Barriers to Human Papillomavirus (HPV) Vaccination of Adolescents School Girls in Morogoro Municipality

Abstract

Background: In Tanzania, cervical cancer is the major cause of morbidity and mortality in women. Human papillomavirus (HPV) infection is responsible for virtually all cases of cervical cancer. Tanzania launched HPV vaccination for girls aged 14 years in the year 2018. However, coverage is still a problem especially for the second dose of the vaccine. There are limited published studies on HPV vaccination done in Tanzania. Objective: To determine Barriers to human papillomavirus (HPV) vaccination of adolescent schoolgirls in Morogoro municipality. Methods: An analytical cross-sectional mixed-method study involving schoolgirls aged 14-16 years, their parents/guardians, and CHMT in Morogoro Municipal Council was conducted. A multistage stratified sampling technique was used to select the sample for the quantitative part. A sample size of 416 schoolgirls was given self-administered structured questionnaires. Data were analyzed by SPSS version 23. The Wilcoxon rank-sum test was used to compare the knowledge on HPV between vaccinated and unvaccinated groups of schoolgirls. For the qualitative part, purposive sampling was used. Four FGDs involving parents and three IDIs were conducted. The thematic data analysis method was used. Results: The proportion of study participants who completed doses of the HPV vaccine was111 (27%). The level of knowledge on HPV was statistically significantly associated with HPV vaccine uptake on the Wilcoxon rank-sum test. Myths and misconceptions, fear of infertility, religious beliefs, traditions and customs, and poor community awareness of HPV vaccine were expressed by participants of FGDs as barriers to HPV vaccination. Conclusion and Recommendations: The proportion of the participants who completed the HPV vaccine was very low. Knowledge of HPV was significantly associated with the uptake of the HPV vaccine. Socio-cultural factors were the main barrier to HPV vaccine uptake. The government should improve community sensitization. Future studies are needed to assess the most effective approaches for the HPV vaccine awareness creation programs in Tanzania.