Background
Methods
Study design and population
Study population
Sampling
Dependent and independent variables
Data analysis
Results
Socio-demographic characteristics of the respondents
Characteristic | Frequency (N = 407) | Percentage (%) |
---|---|---|
Age (years) | ||
9–10 | 116 | 28.5 |
11–12 | 130 | 31.9 |
13+ | 161 | 39.6 |
Residence | ||
Urban | 101 | 24.8 |
Rural | 306 | 75.2 |
Marital status of caretaker | ||
Single | 18 | 4.5 |
Married | 299 | 73.5 |
Divorced/separated | 49 | 12.0 |
Widowed | 41 | 10.0 |
Education level of caretaker | ||
No formal education | 46 | 11.3 |
Primary level | 204 | 50.1 |
Secondary level | 138 | 33.9 |
Tertiary level | 19 | 4.7 |
Religion | ||
Catholic | 75 | 18.4 |
Anglican | 129 | 31.7 |
Moslem | 169 | 41.5 |
Others | 33 | 8.4 |
Tribe | ||
Bagishu | 290 | 71.3 |
Banyole | 62 | 15.2 |
Others | 55 | 13.5 |
Occupation of care taker | ||
House wife | 59 | 14.5 |
Formal employment | 22 | 5.4 |
Business women | 131 | 32.2 |
Farmer | 195 | 47.9 |
Number of siblings | ||
One to two | 61 | 15.0 |
Three to four | 192 | 47.2 |
Five and more | 154 | 37.8 |
Distance to health facility | ||
Less than 1 km | 78 | 19.2 |
Between 1 and 3 km | 289 | 71.0 |
Greater than 3 km | 40 | 9.8 |
Initiation of the HPV vaccine
Reason | Frequency (N = 348) | Percentage |
---|---|---|
Distance to health facility | 50 | 14.4 |
No money | 35 | 10.0 |
Unfriendly health workers | 6 | 1.7 |
Lack of awareness | 182 | 52.3 |
Not due for second dose | 14 | 4.0 |
Others | 61 | 17.5 |
Total | 348* | 100 |
Factors associated with uptake of the HPV vaccine
Variables | Received two doses of | UPR (95% Confidence Interval) | P-value | |
---|---|---|---|---|
HPV vaccine | ||||
Education level of caretaker | Yes (%) | No (%) | ||
None | 6(10.7) | 40(11.4) | 1.0 | |
Primary | 18(32.1) | 186(53) | 0.7(0.27–1.70) | 0.407 |
Secondary & above | 32(57.1) | 125(35.6) | 1.6(0.65–3.73) | 0.316 |
Age group | ||||
9–10 | 9(16.1) | 107(30.5) | 1.0 | |
11–12 | 33(58.9) | 165(47.0) | 2.1(1.0–4.4) | 0.042* |
13–15 | 14(250.) | 79(22.5) | 1.9(0.84–4.4) | 0.121 |
Religion | ||||
Catholics | 13(23.2) | 62(17.7) | 1.0 | |
Anglicans | 24(42.86) | 105(29.9) | 1.1(0.55–2.10) | 0.837 |
Muslims | 14(25.0) | 155(44.2) | 0.5(0.22–1.01) | 0.055 |
Others | 5(8.9) | 29(8.3) | 0.9(0.30–2.38) | 0.755 |
Currently in school | ||||
Yes | 52(92.9) | 323(92.0) | 1.1(0.4–3.04) | 0.842 |
No | 4(7.1) | 28(7.98) | 1.0 | |
Nature of the school | ||||
Government aided | 15(28.3) | 240(73.4) | 1.0 | |
Private funded | 38(71.7) | 87(26.6) | 1.1(0.59–.955) | 0.811 |
Tribe | ||||
Bagishu | 32(57.1) | 258(73.5) | 1.0 | |
Banyole | 15(27) | 47(13.4) | 2.2(1.18–4.04) | 0.012* |
Others | 9(16.1) | 46(13.1) | 1.5(0.707–3.10) | 0.296 |
Occupation | ||||
Housewife | 5(8.9) | 54(15.4) | 1.0 | |
Business woman | 11(19.6) | 11(3.1) | 5.9(2.049–16.9) | < 0.001** |
Formal employment | 15(26.8) | 116(33.1) | 1.4(0.49–3.72) | 0.56 |
Farmer | 25(44.6) | 170(48.4) | 1.5(0.579–3.95) | 0.398 |
Distance to the health facility | ||||
Less than 1 km | 17(30.4) | 61(17.4) | 1.0 | |
1 km -3 km | 34(60.7) | 255(72.7) | 1.9(0.30–0.97) | 0.038* |
More than 3 km | 5(8.9) | 35(9.8) | 1.8(0.21–1.6) | 0.274 |
Obtained HPV vaccine from an outreach clinic | ||||
Yes | 47(83.9) | 121(34.5) | 7.4(3.6–15.2) | < 0.001** |
No | 9(16.1) | 230(65.5) | 1.0 | |
Received an explanation on side effects of vaccine | ||||
Yes | 45(80.4) | 68(19.4) | 10.6(5.5–20.6) | < 0.001** |
No | 11(19.6) | 283(80.6) | 1.0 | |
Paid for HPV vaccine? | ||||
Yes | 4(7.1) | 11(3.1) | 2.0(0.72–5.5) | 0.178 |
No | 52(92.9) | 340(96.9) | 1.0 | |
Had many options from where to receive HPV vaccine | ||||
Yes | 44(81.5) | 107(31.3) | 7.1(3.5–14.2) | < 0.001** |
No | 10(18.5) | 235(68.7) | 1.0 | |
Received any other childhood vaccines | ||||
Yes | 28(50) | 118(33.6) | 1.8(1.05–3.0) | 0.030* |
No | 28(50) | 233(66.4) | 1.0 | |
Received HPV vaccine alongside other services | ||||
