Uganda to improve vaccination coverage against HPV

The ministries of health, education, gender and local government have committed to improving the coverage of the Human Papillomavirus (HPV) vaccine in Uganda.

This was at the National Symposium for Multi-Sectoral Stakeholders' renewed commitment towards increasing HPV vaccination coverage that was held at the Golf Course Hotel in Kampala. 

The essence of this commitment is to revitalise the engagement between the four ministries and renew the commitment and advocacy for HPV at both the national and sub-national levels. 

Prior to the symposium, the ministry of health through the Uganda National Expanded Program on Immunisation (UNEPI) oriented a team of national supervisors on the revised HPV delivery strategy, assigned district teams to ensure effective oversight and tasked each team to implement activities geared at increasing and sustaining uptake of the second dose of HPV (HPV2) in all districts. 

UNEPI will further ensure that all materials including the revised HPV delivery guide, school health register, health facility plan, information, education and communication materials used to sensitise the public are in place. 

The state minister of education and sports, Charles Bakkabulindi represented the education minister and First Lady Janet Museveni, as the guest of honour at the event.

He highlighted the need for a multisectoral approach to tackle cervical cancer saying; "the ministry of education and sports will support the ministry of health in sensitisation and rallying schools to ensure the children are immunised against HPV." 

Bakkabulindi further called on health workers to reach out to patients and not to wait for the patients to approach them for services. This, he said, would improve on the disease prevention targets in the country. 

In the same spirit, the minister of state for health in charge of general duties, Sarah Opendi, reiterated Bakkabulindi's words on a multisectoral approach, noting that the health ministry requires assistance from other sectors to improve HPV immunisation coverage.

"The ministry of education can help with advocacy, gender with approaching mothers and the local government to convene the locals," she said. 

However, Opendi decried the misinformation regarding the vaccine and called on local leaders to tackle the issue. 

The World Health Organisation (WHO) was represented by Dr Annet Kisakye, the immunisation focal person, who said that, globally, the East African region carries the highest burden of cervical cancer. She further stated that Uganda is among the five countries with the highest rates in Africa with 8 out of every 10 women at the Uganda Cancer Institute suffering from cervical cancer. 

Kisakye enumerated various avoidable risk factors that predispose women to cervical cancer including early marriages, multiple sexual partners, multiparity, sexually transmitted illnesses including HIV infection, tobacco use, vitamin deficiency and of course HPV infection. 

In November 2015, Uganda introduced the HPV vaccine in its immunisation schedule in all districts. However, coverage of the second dose has remained low three years since its introduction.

HPV was introduced as a routine vaccine to be delivered during every static and outreach immunisation sessions but intensified through Integrated Child Health Days during the months of April and October where health workers conduct school-based outreaches. 

Yet, the observed practice is that primarily only the first dose of HPV is administered during April with a few second doses administered subsequently.

In October both the first and second doses were provided. During the other months of the year, very little HPV-1 and 2 doses were administered.

As of December 2017, annualised coverage of HPV1 was at 85% and HPV2 was at 41% according to the District Health Information System (DHIS 2), indicating the need for increased coverage to improve HPV2 uptake.