Access and attitudes to HPV vaccination amongst hard-to-reach populations in Kenya
Open accessAbstract
BACKGROUND: Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV) vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya. METHODS: Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14) and semi-structured interviews (n=28) with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place. RESULTS: Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery. CONCLUSIONS: Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the standard school-based delivery, with vaccine offered at multiple venues, potentially through a campaign approach.
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Kenya and Uganda deployed mobile vaccination camps to reach remote and rural populations, ensuring greater coverage among out-of-school adolescents.
“In Kenya and Uganda, mobile vaccination camps have been deployed to reach remote and rural populations, ensuring greater coverage among out-of-school adolescents58,59.”
From Barriers to HPV vaccination among adolescent girls in India: A scoping review (2026) · cites this paper as [59]
The Results (Context for providing HPV vaccines) report that Kenya used mobile clinics for a tetanus vaccination programme. The Discussion recommends considering mobile outreach to reach out-of-school girls in a future HPV programme. The paper does not report that Kenya or Uganda deployed mobile HPV vaccination camps or that such camps increased coverage among out-of-school adolescents. (LLM, conf=0.88)
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Barriers to HPV vaccination among adolescent girls in India: A scoping review
Josten, K., Rose Dhar, R., Reshmi, B., Natti Krishna, V., & Vennila, J. (2026) · The Indian Journal of Medical Research · doi:10.25259/ijmr_1834_2025 · Cited by 6 · see citing works
“In Kenya and Uganda, mobile vaccination camps have been deployed to reach remote and rural populations, ensuring greater coverage among out-of-school adolescents 58,59 .”
- Authors
- Watson-Jones, D., Mugo, N., Lees, S., Mathai, M., Vusha, S., Ndirangu, G., & Ross, D. A.
- Affiliations
- Kenya Medical Research Institute (KE)
- London School of Hygiene & Tropical Medicine (GB)
- University of Nairobi (KE)
- Ministry of Health (KE)
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-06-26
- Volume
- 10
- Issue
- 6
- Pages
- e0123701
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4482601
- OpenAlex
- W1487099310
- Cited by
- 57
- References
- 0
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 4 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 1 · 2018: 6 · 2017: 4 · 2016: 1 · 2015: 1
- FWCI
- 3.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Nairobi Research Archive (University of Nairobi) (submittedVersion)
- Greater South Information System
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- HPV vaccination, cervical cancer prevention, hard-to-reach populations, barriers to vaccination, vaccine acceptance, Maasai pastoralists, informal settlements, school absenteeism, early marriage, parental support, social mobilization, school-based vaccination, vaccine delivery strategies, Kenya
- MeSH terms
- Adolescent, Uterine Cervical Neoplasms, Child, Female, Health Services Accessibility, Humans, Kenya, Health Knowledge, Attitudes, Practice, Patient Acceptance of Health Care, Sexual Behavior, Vaccination, Focus Groups, Papillomavirus Vaccines
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