Authors and Year

Number of girls per region

Measurement Method

Main challenges in HPV vaccine implementation

Nabirye et al., 2020⁸

407

Health system factors were assessed through key informant interviews and an observation checklist. Six key informant interviews with the district health team members who had an expert opinion about the health services factors that influence uptake of HPV vaccination in the district were conducted.

Factors associated with uptake of the HPV vaccine:

1) Lack of awareness about the HPV vaccine, the number of doses that they must receive and the schedule or interval of the vaccines - 45% (182/348) of the adolescents who had either received either one dose or none;

2) Reluctance to vaccinate, being afraid of vaccines and myths about the vaccines - 17.5% (61/348)

3) Distance to health facility - 14.4% (50/348);

4) Lack of money - 10% (35/348);

5) Receiving the vaccine from static sites and not from outreach clinics;

6) Not receiving an explanation on the possible side effects of the HPV vaccine;

7) Not receiving the vaccines alongside other services;

8) Not having many options from where to receive the HPV vaccine.

Barriers to service delivery:

1) Low financing;

2) Myths about the vaccine;

3) Unclear communication on the target for the vaccine’s coverage;

4) Transport challenges to reach the adolescents in the community;

5) Inequity in access for those who prefer utilize private health facilities and for girls in private schools, because private schools and private health facilities are not given the HPV vaccine;

6) Difficulties in the vaccine delivery in Health-centre-based delivery compared to School-based delivery due to the target groups not being evident.

Barriers for human resources for health:

1) Inadequate staff to run the work in the health center;

2) Insufficient training among health workers about the vaccines;

Barriers to vaccines, supplies and medicines:

1) Inconsistency in vaccine supply;

2) Lack of integration of the HPV vaccines with other services.

Kisaakye et al., 2018⁹

460

They conducted five key informant interviews with the district health team members who had an expert opinion about the health service factors that influence uptake of HPV vaccination in Lira district.

Factors associated with uptake of the HPV vaccine:

1) Poor knowledge about the HPV vaccine (56.09%, 258/460);

2) Attained an education level of primary and below;

3) Negative attitudes towards the HPV vaccine;

4) Receiving all the HPV vaccine doses from one vaccination site;

5) Not been recommended or encouraged by a health worker to go for the HPV vaccine;

6) Not been encouraged by a village health team member (VHT);

7) Not receiving full information about the HPV vaccination.

Barriers to vaccine delivery and supplies:

1) HPV vaccine community outreaches were not conducted in the residences of the targeted girls;

2) Unavailability of vaccine at all visits;

3) Lack of sufficient funds to facilitate the transport/delivery of vaccines at the different vaccination sites and the health workers responsible for vaccinating the girls.