Introduction of the HPV Vaccine among Young Girls to Reduce the Long-Term Risk of Cervical Cancer in Eswatini: Programmatic Decision and Roll Out

Document Type : Systematic Review and Meta-analysis

Authors

1 Eswatini Ministry of Health National Cancer Control Program.

2 University of Free State, Faculty of Health Sciences, Division of Public Health, Bloemfontein, South Africa.

3 Eswatini Ministry of Health.

4 Walter Sisulu University Department of Gynaecology and Obstetrics, Mthatha, Eastern Cape, South Africa.

Abstract

Background: Cervical cancer is a significant public health concern in Eswatini. In June 2023, the Eswatini government launched a national school based vaccination program aimed at administering two doses of the human papillomavirus (HPV) vaccine to adolescent girls, with the second dose administered six months after the first. Objective: This study seeks to assess the feasibility of school based HPV vaccination introduction campaign for prevention of cervical cancer among women in the Kingdom of Eswatini in Africa. The lessons learned, and challenges faced during the implementation of the national HPV vaccination program designed to prevent HPV infection are documented to improve HPV vaccination campaign in Africa. Methods: The review study details the planning and execution of the HPV vaccination initiative within Eswatini’s school based campaign, targeting 82,400 girls aged 9-14 years from 12 to 23 June 2023 schooldays. Results: The national goal was to vaccinate 82,400 girls. The campaign achieved a national coverage rate of 55.9%, with 46,512 girls successfully vaccinated. The Manzini region recorded the highest coverage at 60.1%, while the Shiselweni region had the lowest at 48.2%. Conclusions: The introduction of the large-scale HPV vaccination campaign in schools proved successful. However, challenges such as misconceptions about eligibility criteria and misinformation persisted, impacting vaccine uptake and coverage. Continued efforts in community mobilization, public education on eligibility, and integration with healthcare services are essential for sustaining the program. Strengthening partnerships and mobilizing resources will also be critical for its long-term success.

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