title: Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania.
abstract: BACKGROUND
  Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania.
  
  
  METHODS
  A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination.
  
  
  RESULTS
  Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual's area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine.
  
  
  CONCLUSIONS
  Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits.
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK, Mwanza Intervention Trials Unit, National Institute for Medical Research, Mwanza, P O Box 11936, Tanzania.
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson-Jones
authors.affiliation: Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Shelley
authors.initials: S
authors.lastname: Lees
authors.affiliation: National Institute for Medical Research, Mwanza, P O Box 1462, Tanzania.
authors.forename: Joseph
authors.initials: J
authors.lastname: Mwanga
authors.affiliation: National Institute for Medical Research, Mwanza, P O Box 1462, Tanzania.
authors.forename: Nyasule
authors.initials: N
authors.lastname: Neke
authors.affiliation: National Institute for Medical Research, Mwanza, P O Box 1462, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Broutet
authors.affiliation: Immunization and Vaccine Development, Ministry of Health & Social Welfare, Dar es Salaam, Tanzania and.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Maduhu
authors.affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK, MRC Tropical Epidemiology Group, Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: Saidi
authors.initials: S
authors.lastname: Kapiga
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Venkatraman
authors.initials: V
authors.lastname: Chandra-Mouli
authors.affiliation: World Health Organization, Geneva, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Bloem
authors.affiliation: MRC Tropical Epidemiology Group, Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Ross
mesh_terms: D000293:Adolescent; D000067697:Adolescent Health; D003695:Delivery of Health Care / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010342:Patient Acceptance of Health Care; D012572:School Health Services / Q000458:organization & administration; D013636:Tanzania; D014611:Vaccination
chemical_list: D053918:Papillomavirus Vaccines
keywords: Adolescent; HPV; Tanzania; health; integration; vaccine