Preparing for human papillomavirus vaccine introduction in Kenya: implications from focus-group and interview discussions with caregivers and opinion leaders in Western Kenya

BMC Public Health

Eileen F Dunne⁶  Kayla F Laserson²  Tabu Collins⁵  Susan A Wang³  Penelope A Phillips-Howard¹  Frank Odhiambo²  Jennine Kinsey⁶  Jessie Ford⁴  Melissa A Habel⁶  Kelvin O Oruko²  Allison L Friedman⁶ 

[1] Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, UK;Kenya Medical Research Institute (KEMRI)/CDC Research and Public Health Collaboration and CDC Center for Global Health, KEMRI Kisian Campus, PO Box 1578–40100, Kisumu, Kenya;World Health Organization, Department of Immunization, Vaccines and Biologicals, Avenue Appia 20, 1211 27 Geneva, Switzerland;Department of Sociology, New York University, 295 Lafayette Street, 4th Floor, 10012-9605 New York, NY, New York;Kenya Ministry of Health, P.O. Box 30016–00100, Cathedral Rd, Nairobi, Kenya;U.S. Centers for Disease Control & Prevention (CDC), 1600 Clifton Road, NE, 30333 Atlanta, GA, USA

关键词: Kenya;    Low-or-middle income countries;    Mobilization;    Communication;    Qualitative research;    HPV vaccine acceptability;   

Others  :  1128298
DOI  :  10.1186/1471-2458-14-855

 received in 2013-11-22, accepted in 2014-07-29,  发布年份 2014

【 摘 要 】

Background

Cervical cancer claims the lives of 275,000 women each year; most of these deaths occur in low-or middle-income countries. In Kenya, cervical cancer is the leading cause of cancer-related mortality among women of reproductive age. Kenya’s Ministry of Public Health and Sanitation has developed a comprehensive strategy to prevent cervical cancer, which includes plans for vaccinating preteen girls against human papillomavirus (HPV) by 2015. To identify HPV vaccine communication and mobilization needs, this research sought to understand HPV vaccine-related perceptions and concerns of male and female caregivers and community leaders in four rural communities of western Kenya.

Methods

We conducted five focus groups with caregivers (n = 56) and 12 key-informant interviews with opinion leaders to explore cervical cancer-related knowledge, attitudes and beliefs, as well as acceptability of HPV vaccination for 9–12 year-old girls. Four researchers independently reviewed the data and developed codes based on questions in interview guides and topics that emerged organically, before comparing and reconciling results through a group consensus process.

Results

Cervical cancer was not commonly recognized, though it was understood generally in terms of its symptoms. By association with cancer and genital/reproductive organs, cervical cancer was feared and stigmatized. Overall acceptability of a vaccine that prevents cervical cancer was high, so long as it was endorsed by trusted agencies and communities were sensitized first. Some concerns emerged related to vaccine safety (e.g., impact on fertility), program intent, and health equity.

Conclusion

For successful vaccine introduction in Kenya, there is a need for communication and mobilization efforts to raise cervical cancer awareness; prompt demand for vaccination; address health equity concerns and stigma; and minimize potential resistance. Visible endorsement by government leaders and community influencers can provide reassurance of the vaccine’s safety, efficacy and benefits for girls and communities. Involvement of community leadership, parents and champions may also be critical for combatting stigma and making cervical cancer relevant to Kenyan communities. These findings underscore the need for adequate planning and resources for information, education and communication prior to vaccine introduction. Specific recommendations for communication and social-marketing strategies are made.

【 授权许可】

   
2014 Friedman et al.; licensee BioMed Central Ltd.

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