Yes | 26(46.4) | 27(7.7) | 5.8(3.4–9.7) | < 0.001** |
No | 30(53.6) | 323(92.3) | 1.0 | |
Received adequate information about the vaccine | ||||
Yes | 35(62.5) | 53(15.1) | 6.0(3.5–10.4) | < 0.001** |
No | 21(37.5) | 298(84.9) | 1.0 | |
Heard of someone with side effects of HPV vaccine | ||||
Yes | 5(8.9) | 9(2.6) | 2.8(1.0–6.8) | 0.031* |
No | 51(91.1) | 342(97.4) | 1.0 | |
A of where to report side effects of HPV vaccine? | ||||
Yes | 20(35.7) | 44(12.5) | 3.0 (1.7–5.1) | < 0.001** |
No | 36(64.3) | 307(87.5) | 1.0 |
Variables | N = 407 (%) | UPR (95% CI) | Adj.PR(95%CI) | P-value |
---|---|---|---|---|
Age group | ||||
9–10 | 116(28.5) | 1.0 | 1.0 | |
11–12 | 198(48.6) | 2.1(1.0–4.4) | 1.3(0.57–3.01) | 0.527 |
13–15 | 93(22.9) | 1.9(0.84–4.4) | 1.2(0.48–3.27) | 0.64 |
Obtaining vaccine from outreach clinic | ||||
Yes | 168(41.3) | 7.4(3.6–15.15) | 2.6(1.16–5.86) | 0.020* |
No | 239(58.7) | 1.0 | 1.0 | |
Explanation on side effects of HPV vaccine | ||||
Yes | 113(27.8) | 10.6(5.5–20.57) | 2.7(1.13–6.4) | 0.024* |
No | 294(72.2) | 1.0 | 1.0 | |
Many options to receive vaccine | ||||
Yes | 151(38.1) | 7.1(3.5–14.18) | 3.6(1.58–8.13) | 0.002* |
No | 245(61.9) | 1.0 | 1.0 | |
Received other vaccines | ||||
Yes | 146(35.9) | 1.8(1.05–3.01) | 0.6(0.317–1.2) | 0.206 |
No | 261(64.1) | 1.0 | 1.0 | |
Got vaccine with other services | ||||
Yes | 53(13.0) | 5.8(3.4–9.7) | 2.3(1.11–4.59) | 0.024* |
No | 353(86.7) | 1.0 | 1.0 | |
Received adequate information about HPV vaccine | ||||
Yes | 88 | 6.0(3.5–10.4) | 1.6(0.85–3.33) | 0.137 |
No | 319 | 1.0 | 1.0 | |
Heard of someone with side effects of vaccine | ||||
Yes | 14 | 2.8(1.0–6.8) | 1.2(0.38–3.9) | 0.723 |
No | 393 | 1.0 | 1.0 |
Barriers to service delivery
“Previously, GAVI was supplementing the PHC Funds but in the last financial year, it has been hard to manage and I am sure that some facilities have not been able to conduct outreaches in both the schools and the community” (Key informant 2, DHT).
“We supply the vaccine to the public and private not for profit health facilities, we are not giving the private clinics, this is because many of them are not equipped with the cold chain and they do not report to us.”(Key Informant 1, DHT)
“We give out this vaccine to government schools only, the private schools don’t benefit because they have to obtain parental consent for their pupils to get it. In the Government schools, the school authority gives the consent”.(Key Informant 3 health facility in-charge)
Facilitators to service delivery
“Health facilities liaise with the schools so that arrangements are made for the HPV vaccination, for example they set aside a classroom where the equipment can be placed so that the vaccination can take place”.(Key Informant 2, Healthy facility in-charge)
Barriers for human resources for health
“We have few staff, which also compromises our service delivery. If some health workers go to the outreach clinic, you can feel the impact in the health facility when a few of us are left here”.(Key Informant 1, Healthy facility in-charge)
“PHC funds have helped to facilitate vaccinators and this is a good strategy for us. In addition, we use phone messages to thank them for the good work they do despite the hardship” (Key informant 1, District Health Team).
Barriers to vaccines, supplies and medicines
“The inconsistence in vaccine supply is a major barrier to completion of the doses, and it is something that I know is beyond the District Health Office to handle.”(Key informant 1, DHT)
“Supply of the vaccine is very poor and inconsistent. Despite this, we give out the doses as and when we receive the stock, but in that case, we can’t ascertain the efficacy of the vaccine”.(Key informant 2, DHT)
“Furthermore, this is an integrated service and people get very many services at once, may be this has contributed to the success”.(Key informant 4, Health facility in-charge)