Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination in Tanzania.

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Health Policy Plan. 2016 Jul;31(6):691-9. doi: 10.1093/heapol/czv119. Epub 2016 Jan 14.

Feasibility and acceptability of delivering adolescent health interventions alongside HPV vaccination inTanzania.

Watson-Jones D¹, Lees S², Mwanga J³, Neke N³, Changalucha J³, Broutet N⁴, Maduhu I⁵, Kapiga S⁶, Chandra-Mouli V⁴, Bloem P⁴, Ross DA⁷.

¹Faculty 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.
²Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
³National Institute for Medical Research, Mwanza, P O Box 1462, Tanzania.
⁴World Health Organization, Geneva, Switzerland.
⁵Immunization and Vaccine Development, Ministry of Health & Social Welfare, Dar es Salaam, Tanzania and.
⁶Faculty 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.
⁷MRC Tropical Epidemiology Group, Faculty of Epidemiology and Public Health, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.

Abstract below; full text is at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4916316/

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 healtheducation 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.

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