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HPV VACCINATION Dr Frida Mghamba 2nd East Africa WE CAN Summit 11th September 2014 Outline • Introduction • Comprehensive approach for cervical cancer prevention and control • HPV vaccination Demonstration project • Lesson learned in HPV vaccination • Role of GAVI and WHO Introduction • Cervical cancer is the abnormal uncontrolled growth of cells in the cervix. • The cells of the cervix change in a way that leads to abnormal growth and invasion of other tissues or organs of the body. • Nearly all cervical cancers are caused by HPV infection. • There are more than 40 HPV types that can infect the genital areas of males and females • The HPV types 16 and 18 account for about 70% of all HPV cervical cancers worldwide Comprehensive Approach to cervical cancer prevention and control • Primary prevention – Education: delay age of first sexual intercourse, use condoms, limit number of partners, avoid tobacco use – HPV vaccines • Secondary prevention: early detection – Screening: Identify and treat precancerous lesions before they progress to cervical cancer – Early diagnosis: Identify and treat early cancer while chance of cure is still good (reduces cervical cancer mortality) • Tertiary prevention: treatment and palliative care HPV vaccination • HPV vaccination is the primary preventive method for cervical cancers caused by HPV infection. • It prevents women from acquiring HPV infection in the first instance, so there is no risk of an infection progressing to cervical cancer later in life. • The vaccine is recommended by WHO for ages 9-13 years. • The HPV vaccine is safe , very effective and provides complete immunity after two doses six months apart. • HPV vaccination demonstration project • HPV demonstration project aims to demonstrate how the HPV vaccine targeting girls aged 9-13 years can be delivered in routine setting and its implication on coverage feasibility, acceptability and cost. • Target age group for the HPV vaccination is school-going girls, school-based vaccination is one of the vaccination strategies adopted to achieve the best coverage rates. • Data from the MOEVT show that girls with 9-13 years 95% are in grade IV therefore this programme target all girls in class IV with age 9 and above. • The girls out of school due to various reasons was vaccinated with age of 9years.. RESULT OF HPV VACCINATION • 1st round of HPV vaccination was conducted on 5th to 9th May this year in Kilimanjaro region • Total number of girls vaccinated in school was 17,222 out of 18,316 (94.0%) • The girls vaccinated out of schools were 416 out of 597(69.70%). • Overall coverage was 93% HPV VACCINATION COVERAGE CHALLENGES • Misconception among parents/guardian • Refusal because of religious belief in three religious schools • Fund for operational for the 2nd year LESSON LEARNT • Community health worker can be used as platform for reaching hard to reach and out of school • Through micro planning resulted into good vaccination coverage, better resources utilization and avoidance of duplication • Operational plan correctly resulted into appropriate proper distribution of vaccine and supplies • Delivering of vaccine in school is cheap and cost effective strategies • Targeted girls who were already vaccinated can be used as ingredient for change and increase acceptance among girls and community ROLE OF GAVI AND WHO GAVI • To provide financial support • To supply HPV vaccines WHO • To provide technique support in – Training – Supportive supervision – Monitoring and evaluation Thank you