Determinants of the Implementation of Human Papillomavirus Vaccination in Zambia: Application of the Consolidated Framework for Implementation Research.

Determinants of the Implementation of Human Papillomavirus Vaccination in Zambia: Application of the Consolidated Framework for Implementation Research.

Publication date: Dec 28, 2023

Cervical cancer can be prevented, primarily by the administration of the human papillomavirus (HPV) vaccine. Healthcare workers (HCWs) and teachers play important roles when schools are used for vaccine delivery; however, challenges exist. This study aimed to understand the barriers and facilitators to HPV vaccination that are perceived by HCWs and teachers. Guided by the consolidated framework for implementation research (CFIR), key informant interviews were conducted in Lusaka district between June 2021 and November 2021 using a semi-structured questionnaire. Recorded interviews were transcribed verbatim and imported into NVIVO 12 for data management and analysis. We coded transcripts inductively and deductively based on the adapted CFIR codebook. We reached saturation with 23 participants. We identified barriers and facilitators across the five CFIR domains. Facilitators included offering the HPV vaccine free of charge, HPV vaccine effectiveness, stakeholder engagement, and timely planning of the HPV vaccination. Barriers included vaccine mistrust due to its perceived novelty, low levels of parental knowledge, myths and misinformation about the vaccine, lack of parental consent to vaccinate daughters, lack of transport for vaccination outreach, lack of staff incentives, and inadequate sensitisation. Using the CFIR as a guiding framework, we have identified implementation barriers and facilitators to HPV vaccination among HCWs and teachers. Most of the identified barriers are modifiable, hence it is prudent that these are addressed for a high HPV vaccine uptake.

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Concepts Keywords
Healthcare barriers
Papillomavirus COVID-19 vaccine
Teachers facilitators
Zambia healthcare workers
HPV vaccination
implementation determinants
myths and misinformation
parental consent


Type Source Name
disease VO Human papillomavirus
disease VO vaccination
disease MESH Cervical cancer
disease VO vaccine
disease VO vaccine effectiveness
disease VO LACK
drug DRUGBANK Etoperidone
drug DRUGBANK Coenzyme M
disease MESH COVID 19
disease MESH cancer
disease MESH death
disease MESH co infection
disease MESH AIDS
disease IDO country
disease IDO facility
disease VO population
drug DRUGBANK Spinosad
disease MESH morbidity
disease IDO process
disease VO effectiveness
disease VO effective
disease VO vaccinated
disease MESH blood clots
disease VO Thing
disease MESH papillomavirus infections
drug DRUGBANK Trihexyphenidyl
drug DRUGBANK Profenamine
disease VO report
disease VO Papillomavirus vaccine
disease MESH Papilloma
drug DRUGBANK Buprenorphine
disease MESH opioid addiction
disease VO USA
disease VO document
disease VO organization
disease VO immunization
disease MESH malaria
pathway KEGG Malaria
disease IDO intervention
disease MESH Allergy
disease VO Equity
disease VO protocol
disease VO COVID-19 vaccine

Original Article

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