Assessment of factors influencing human papilloma virus vaccine uptake among eligible female adolescents in secondary schools in Missenyi District Council, Tanzania

Abstract

Background: High vaccination rates against Human Papilloma Virus (HPV) is a milestone in primary prevention of cervical cancer. With an increasing number of cases and deaths in the country among women however, like many other countries around the globe, Tanzania has had a high number of district councils (over 90%) who were underperforming in HPV vaccine uptake especially for 2nd dose. Despite the safe, effective, and opportunities for free vaccine delivery in health-care settings, the councils maintained low HPV vaccine update target (< 80%) in 2019. Objective: To assess factors influencing HPV vaccine uptake among eligible female adolescents in secondary schools in Missenyi district council (DC), Tanzania in 2019. Methods: A cross-sectional study was conducted among eligible female adolescents who were 14 years old in 2019 in Missenyi DC. A self-administered structured questionnaire was provided to 450 participants from 10 secondary schools after the assent. Key informant interview (KII) was done to health care officials. Independent variables were program, health care provider and beneficiaries related factors while dependent variable was HPV vaccine dose I and II uptake. Data was summarized by univariate and chi-square was used to assess association and p-value, <0.05 was considered statistically significant. The strength of association between dependent and independent variable was measured using Poisson regression analysis. Results: The study shown that, majority (92%) of the 456 interviewed participants were aware of HPV vaccine and 70% reported school as common source of information. About 45% (203/450) of the respondents received HPV vaccine 1st dose and 53% of them were vaccinated at school. There was statistical significance association between guardian who reside with the girl and HPV vaccine uptake. Respondents who reside with mothers were 20% more likely to be vaccinated compared to those reside with both parents (p-value, 0.05). Of those received 1st dose, 54% (111/203) received HPV vaccine 2nd dose and 81% were vaccinated at the health facility. Distance, students class level, shortage of staff, parents’ level of education, misconception, guardians’ occupation and funding were the common barriers of HPV vaccine uptake reported. Conclusion: HPV vaccine uptake was low below the national threshold due to barriers which were program based, beneficiaries and health care provider related. Addressing them such as outreach and mobile services revival, staffing and using schools as an access strategy shall influence uptake.