Study links low HPV vaccine uptake to ignorance among rural Busoga women
Keep in mind that HPV vaccination prevents new HPV infections but does not treat existing HPV infections or diseases. Photo | Internet
What you need to know:
- Researchers say Uganda’s chance of meeting the World Health Organization’s target of 90% HPV vaccine coverage by 2030 remains slim.
A new study has found alarmingly low awareness and uptake of the Human Papillomavirus (HPV) vaccine among rural women in Uganda’s Busoga Sub-region, despite high public willingness to vaccinate daughters against the virus that causes cervical cancer.
The research, published in ScienceDirect on April 19, was conducted in November 2023 by Denmark’s Aarhus University in collaboration with Rays of Hope Hospice Jinja (RHHJ), a local NGO providing palliative care and cancer awareness in Busoga.
According to the US Centers for Disease Control and Prevention (CDC), HPV is a widespread virus linked to several cancers. It can be prevented through early vaccination, typically administered to girls aged under 18.
The study surveyed five districts—Jinja, Iganga, Buyende, Mayuge and Namutumba—categorising the first two as peri-urban and the rest as rural based on urban population levels. It covered 213 mothers and their 388 daughters.
“Altogether, 49 to 63 daughters (12.6%–16.2%) were single-dose vaccinated, and 79 (20.4%) had received both doses. This yields an ‘any-dose’ HPV vaccination rate of between 33% and 36.6%,” the report states.
However, only 13.1% of the girls had vaccination cards to confirm they had received the shot.
‘Critical study’
One of the study’s most revealing findings was that just 12.6% of daughters had heard of HPV, while 36.5% were aware of the vaccine. Despite this, 94.9% of mothers said they would vaccinate their daughters if given the opportunity.
“The findings point to the urgent need for improved outreach, especially in the most peripheral districts where awareness is lowest,” said Ms Sylvia Nakami, Executive Director of RHHJ, whose team helped implement the study.
Margrethe Junker, a Danish oncologist and volunteer at RHHJ, described the results as “critical.”
“HPV is the leading cause of cervical cancer, the most common cancer among Ugandan women. This vaccine saves lives. There’s no time to waste,” she said.
The study found that living in a peri-urban area significantly increased the likelihood of a daughter being fully vaccinated, indicating a gap in health service access between urban and rural communities.
Researchers used verbal questionnaires administered by trained local assistants, who were selected from RHHJ’s network of community volunteers. The use of Lusoga and Luganda ensured participants could respond in their preferred languages, with translations reviewed for accuracy.
To avoid bias, the study excluded households of known cancer patients or former RHHJ clients, whose prior exposure to cancer education might skew results.
Margrethe Junker, a volunteer doctor and programme development advisor at Rays of Hope Hospice Jinja (RHHJ), says the findings point to the great need for better coverage of HPV vaccination in Busoga. PHOTO/FILE/PHILIP WAFULA
The study also acknowledged several limitations. Chief among them was the reliance on mothers' recollection of their daughters’ vaccination status, which may introduce recall bias. Additionally, the sample was not drawn from updated demographic data due to the cost and logistical challenges in rural Uganda.
“Despite efforts to introduce the HPV vaccine nationally in 2015, our findings reveal persistent challenges in achieving optimal vaccination rates in rural settings,” the researchers said. “The disparity is more pronounced in peripheral districts compared to those closer to urban centres.”
‘Uganda’s slim chances’
According to the study, 61.9% of participants believed the vaccine prevents cervical cancer, although 34.9% were unaware of this fact. HPV was correctly identified as a sexually transmitted virus by some, but others confused it with a vaccine or gave vague responses.
The researchers say Uganda’s chance of meeting the World Health Organization’s target of 90% HPV vaccine coverage by 2030 remains slim unless there’s a radical shift in how rural communities are engaged.
“Prioritising HPV vaccination as a public health intervention is essential,” the report concludes. “In doing so, Uganda can significantly reduce cervical cancer cases and protect the next generation of women from preventable disease.”
