Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries
Abstract Background Social mobilisation during new vaccine introductions encourages acceptance, uptake and adherence to multi-dose schedules. Effective communication is considered especially important for human papillomavirus (HPV) vaccine, which targets girls of an often-novel age group. This study...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2016-08-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-016-3517-8 |
| _version_ | 1818935496981610496 |
|---|---|
| author | Severin Kabakama Katherine E. Gallagher Natasha Howard Sandra Mounier-Jack Helen E. D. Burchett Ulla K. Griffiths Marta Feletto D. Scott LaMontagne Deborah Watson-Jones |
| author_facet | Severin Kabakama Katherine E. Gallagher Natasha Howard Sandra Mounier-Jack Helen E. D. Burchett Ulla K. Griffiths Marta Feletto D. Scott LaMontagne Deborah Watson-Jones |
| author_sort | Severin Kabakama |
| collection | DOAJ |
| description | Abstract Background Social mobilisation during new vaccine introductions encourages acceptance, uptake and adherence to multi-dose schedules. Effective communication is considered especially important for human papillomavirus (HPV) vaccine, which targets girls of an often-novel age group. This study synthesised experiences and lessons learnt around social mobilisation, consent, and acceptability during 55 HPV vaccine demonstration projects and 8 national programmes in 37 low and middle-income countries (LMICs) between January 2007 and January 2015. Methods A qualitative study design included: (i) a systematic review, in which 1,301 abstracts from five databases were screened and 41 publications included; (ii) soliciting 124 unpublished documents from governments and partner institutions; and (iii) conducting 27 key informant interviews. Data were extracted and analysed thematically. Additionally, first-dose coverage rates were categorised as above 90 %, 90–70 %, and below 70 %, and cross-tabulated with mobilisation timing, message content, materials and methods of delivery, and consent procedures. Results All but one delivery experience achieved over 70 % first-dose coverage; 60 % achieved over 90 %. Key informants emphasized the benefits of starting social mobilisation early and actively addressing rumours as they emerged. Interactive communication with parents appeared to achieve higher first-dose coverage than non-interactive messaging. Written parental consent (i.e., opt-in), though frequently used, resulted in lower reported coverage than implied consent (i.e., opt-out). Protection against cervical cancer was the primary reason for vaccine acceptability, whereas fear of adverse effects, exposure to rumours, lack of project/programme awareness, and schoolgirl absenteeism were major reasons for non-vaccination. Conclusions Despite some challenges in obtaining parental consent and addressing rumours, experiences indicated effective social mobilisation and high HPV vaccine acceptability in LMICs. Social mobilisation, consent, and acceptability lessons were consistent across world regions and HPV vaccination projects/programmes. These can be used to guide HPV vaccination communication strategies without additional formative research. |
| first_indexed | 2024-12-20T05:21:06Z |
| format | Article |
| id | doaj.art-e979482704f2433b94afeeb20bb1adef |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-20T05:21:06Z |
| publishDate | 2016-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-e979482704f2433b94afeeb20bb1adef2022-12-21T19:52:01ZengBMCBMC Public Health1471-24582016-08-0116111010.1186/s12889-016-3517-8Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countriesSeverin Kabakama0Katherine E. Gallagher1Natasha Howard2Sandra Mounier-Jack3Helen E. D. Burchett4Ulla K. Griffiths5Marta Feletto6D. Scott LaMontagne7Deborah Watson-Jones8Mwanza Intervention Trials Unit, National Institute for Medical ResearchMwanza Intervention Trials Unit, National Institute for Medical ResearchDepartment of Global Health and Development, London School of Hygiene and Tropical MedicineDepartment of Global Health and Development, London School of Hygiene and Tropical MedicineDepartment of Global Health and Development, London School of Hygiene and Tropical MedicineDepartment of Global Health and Development, London School of Hygiene and Tropical MedicinePATH, Vaccine Access and DeliveryPATH, Vaccine Access and DeliveryMwanza Intervention Trials Unit, National Institute for Medical ResearchAbstract Background Social mobilisation during new vaccine introductions encourages acceptance, uptake and adherence to multi-dose schedules. Effective communication is considered especially important for human papillomavirus (HPV) vaccine, which targets girls of an often-novel age group. This study synthesised experiences and lessons learnt around social mobilisation, consent, and acceptability during 55 HPV vaccine demonstration projects and 8 national programmes in 37 low and middle-income countries (LMICs) between January 2007 and January 2015. Methods A qualitative study design included: (i) a systematic review, in which 1,301 abstracts from five databases were screened and 41 publications included; (ii) soliciting 124 unpublished documents from governments and partner institutions; and (iii) conducting 27 key informant interviews. Data were extracted and analysed thematically. Additionally, first-dose coverage rates were categorised as above 90 %, 90–70 %, and below 70 %, and cross-tabulated with mobilisation timing, message content, materials and methods of delivery, and consent procedures. Results All but one delivery experience achieved over 70 % first-dose coverage; 60 % achieved over 90 %. Key informants emphasized the benefits of starting social mobilisation early and actively addressing rumours as they emerged. Interactive communication with parents appeared to achieve higher first-dose coverage than non-interactive messaging. Written parental consent (i.e., opt-in), though frequently used, resulted in lower reported coverage than implied consent (i.e., opt-out). Protection against cervical cancer was the primary reason for vaccine acceptability, whereas fear of adverse effects, exposure to rumours, lack of project/programme awareness, and schoolgirl absenteeism were major reasons for non-vaccination. Conclusions Despite some challenges in obtaining parental consent and addressing rumours, experiences indicated effective social mobilisation and high HPV vaccine acceptability in LMICs. Social mobilisation, consent, and acceptability lessons were consistent across world regions and HPV vaccination projects/programmes. These can be used to guide HPV vaccination communication strategies without additional formative research.http://link.springer.com/article/10.1186/s12889-016-3517-8HPVVaccinationLMICsAcceptabilityMobilisationCommunication |
| spellingShingle | Severin Kabakama Katherine E. Gallagher Natasha Howard Sandra Mounier-Jack Helen E. D. Burchett Ulla K. Griffiths Marta Feletto D. Scott LaMontagne Deborah Watson-Jones Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries BMC Public Health HPV Vaccination LMICs Acceptability Mobilisation Communication |
| title | Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries |
| title_full | Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries |
| title_fullStr | Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries |
| title_full_unstemmed | Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries |
| title_short | Social mobilisation, consent and acceptability: a review of human papillomavirus vaccination procedures in low and middle-income countries |
| title_sort | social mobilisation consent and acceptability a review of human papillomavirus vaccination procedures in low and middle income countries |
| topic | HPV Vaccination LMICs Acceptability Mobilisation Communication |
| url | http://link.springer.com/article/10.1186/s12889-016-3517-8 |
| work_keys_str_mv | AT severinkabakama socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT katherineegallagher socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT natashahoward socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT sandramounierjack socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT helenedburchett socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT ullakgriffiths socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT martafeletto socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT dscottlamontagne socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries AT deborahwatsonjones socialmobilisationconsentandacceptabilityareviewofhumanpapillomavirusvaccinationproceduresinlowandmiddleincomecountries |