Acceptability of the human papillomavirus vaccine in schools in Lusaka in Zambia: Role of community and formal health system factors

ABSTRACT

Zambia has one of the highest cervical cancer rates in the world. This paper explores the acceptability of the Human Papillomavirus vaccine administered in girls (9–13 years) in Zambia. A qualitative case study was conducted in two schools in Lusaka district, which participated in the pilot for the Human Papillomavirus vaccine rollout. The study revealed that community level health systems factors such as knowledge levels about the vaccine, sexual morality concerns, conflicting views from parents on the vaccine, rumours that the vaccine contained cervical cancer and that it causes infertility in girls, previous bad experience with other vaccines, religious beliefs such as belief that God protects against illness, the nature of the school environment as well as faith in doctors shaped the uptake of the vaccine. Furthermore, formal health system factors such as availability of health workers and nature of collaboration between the Ministries of Health and Education influenced acceptability of the vaccine among the girls. Strengthening collaboration between community and formal health systems can play a vital role in supporting uptake of vaccines at community level as factors that hinder uptake of the vaccines emanate from both the community and health sector.

KEYWORDS:

• community
• health systems
• vaccines
• acceptability

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

FK conducted the interviews, performed the first coding, and drafted the manuscript. FK, JMZ and OM all participated in the study design and data analysis. All authors read and approved the final manuscript.

Ethics approval and consent to participate

The study was approved by Excellence in Research Ethics and Science (ERES), located in Lusaka, and the National Health Research Authority (NHRA) in Zambia. Signed informed consent was obtained from individual participants before each interview.

Availability of data and materials

The transcripts generated from the research study are not publicly available due to the sensitive nature of the topic.