • Girls (including pre-adolescents and adolescents) represent a new population that has not been regularly targeted for routine immunization by the Expanded Program on Immunization;…”

“…• Stigma and controversy, targeting female adolescents ages 9-13 years for a sexually transmitted infection; 79,82 • Parental concerns over the vaccines' safety and its potential side effects, including unjustified fears of future infertility, early sexual debut, and potential for increased sexual activity; [83][84][85] • Differences in acceptable communication strategies and dissemination of health information, as well as parental consent preferences (e.g. opt-in versus opt-out);…”

Strengthening National Immunization Coverage Capacity and Effectiveness Strategies in Vaccine Preventable Diseases in Rural and Urban Settings in Sub-Saharan Africa

“…Reducing the immunization disparities amongst unprivileged in remotes rural communities to uptake immunization programs as a need and demand against knowledge limitations and not as "a government or political party pay back/compensation post-election into power or political agenda" is the ultimate responsibility of health professionals and stakeholders to distance from such illed-practices and politics misconception or reality [18].…”