Integrating human papillomavirus vaccination into maternal, newborn, and child health week in Abia State, South-East Nigeria: a programmatic experience
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254016Keywords:
Cervical cancer, HPV vaccine, HPV vaccination, Immunisation, Nigeria, Child healthAbstract
Background: Despite being preventable, cervical cancer incidence continues to rise amid ongoing interventions. Following the introduction of the single-dose human papillomavirus (HPV) vaccine in October 2023, Nigeria has faced several challenges. Integrating HPV vaccination into the Maternal Newborn and Child Health Week (MNCHW) is a potential strategy to increase HPV vaccine uptake. Our objective was to assess the feasibility, acceptability, and operational processes of integrating HPV vaccination into MNCHW.
Methods: This was a descriptive, cross-sectional study among the immunization and nutrition program officers at the State and LGA levels. Secondary data from the final MNCHW call-in data were retrieved and data on HPV vaccine doses given were extracted for analysis. Open data kit (ODK) collect forms were used to obtain data from the respondents. The IBM statistical package for the social sciences (SPSS) version 26 was used for data analysis.
Results: A total of 93 program officers participated in the survey. The mean age was 44.8±8.0 years. Females constituted 76.3% and the majority (94.8%) were from the LGA level. A total of 30,523 HPV vaccine doses were reported on DHIS2 for June, representing a five-fold increase compared to pre-integration months. The most prevalent challenges reported were inadequate funding (24%) and team insufficiency (24%). Most (95.6%) had overall satisfaction with the program.
Conclusions: The integration of HPV vaccination into the MNCHW in June significantly improved HPV vaccine uptake. Most respondents were satisfied with the integration. Programmatic challenges and areas of improvement were noted. It is recommended that this integrative approach be sustained, scaled up, and further strengthened to maximize its impact in Abia State.
Metrics
References
World Health Organization. Cervical cancer. 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/cervical-cancer. Accessed on 18 September 2025.
Li Z, Liu P, Yin A, Zhang B, Xu J, Chen Z, et al. Global landscape of cervical cancer incidence and mortality in 2022 and predictions to 2030: The urgent need to address inequalities in cervical cancer. Int J Cancer. 2025;157(2):288-97. DOI: https://doi.org/10.1002/ijc.35369
ICO/IARC Information Centre on HPV and Cancer. Nigeria Human Papillomavirus and Related Cancers, Fact Sheet 2023. 2023. Available at: https://hpv centre.net/statistics/reports/NGA_FS.pdf. Accessed on 18 September 2025.
WHO. Cervical Cancer Elimination Initiative. 2022. Available at: https://www.who.int/initiatives/ cervical-cancer-elimination-initiative. Accessed on 18 September 2025.
eClinicalMedicine. Global strategy to eliminate cervical cancer as a public health problem: are we on track? EClinicalMedicine. 2023;55:101842. DOI: https://doi.org/10.1016/j.eclinm.2023.101842
World Health Organization. WHO Regional Office for Africa. Nigeria to vaccinate 7.7 million girls against leading cause of cervical cancer. 2023. Available at: https://www.afro.who.int/countries/ nigeria/news/nigeria-vaccinate-77-million-girls-against-leading-cause-cervical-cancer. Accessed on 18 September 2025.
UNICEF. Generations unite in Nigeria’s HPV vaccine campaign. UNICEF. 2024. Available at: https://www.unicef.org/stories/generations-unite-nigerias-hpv-vaccine-campaign. Accessed on 18 September 2025.
Nguyen NY, Okeke E, Anglemyer A, Brock T. Identifying Perceived Barriers to Human Papillomavirus Vaccination as a Preventative Strategy for Cervical Cancer in Nigeria. Ann Glob Heal. 2020;86(1):118. DOI: https://doi.org/10.5334/aogh.2890
Otorkpa OJ, Onifade AA, Otorkpa CO. The Surge in Human Papillomavirus Vaccine Rejection in Nigeria. Cancer Prev Res (Phila). 2024;17(11):497-8. DOI: https://doi.org/10.1158/1940-6207.CAPR-24-0318
Egbon M, Ojo T, Aliyu A, Bagudu ZS. Challenges and lessons from a school-based human papillomavirus (HPV) vaccination program for adolescent girls in a rural Nigerian community. BMC Public Health. 2022;22(1):1-8. DOI: https://doi.org/10.1186/s12889-022-13975-3
Balogun FM, Omotade OO. Facilitators and barriers of healthcare workers’ recommendation of HPV vaccine for adolescents in Nigeria: views through the lens of theoretical domains framework. BMC Health Serv Res. 2022;22:824. DOI: https://doi.org/10.1186/s12913-022-08224-7
Talabi O, Gilbert H, Fawzi MCS, Anorlu R, Randall T. Examining barriers and facilitators of HPV vaccination in Nigeria, in the context of an innovative delivery model: a mixed-methods study. BMJ Public Health. 2023;1(1):e000003. DOI: https://doi.org/10.1136/bmjph-2023-000003
Olubodun T, Ogunsola EA, Coker MO, Olayinka SA, Elegbede WÀ, Ojediran JO, et al. HPV vaccine knowledge, attitude, and programme satisfaction among parents and caregivers of vaccine recipients in Ogun state Nigeria. Reprod Health. 2024;21(1). DOI: https://doi.org/10.1186/s12978-024-01913-y
Liverpool School of Tropical Medicine. Evaluation of Maternal , Neonatal and Child Health Week in Nigeria from 2010 to 2014 FINAL REPORT - DRAFT. 2016. Available at: https://www.lstmed. ac.uk/projects/evaluation-of-maternal-newborn-and-child-health-weeks. Accessed on 18 September 2025.
