Acceptability of an integrated school-based HPV vaccination program within two districts of Tanzania: A qualitative descriptive study.
Acceptability of an integrated school-based HPV vaccination program within two districts of Tanzania: A qualitative descriptive study.
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DOI：
10.1371/journal.pgph.0001394
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发表时间：
2023
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坦桑尼亚是撒哈拉以南非洲地区宫颈癌发病率和死亡率最高的国家之一。坦桑尼亚卫生部制定了一项综合性青少年健康计划，即HPV-Plus，将HPV疫苗接种与额外的健康服务相结合：营养评估，视力筛查，少女疫苗接种以及所有性别的教育。这项定性描述性研究评估了坦桑尼亚两个地区HPV-Plus计划的可接受性。关键的线人，包括少女，父母，计划规划者，并在恩琼贝和达累斯萨拉姆坦桑尼亚的方案执行者进行了采访，以评估该方案的可接受性。使用基于团队的迭代主题分析方法，包括归纳和演绎编码的成绩单进行了分析。可接受性的理论框架被用来指导分析，根据干预的一致性，情感的态度和看法，和感知的有效性的理论结构的主题进行分类。HPV-Plus计划在利益相关者中的总体可接受性很高。关于影响HPV疫苗可接受性的因素，最突出的发现主要与HPV，宫颈癌和HPV疫苗的教育和知识水平有关。HPV+计划的教育部分是提高可接受性的关键。家长对该计划的接受程度最低。这主要是因为人们认为在整个方案实施过程中没有充分参与。提高主要利益相关者对HPV疫苗接种计划的接受程度对于促进疫苗接种和实现疫苗接种覆盖率目标至关重要。我们的研究结果表明，在HPV-Plus计划中纳入全面的教育内容是促进利益相关者接受HPV疫苗的关键。
Tanzania has one of the highest cervical cancer incidence and mortality rates in sub-Saharan Africa. The Tanzanian Ministry of Health developed an integrated adolescent health program, HPV-Plus, that combines HPV vaccination with additional health services: nutritional assessments, vision screening, and vaccination for adolescent girls, and education for all genders. This qualitative descriptive study evaluated the acceptability of the HPV-Plus program in two districts in Tanzania. Key informants comprising of adolescent girls, parents, program planners, and program implementers in Njombe and Dar es Salaam Tanzania were interviewed to assess the program acceptability. Transcripts were analyzed using a team-based iterative thematic analysis approach, consisting of both inductive and deductive coding. The Theoretical Framework of Acceptability was used to guide analysis, with themes categorized according to theoretical constructs of intervention coherence, affective attitudes and perceptions, and perceived effectiveness. Overall acceptability of the HPV-Plus program was high among stakeholders. The most salient finding regarding factors that influenced HPV vaccine acceptability was largely related to education and knowledge levels surrounding the HPV, cervical cancer, and HPV vaccines. The educational component of the HPV-Plus program was key in increasing acceptability. Parents reported the lowest acceptability towards the program. This was found to be primarily due to perceptions of not being sufficiently engaged throughout program implementation. Increasing acceptability of HPV vaccination programs among key stakeholders is critical to facilitating vaccine uptake and meeting vaccination coverage targets. Our results demonstrate that the inclusion of a comprehensive education component within the HPV-Plus program was key in facilitating HPV vaccine acceptability amongst stakeholders.