Knowledge, perception, and practice of stakeholders towards HPV vaccination program; A school based study in Kampala.

Abstract

Background: Cervical cancer remains a major public health challenge, accounting for substantial morbidity and mortality. Human Papilloma Virus (HPV) Vaccination is the recommended primary intervention for HPV prevention however there‘s limited evidence on the level of knowledge, attitude, and practices of stakeholders on HPV vaccination in Kampala. Objective: To assess stakeholders‘ knowledge, perceptions, and practices towards HPV vaccination program in Kampala district, Uganda order to guide programs aimed at improving uptake of the vaccine. Methods: A descriptive cross-sectional study using mixed methods to collect and analyze data from 524 adolescent girls, their teachers, and parents obtained through multistage sampling and purposive sampling methods, respectively in Kampala district, Uganda. A structured questionnaire was administered to the girls and six Focus group discussions, and 13 key informant interviews (teacher and parents) were conducted. Quantitative data were entered in epidata, cleaned, and analyzed in Stata 14. Qualitative data were analyzed using thematic content analysis in atlas ti version 8. Results: About 49.2% (258/524) of the girls had low knowledge of HPV. Qualitatively, knowledge was lacking among teachers and parents especially concerning the target age group, dosage, and vaccine interval. Girls residing in rural areas (aPR=0.35, C. I=0.14-0.85, P -value=0.028) had lower knowledge levels compared to those in urban areas. About 51.9% (272/524) of girls had negative perceptions towards HPV vaccination. High HPV knowledge (aPR=3.02, C. I=2.37-3.84, P -value=0.000) influenced positive perceptions. Parents expressed negative perceptions, beliefs, superstitions, and safety concerns of the vaccine. Only 8.6% (45/524) girls had good HPV vaccination practices. Girls whose mothers were healthcare providers (aPR=1.94, C. I=1.10-3.41, P -value=0.021), girls with high knowledge levels (aPR=1.79, C. I=1.21-2.63, P -value=0.003) and positive perceptions (aPR=2.87, C. I=1.93-4.27, P -value=0.000) had higher odds of vaccination. Conclusion: All stakeholders generally had low levels of knowledge, negative perceptions, and poor practices toward vaccination. There is a need for enhancing sensitization campaigns in schools and communities to improve awareness, perceptions, and practices of the key stakeholders on HPV vaccination.