African Journal of Public Health and Health Systems | 19 February 2020
Assessing Coverage and Timeliness of the Second-Dose HPV Vaccine in School-Based Programmes for Adolescent Girls in Kigali, 2020: A Policy Analysis
A, m, i, n, a, t, a, D, i, o, p, ,, M, o, u, s, s, a, N, d, i, a, y, e, ,, F, a, t, o, u, S, a, r, r
Abstract
School-based human papillomavirus (HPV) vaccination is a cornerstone of cervical cancer prevention in sub-Saharan Africa. High coverage and timely administration of the two-dose schedule are essential for effective population protection. This policy analysis aimed to assess the coverage and timeliness of the second HPV vaccine dose delivered through the school-based programme for adolescent girls in Kigali. It sought to identify systemic facilitators and barriers influencing these outcomes. A desk-based policy analysis was conducted. This involved a review of national immunisation policy documents, programme reports, and grey literature. A framework approach was used to evaluate programme design, implementation processes, and monitoring systems against stated policy objectives. Second-dose coverage was substantially lower than first-dose coverage, indicating a significant drop-out rate. A principal barrier was the absence of a robust tracking and recall system for girls due for their second dose, especially those absent on vaccination days. Over-reliance on school attendance as the delivery platform was a noted vulnerability. While the policy framework for HPV vaccination in Kigali is established, implementation gaps prevent high, timely second-dose coverage. Strengthening dose-tracking and developing strategies to reach out-of-school girls are critical. Key recommendations include: integrating a digital child-based tracking system into the national immunisation programme; developing and resourcing specific outreach strategies for absent girls; and enhancing data collection on vaccination timeliness for improved programme evaluation. HPV vaccination, immunisation programmes, school-based health services, adolescent health, health policy, cervical cancer prevention, programme evaluation This analysis provides evidence for policymakers and programme managers on specific systemic weaknesses affecting second-dose HPV vaccine coverage, offering direct guidance for strengthening programme implementation.