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In conclusion, acceptability was highest where the key stakeholders understood that the vaccine
protected against a deadly disease and that most girls were potentially at risk of getting the disease if
not vaccinated; that there was a good reason for vaccinating only girls of a particular age or class; and
that the vaccine was generally safe, as was confirmed by the lack of adverse effects following the
vaccinations.
Feasibility of HPV Vaccination Implementation in Uganda
Dr. Dan Murokora
Medical Director, Uganda Women’s Health Initiative
and President, Association of Obstetricians and Gynaecologists of Uganda
According to Dr. Dan Murokora, feasibility of HPV vaccine introduction was assessed by conducting
interviews with teachers, health workers, and UNEPI personnel and by reviewing documents such as
registers for HPV vaccinations, HPV training manuals, microplans, and supportive supervision reports.
The objectives of the feasibility evaluation were the following:
• Assess health system preparedness to conduct the HPV vaccination project.
• Assess the impact of the vaccinations on health and education systems.
• Assess effectiveness of training to prepare health workers and others to implement the
vaccination exercise.
• Explore the extent to which existing health and education systems and structures had
normalized the HPV vaccination program in the second year.
Assessment of the impact on health systems revealed that
the program did increase demand on human resources, HPV vaccinations are feasible
leading in some cases to postponement or cancellation of using existing education and
routine clinic services, and staff had to be re-deployed to
health systems, but planners
address the shortages. However, this only occurred during
must assess systems before
the vaccination days three times per year. In spite of the
challenge of attaining high coverage with HPV vaccinations,
starting a program and tailor
the systems performed well, and health workers benefitted interventions accordingly.
from new knowledge and skills. Some improvements were
made to the cold chain, so there were few challenges in this system in the program.
Researchers found that the vaccination project did not significantly disrupt school programs, although
teachers ultimately performed more tasks than were anticipated during training. These included
watching girls for 15 minutes after vaccination (for fainting) and helping with record keeping. Schools
offered an excellent venue for reaching girls in both the school-based and the CDP strategies. The major
challenge for reaching the target population was the need for age verification in the district where girls
were vaccinated by age in the CDP strategy.
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