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Research article
JULIET NABIRYE
Makerere University College of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4731-5811
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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..
Keywords
uptake, Health system, Human papillomavirus vaccine, cervical cancer, Low income country, adolescent girls
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CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Review #1 received
Received 11 Jan, 2020
Reviewer #1 agreed
On 04 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Editor assigned
On 03 Dec, 2019
Submission checks complete
On 02 Dec, 2019
Editor invited
On 02 Dec, 2019
Version 1
Posted 20 Jun, 2019
No comments provided
Editorial decision: Major revision
On 03 Nov, 2019
Review #2 received
Received 28 Aug, 2019
Review #1 received
Received 28 Aug, 2019
Reviewer #2 agreed
On 19 Aug, 2019
Reviewer #3 agreed
On 19 Aug, 2019
Reviewer #1 agreed
On 17 Aug, 2019
Reviewers invited
Invitations sent on 03 Jul, 2019
Submission checks complete
On 19 Jun, 2019
Editor invited
On 17 Jun, 2019
Editor assigned
On 17 Jun, 2019
First submitted
On 13 Jun, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
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A new preprint design is coming!
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
JULIET NABIRYE
Makerere University College of Health Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4731-5811
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Review #1 received
Received 11 Jan, 2020
Reviewer #1 agreed
On 04 Jan, 2020
Reviewers invited
Invitations sent on 03 Jan, 2020
Editor assigned
On 03 Dec, 2019
Submission checks complete
On 02 Dec, 2019
Editor invited
On 02 Dec, 2019
Version 1
Posted 20 Jun, 2019
No comments provided
Editorial decision: Major revision
On 03 Nov, 2019
Review #2 received
Received 28 Aug, 2019
Review #1 received
Received 28 Aug, 2019
Reviewer #2 agreed
On 19 Aug, 2019
Reviewer #3 agreed
On 19 Aug, 2019
Reviewer #1 agreed
On 17 Aug, 2019
Reviewers invited
Invitations sent on 03 Jul, 2019
Submission checks complete
On 19 Jun, 2019
Editor invited
On 17 Jun, 2019
Editor assigned
On 17 Jun, 2019
First submitted
On 13 Jun, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
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..
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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