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Questions and Answers
2. How were the districts in Uganda chosen for the vaccination demonstration project?
Dr. Mugisha explained that the two districts for the Uganda project were chosen for regional variation,
willingness, and ability (e.g., availability of health workers) to work with the program, and availability of
the correct number of girls to match the number of doses of vaccine donated. Nine districts were
potentially qualified in terms of numbers of girls to match the number of doses of vaccine available, and
these were all visited to determine those that were interested and able to participate.
In regard to a question about consent for vaccination, Dr. Mugisha noted that there was no written
consent from families to have girls participate, but the community and parents were informed by
extensive IEC efforts, and the goal was to make this program similar to the regular Expanded
Programme on Immunization (EPI) (which does not require written consent), so that unnecessary fears
would not be generated.
3. Was vaccine acceptability related to social or economic factors? Was reluctance of girls and
parents to receive vaccine based on religious or cultural factors?
Dr. Bamwine responded that reluctance on the part of families to participate in the vaccination program
occurred in isolated cases and did not seem to be linked to religious beliefs nor to educational levels but
rather to rumors about problems with the vaccine. Dr. Ssekitto added that those who refused HPV
vaccination frequently did not accept any immunization programs.
4. The problem with the high rates of cervical cancer is not that our women are at fault for not
getting screened; it is a problem with our health systems. How much priority are ministries of
health giving to health system improvement?
Dr. Dangou responded that health systems strengthening is indeed a critical issue, and that WHO is
focused on this. In the past, they have focused on infectious diseases but are now turning attention to
the non-communicable diseases, including cancer. WHO is seeing member states implementing cancer
control plans, and is providing assistance.
Report of an African Regional Meeting on Cervical Cancer: September 2010 27