Human papillomavirus vaccine uptake and its determinants among school-going girls in Migori County, Kenya: A qualitative study

Authors

  • Jared Ndege
  • Macharia Wachira
  • Yvonne Wekesa
  • Lobikieki Kissambu
  • Victor Tetty
  • Arnold Bugah
  • Ruth Lusike
  • Francis Okoth
  • Ndung'u Muchiri
  • Wycliffe Musalia
  • Millicent Masinde
  • Alfred Mokomba
  • Jacqueline Chesang'
  • Innocent Maranga
  • Eunice Cheserem
  • Margaret Kilonzo
  • Rose Kosgei

DOI:

https://doi.org/10.59692/zr8v6378

Keywords:

Cervical cancer, Human papillomavirus, Kenya, Vaccination, Vaccine hesitancy

Abstract

Background: Cervical cancer remains a major public health challenge worldwide, particularly in Sub-Saharan Africa, where disease burden remains disproportionately high. Human papillomavirus (HPV) vaccination is a key strategy to prevent cervical cancer. Despite its availability in Kenya, uptake remains low in certain regions including Migori County.

Objective: To explore the determinants of HPV vaccine uptake among school-going girls aged 10-14 years in Migori County, Kenya, from the perspectives of teachers, health care workers, parents, guardians, and community health promoters.

Methods: A qualitative study in Migori County, Kenya, used focus group discussions and in-depth interviews to identify determinants of HPV vaccination. The study included 260 participants; teachers, healthcare providers, community health promoters (CHPs), and parents selected through stratified, snowball, and convenience sampling. Audio-recorded interviews were transcribed verbatim and analyzed inductively using thematic analysis in NVivo 14.

Results: Key facilitators included school-based delivery, trusted messaging from CHPs, parental awareness, and community sensitization via religious and political leaders. Barriers included myths and misconceptions, religious and cultural beliefs, inadequate awareness among CHPs, communication challenges, and logistical barriers to vaccine delivery.

Conclusion: HPV vaccine uptake in Migori County is influenced by cultural beliefs, communication, and health system capacity. Strengthening school-based vaccination, addressing misinformation, and enhancing the capacity of health care workers and community health promoters may improve vaccine uptake and support cervical cancer prevention.

References

1. Bruni L, Albero G, Rowley J, et al. Global and regional estimates of genital human papillomavirus prevalence among men: a systematic review and meta-analysis. Lancet Glob Health. 2023;11(9):e1345-e1362. doi:10.1016/S2214-109X(23)00305-4

2. World Health Organization. Electronic address: sageexecsec@who.int. Human papillomavirus vaccines: WHO position paper, May 2017-Recommendations. Vaccine. 2017;35(43):5753-5755. doi:10.1016/j.vaccine.2017.05.069

3. Yusupov A, Popovsky D, Mahmood L, Kim AS, Akman AE, Yuan H. The nonavalent vaccine: a review of high-risk HPVs and a plea to the CDC. Am J Stem Cells. 2019;8(3):52-64. Published 2019 Dec 15

4. Bruni L, Saura-Lázaro A, Montoliu A, et al. HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010-2019. Prev Med. 2021;144:106399. doi:10.1016/j.ypmed.2020.106399

5. Mbuthia, F., Gitonga, M., Mbuthia, B. (2023). Prevalence and Epidemiological Profile of Cervical Cancer Patients Attending Nyeri County and Referral Hospital, Kenya: a Review of Records. Int J Cancer Res Ther, 8(4), 164-169

6. County Department of Health. Migori County HPV Vaccination Register. 2023

7. Paul P, Fabio A. Literature review of HPV vaccine delivery strategies: considerations for school- and non-school based immunization program. Vaccine. 2014;32(3):320-326. doi:10.1016/j.vaccine.2013.11.070

8. Dubé E, Gagnon D, Clément P, et al. Challenges and opportunities of school-based HPV vaccination in Canada. Hum Vaccin Immunother. 2019;15(7-8):1650-1655. doi:10.1080/21645515.2018.1564440

9. Davies C, Stoney T, Hutton H, et al. School-based HPV vaccination positively impacts parents' attitudes toward adolescent vaccination. Vaccine. 2021;39(30):4190-4198. doi:10.1016/j.vaccine.2021.05.051

