Ethical challenges surrounding human papillomavirus vaccination among students, parents, health care workers, school teachers and policy makers in Ubungo municipality

Abstract

Background: Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) has introduced Human Papilloma virus (HPV) vaccination into its immunization program. This program aimed at reducing the incidence and prevalence of HPV associated with cervical cancer in Tanzania. As to conform to the global accepted strategy for preventing cervical cancer and genital warts. However, the guideline for ethical adherence was not in place to reach adolescent school girls to implement the HPV Vaccination program. Objective: The objective of this study was to explore ethical challenges surrounding vaccination in Tanzania: The Case of Human PapillomaVirus in Ubungo Municipality Methodology: An exploratory study design, which employed Qualitative methodology was used in which fourteen (14) In-depth interviews and two (2) Focused group discussions were used to address the study objectives. This study was conducted in Ubungo Municipal, Dar es Salaam, Tanzania. Study subjects were vaccinated adolescent girls, Parents, Policy Makers for vaccination program from department of Policy and Planning in the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), School Teachers and Health Care Workers. Purposive sampling method was used to obtain study subjects where the saturation was reached at 14th participant and second FGD by learning no new information was generated and data collection stopped based on power of information. Data obtained were analyzed by thematic analysis with the help of the Computer- Assisted Qualitative Data Analysis Software (CAQDAS). The study duration scheduled for two consecutive months. Findings The study revealed that, Parents and schoolgirls were not fully informed about the program of HPV Vaccination, that’s includes the benefits and related side effects. The challenges in decision making in HPV vaccination investigated where informed consent among parents of vaccinated girls, informed consent among the vaccinated adolescent schoolgirls, mass vaccination in relation to person’s autonomy and insufficient information in HPV vaccination were outlined Conclusion and recommendation The findings from this study conclude that, during the HPV vaccination program as public program for specified age group without considering their environments and counterpart groups compromises the justice to the general population of concerned. In addition, the study found that some ethical principles were not observed during HPV vaccination program. For example in decision-making process where parents were poorly engaged to decide for their children and insufficient information to schoolgirls and parents which lead to mistrust of the program to the community. Therefore, the study suggest further study to explore more ethical issues in regard to mass vaccination. Key words: Human papilloma Virus, autonomy, justices, discrimination