UNICEF. A week of care for mother and baby | UNICEF Nigeria. UNICEF Nigeria. 2023. Available at: https://www.unicef.org/nigeria/stories/week-care -mother-and-baby. Accessed on 18 September 2025.
Akinleye O, Dura G, de Wagt A, Davies A, Chamla D. Integration of HIV Testing into Maternal, Newborn, and Child Health Weeks for Improved Case Finding and Linkage to Prevention of Mother-to-Child Transmission Services in Benue State, Nigeria. Front Public Health. 2017;5(APR):71. DOI: https://doi.org/10.3389/fpubh.2017.00071
Abia State Ministry of health. Strategic Health Development Plan (2010-2015). Umuahia; 2009. Available at: https://ngfrepository.org.ng:8443/jspui/ bitstream/123456789/3251/1/Abia%20State%20Strategic%20Health%20Development%20Plan%202010-2015.doc.pdf. Accessed on 18 September 2025.
WHO. Global strategy to accelerate the elimination of cervical cancer as a public health problem: technology landscape. World Health Organization. 2020. Available at: https://www.who.int/ publications/i/item/9789240014107. Accessed on 18 September 2025.
Picillo B, Ewald L, Chee G. Leveraging immunization campaigns to strengthen routine immunization and health systems, A Systematic Review of Literature. 2021;15-34.
Rane MS, Page LC, McVeigh E, Miller K, Baure D, Elizabeth Halloran M, et al. Improving adolescent human papillomavirus (HPV) immunization uptake in school-based health centers through awareness campaigns. Vaccine. 2021;39(12):1765-72. DOI: https://doi.org/10.1016/j.vaccine.2021.02.006
Waheed DEN, Bolio A, Guillaume D, Sidibe A, Morgan C, Karafillakis E, et al. Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries? Front Public Health. 2023;11:1112981. DOI: https://doi.org/10.3389/fpubh.2023.1112981
Haddison EC, Engoung DB, Bodo CB, Njie VM. Overcoming HPV vaccine hesitancy: insights from a successful school-based vaccination campaign in the Saa health district of Cameroon. BMC Infect Dis. 2025;25(1). DOI: https://doi.org/10.1186/s12879-025-10864-z
Rani U, Darabaner E, Seserman M, Bednarczyk RA, Shaw J. Public Education Interventions and Uptake of Human Papillomavirus Vaccine: A Systematic Review. J Public Health Manag Pract. 2022;28(1):E307-15. DOI: https://doi.org/10.1097/PHH.0000000000001253
World Health Organization. Essential Programme on Immunization: School vaccination. World Health Organization. 2025. Available at: https://www.who. int/teams/immunization-vaccines-and-biologicals/ essential-programme-on-immunization/integration/ school-vaccination. Accessed on 18 September 2025.
Perman S, Turner S, Ramsay AIG, Baim-Lance A, Utley M, Fulop NJ. School-based vaccination programmes: a systematic review of the evidence on organisation and delivery in high income countries. BMC Public Health. 2017;17(1):252. DOI: https://doi.org/10.1186/s12889-017-4168-0
Engel D, Afeli ADJ, Morgan C, Zeck W, Ross DA, Vyankandondera J, et al. Promoting adolescent health through integrated human papillomavirus vaccination programs: The experience of Togo. Vaccine. 2022;40:A100-6. DOI: https://doi.org/10.1016/j.vaccine.2021.11.021
Sibomana H, Ukwishaka J, Mtenga H, Luoga O, Acosta D, Fisher-Borne M, et al. Health worker experiences on the integration of digital health tools for HPV vaccination and cervical cancer services in Rwanda. BMC Digit Health. 2025;3(1):1-14. DOI: https://doi.org/10.1186/s44247-024-00144-2
Guillaume D, Rosen JG, Mlunde LB, Njiro BJ, Munishi C, Mlay D, et al. Acceptability of an integrated school-based HPV vaccination program within two districts of Tanzania: A qualitative descriptive study. PLOS Glob Public Health. 2023;3(1):e0001394. DOI: https://doi.org/10.1371/journal.pgph.0001394
Wheldon CW, Sykes KJ, Ramaswamy M, Bass SB, Collins BN. Integrating HPV Vaccination Within PrEP care Delivery for Underserved Populations: A Mixed Methods Feasibility Study. J Community Health. 2023;48(4):640. DOI: https://doi.org/10.1007/s10900-023-01202-y