title: Feasibility of delivering HPV vaccine to girls aged 10 to 15 years in Uganda.
abstract: BACKGROUND
  Cervical cancer is a leading cause of mortality among women in Uganda. The availability of the human papillomavirus (HPV) vaccine presents an opportunity to prevent cervical cancer. The Government of Uganda conducted a demonstration project exploring the feasibility of two delivery strategies.
  
  
  OBJECTIVE
  To explore the feasibility of two HPV vaccine delivery strategies: 1) a stand-alone school-based strategy that selected girls based on their enrolment in grade 5 (known as the "grade-based" strategy; and 2) an age-based strategy that delivered the HPV vaccine based on the girls' age (10-year-olds). This strategy combined the delivery of the vaccine with the distribution of deworming medication and vitamin A through an existing Child Days Plus program.
  
  
  METHODS
  A qualitative study that explored the feasibility of the two delivery strategies from the perspective of health workers, district leaders, and staff of the Uganda National Expanded Programme on Immunization, utilizing in-depth interviews and focus group discussions.
  
  
  RESULTS
  Coverage data showed that more girls (88%) were vaccinated using the grade-based strategy and completed all three doses compared to those (73%) vaccinated using the age-based strategy. Health workers and teachers indicated that determining vaccination eligibility was easier by grade than by age and there were minor disruptions to health services and school programs during vaccinations, as reported by health workers and teachers using the grade-based strategy.
  
  
  CONCLUSIONS
  HPV vaccine delivery at schools using grade eligibility was more feasible than selecting girls by age. Lessons learned in Uganda could be relevant for countries considering implementing HPV vaccinations.
authors.affiliation: PATH, Seattle, USA and Kampala, Uganda.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mugisha
authors.affiliation: PATH, Seattle, USA and Kampala, Uganda.
authors.forename: D Scott
authors.initials: DS
authors.lastname: LaMontagne
authors.affiliation: Child Health and Development Centre, Kampala, Uganda.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Katahoire
authors.affiliation: Uganda Women's Health Initiative, Kampala, Uganda.
authors.forename: Daniel
authors.initials: D
authors.lastname: Murokora
authors.affiliation: PATH, Seattle, USA and Kampala, Uganda.
authors.forename: Edward
authors.initials: E
authors.lastname: Kumakech
authors.affiliation: Ministry of Health, Kampala, Uganda.
authors.forename: Rachel
authors.initials: R
authors.lastname: Seruyange
authors.affiliation: PATH, Seattle, USA and Kampala, Uganda.
authors.forename: Vivien Davis
authors.initials: VD
authors.lastname: Tsu
mesh_terms: D000293:Adolescent; D002648:Child; D003153:Community Health Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D007407:Interviews as Topic; D053918:Papillomavirus Vaccines; D036301:Qualitative Research; D012572:School Health Services / Q000458:organization & administration*; D014454:Uganda; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; adolescent girls; cervical cancer; immunization; school-based program; vaccination
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