Assure that all 14 year old girls receive HPV vaccinations
In 2017 the UN reported that cervical cancer kills more than 250,000 women every year and 85 percent of these deaths occur in low- and middle income countries. According to the World Health Organization 2020 Report, Costing the National Response to Cervical Cancer: United Republic of Tanzania, 2020–2024, Tanzania had the fourth highest incidence rate of cervical cancer in the world with 59.1 new cases per 100,000 women. Cervical cancer mortality is also high, with 42.7 deaths per 100,000 in 2018.
The Tanzanian Ministry of Health responded by implementing a national HPV vaccination plan for girls 9-14 years of age. This is driven primarily through the schools.
In Ayalagaya and Arri wards the schools are supposed to send a girl to the clinic for the 1st vaccination the month she turns 14, then 6 months later for the 2nd vaccination. The dispensaries are also charged with tracking which girls are vaccinated and with following up when girls miss a dose. This is a completely manual process.
In 2021, Karimu reviewed how the schools and dispensaries were tracking HPV vaccinations and discovered that not all schools followed the process. Girls may not be sent in a timely manner for the 1st donse. If a girl gets the 1st dose while in primary school, but does not qualify for or attend secondary school, she may miss her 2nd dose. The dispensaries are not following up with parents when vaccinations are overdue. And parents are also not well aware of the importance of the vaccine so are not making sure their girls get vaccinated.
Karimu is implementing an HPV intervention to improve and track the process, make sure that schools and dispensaries are working closely together, and elevate the importance of the vaccination in parents’ and students’ minds. For each school a teacher will be given a special notebook. She will track the HPV vaccination schedule, including which girls turn 14 in which months and parent contact information, and communicate that with the local dispensary. The dispensaries will track the vaccinations, identify any girls who did not get their vaccination as expected, and reach out to the schools or parents to complete the vaccination regimen. Karimu will review the documents monthly to correlate that to-be-vaccinated list from the schools matches the vaccinated list from the dispensaries until we see that the process is working effectively.
Karimu is increasing awareness of the HPV vaccine and its importance by:
- Giving all 14 year old girls fliers to read and take home to their parents
- Including the importance of HPV vaccination in the girls hygiene curriculum
- Integrating content on cervical cancer and HPV vaccination in the TV content to be shown in the dispensary waiting rooms (those with electricity and a TV).
This intervention will terminate when we see the process working well between all schools and clinics in the area.
- Increase HPV vaccination rate for girls
- Reduce cervical cancer