10. Cooper S, Schmidt BM, Jama NA, et al. Factors that influence caregivers' and adolescents' views and practices regarding human papillomavirus (HPV) vaccination for adolescents: a qualitative evidence synthesis. Cochrane Database Syst Rev. 2025;4(4):CD013430. Published 2025 Apr 15. doi:10.1002/14651858.CD013430.pub2

11. Karanja-Chege CM. HPV Vaccination in Kenya: The Challenges Faced and Strategies to Increase Uptake. Front Public Health. 2022;10:802947. Published 2022 Mar 21. doi:10.3389/fpubh.2022.802947

12. Mwenda V, Mburu W, Bor JP, et al. Cervical cancer programme, Kenya, 2011-2020: lessons to guide elimination as a public health problem. Ecancermedicalscience. 2022;16:1442. Published 2022 Aug 26. doi:10.3332/ecancer.2022.1442

13. Bogani G, Sopracordevole F, Ciavattini A, et al. Duration of human papillomavirus persistence and its relationship with recurrent cervical dysplasia. Eur J Cancer Prev. 2023;32(6):525-532. doi:10.1097/CEJ.0000000000000822

14. Hailu G, Wirtu D, Tesfaye T, Getachew M. Human papillomavirus vaccine uptake and associated factors among adolescent girls in high schools of Nekemte city, Western Ethiopia, 2020. BMC Womens Health. 2023;23(1):560. Published 2023 Oct 28. doi:10.1186/s12905-023-02702-8

15. D’Augè TG, Giannini A, Bogani G, Dio CD i, Laganà AS, Donato VD i, et al. Prevention, screening, treatment and follow-up of gynecological cancers: state of art and future perspectives. Clinical Experimental Obstetrics Gynecol. 2023;50:1–8

16. Bezbaruah, R., N. Sailo, K. Deka, Y. D. Bhutia, and B. B. Kakoti. 2024. “ Myths and facts about vaccination: Dispelling myths and misconceptions with science. In Advanced Vaccination Technologies for Infectious and Chronic Diseases (pp. 441-454).” Academic Press. https://doi.org/10.1016/B978-0-443-18564-9.00018-7.

17. Dunne EF, Unger ER, Sternberg M, et al. Prevalence of HPV infection among females in the United States. JAMA. 2007;297(8):813-819. doi:10.1001/jama.297.8.813

18. Stanley M. Pathology and epidemiology of HPV infection in females. Gynecol Oncol. 2010;117(2 Suppl):S5-S10. doi:10.1016/j.ygyno.2010.01.024

19. World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: World Health Organization; 2020

20. Foss HS, Oldervoll A, Fretheim A, Glenton C, Lewin S. Communication around HPV vaccination for adolescents in low- and middle-income countries: a systematic scoping overview of systematic reviews. Syst Rev. 2019;8(1):190. Published 2019 Aug 1. doi:10.1186/s13643-019-1100-y

21. Galati L, Chiantore MV, Marinaro M, Di Bonito P. Human Oncogenic Viruses: Characteristics and Prevention Strategies-Lessons Learned from Human Papillomaviruses. Viruses. 2024;16(3):416. Published 2024 Mar 8. doi:10.3390/v16030416

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Published

2026-08-03

Issue

Vol. 38 No. 2 (2026): JOGECA Volume 38 Issue 2

Section

Original research

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Copyright (c) 2026 Jared Ndege, Macharia Wachira, Yvonne Wekesa, Lobikieki Kissambu, Victor Tetty, Arnold Bugah, Ruth Lusike, Francis Okoth, Ndung'u Muchiri, Wycliffe Musalia, Millicent Masinde, Alfred Mokomba, Jacqueline Chesang', Innocent Maranga, Eunice Cheserem, Margaret Kilonzo, Rose Kosgei

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Human papillomavirus vaccine uptake and its determinants among school-going girls in Migori County, Kenya: A qualitative study. (2026). Journal of Obstetrics and Gynaecology of Eastern and Central Africa, 38(2), 43-48. https://doi.org/10.59692/zr8v6378

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