Uptake of Human Papiloma Virus (HPV) Vaccine in Kenya: Barriers and Facilitators - A Scoping Review
Résumé
Cervical cancer is a leading cause of cancer-related deaths among women in Kenya, with human papillomavirus (HPV) as the primary causative agent. Despite the World Health Organisation (WHO) recommendations for HPV vaccination, uptake remains suboptimal. By 2020, only 33% of eligible adolescent girls had received the first dose, and just 16% had completed the second dose. Given the crucial role of HPV vaccination in cervical cancer prevention, understanding the factors influencing vaccine uptake is essential. This scoping review assessed HPV vaccine uptake among adolescent girls in Kenya, identified key barriers, and explored facilitators to improve coverage. A systematic search was conducted in MEDLINE (PubMed), CINAHL, and Google Scholar, focusing on studies published between 2006 and 2025. A total of 12 eligible studies were included, comprising six qualitative, five quantitative, and one mixed-method study. The findings indicate that the average first-dose uptake was 52%, but subsequent dose completion rates were significantly lower, highlighting challenges in ensuring full vaccine coverage. Barriers to uptake included widespread misinformation, vaccine hesitancy, financial constraints, long distances to healthcare facilities, negative provider attitudes, and socio-cultural opposition, including religious concerns and male guardian hesitancy. Additionally, the COVID-19 pandemic disrupted HPV vaccination programs, further reducing access. Facilitators of vaccine uptake included school-based vaccination programs, community engagement initiatives, targeted public education campaigns, and retraining of healthcare providers to improve vaccine advocacy. Integration of HPV vaccination with routine immunisation programs and youth-friendly reproductive health services was also identified as a strategy to enhance accessibility and adherence. Improving HPV vaccine uptake in Kenya requires a multi-pronged approach, including strengthening healthcare infrastructure, addressing vaccine safety concerns through transparent communication, and actively engaging key stakeholders, including parents, teachers, and community leaders. Policy adjustments, such as adopting a single-dose regimen where feasible, may further enhance vaccine accessibility and adherence. A comprehensive, collaborative strategy is essential to increasing HPV vaccine coverage and reducing the burden of cervical cancer in Kenya.
##plugins.generic.usageStats.downloads##
Références
Ambali, R. T., John-Akinola, Y. O., & Oluwasanu, M. M. (2022). Indepth Interviews’ on Acceptability and Concerns for Human Papilloma Virus Vaccine Uptake among Mothers of Adolescent Girls in Community Settings in Ibadan, Nigeria. Journal of Cancer Education : The Official Journal of the American Association for Cancer Education, 37(3), 748–754. https://doi.org/10.1007/s13187-020-01876-1
Amponsah-Dacosta, E., Blose, N., Nkwinika, V. V., & Chepkurui, V. (2022). Human Papillomavirus Vaccination in South Africa: Programmatic Challenges and Opportunities for Integration With Other Adolescent Health Services? Frontiers in Public Health, 10, 799984. https://doi.org/10.3389/fpubh.2022.799984
Arbyn M., et al. (2018). HPV vaccination and cervical cancer screening programs in sub-Saharan Africa: Achievements and challenges. Vaccine, 36(32), 4806–4813.
Canfel, K. (2020). HPV vaccine uptake among adolescent females in developing countries: Barriers and opportunities. Journal of Global Health, 10(1).
Chigozie, N., Hilfinger Messiaa, D. K., Adebola, A., & Ojiegbe, T. (2022). Men’s willingness to support HPV vaccination and cervical cancer screening in Nigeria. Health Promotion International, 37(1), daab056. https://doi.org/10.1093/heapro/daab056
Dilley, S. E. (2018). Human papillomavirus vaccination uptake: Barriers and facilitators in the United States and globally. Journal of Adolescent Health, 63(5), 623–632.
Essoh, T.-A., Adeyanju, G. C., Adamu, A. A., Tall, H., Aplogan, A., & Tabu, C. (2023). Exploring the factors contributing to low vaccination uptake for nationally recommended routine childhood and adolescent vaccines in Kenya. BMC Public Health, 23(1), 912. https://doi.org/10.1186/s12889-023-15855-w
Globocan. (2020). Cervical cancer: Estimated incidence, mortality and prevalence worldwide in 2020. International Agency for Research on Cancer. https://gco.iarc.fr/
Kaaria, F., Odhiambo, F. B., Okenyoru, D. S., Murugi, L., Matoke, V. O., Salima, R., Anyika, D., Ogutu, G., & Musau, A. (2024). Religious leaders’ willingness to promote the uptake of human papillomavirus vaccine among their congregants in Mavoko Sub-County, Machakos County, Kenya. The Pan African Medical Journal, 48, 141.
Karanja-Chege, C. M. (2022). HPV Vaccination in Kenya: The Challenges Faced and Strategies to Increase Uptake. Frontiers in Public Health, 10, 802947. https://doi.org/10.3389/fpubh.2022.802947
Kariuki, V. W., Nduati, R., & Wangombe, A. (2024). Factors Associated with Human Papillomavirus Vaccine Uptake in Adolescents Aged 10–12 Years in Kiambu Sub-County, Kenya. Iconic Research and Engineering Journals, 7(7), 1705445.
Kreimer, A. R., Watson-Jones, D., Kim, J. J., & Dull, P. (2024). Single-dose human papillomavirus vaccination: An update. JNCI Monographs, 2024(67), 313– 316. https://doi.org/10.1093/jncimonographs/lgae030
Kwena, T. T., Psusma, T. S., Mukthar, V., K, & Arudo, J. O. (2023). Assessing Healthcare Provider’s Skills in the Management of COVID-19 Infection at Busia County Referral Hospital, Kenya. Evidence-Based Nursing Research, 6(1), 28–38. https://doi.org/10.47104/ebnrojs3.v6i1.320
Lubeya, M. K., Mwanahamuntu, M., Chibwesha, C., Mukosha, M., Wamunyima, M. M., & Kawonga, M. (2022). Implementation strategies to increase human papillomavirus vaccination uptake for adolescent girls in sub-Saharan Africa: A scoping review protocol. PLOS ONE, 17(8), e0267617. https://doi.org/10.1371/journal.pone.0267617
Mabeya, H., Menon, S., Weyers, S., Naanyu, V., Mwaliko, E., Kirop, E., Orango, O., Vermandere, H., & Vanden Broeck, D. (2018). Uptake of three doses of HPV vaccine by primary school girls in Eldoret, Kenya; a prospective cohort study in a malaria endemic setting. BMC Cancer, 18(1), 557. https://doi.org/10.1186/s12885-018-4382-x
Masika, M. M., Ogembo, J. G., Chabeda, S. V., Wamai, R. G., & Mugo, N. (2015). Knowledge on HPV Vaccine and Cervical Cancer Facilitates Vaccine Acceptability among School Teachers in Kitui County, Kenya. PloS One, 10(8), e0135563. https://doi.org/10.1371/journal.pone.0135563
Ministry of Health (MOH), Kenya. (2018). Kenya National Cancer Screening Guidelines. Government of Kenya.Nairobi.
Mwangi, A. W., Mbuthia, J. N., & Wanjiru, F. K. (2020). Determinants of HPV vaccine uptake among adolescent girls in Kenya: A cross-sectional study. Journal of Public Health in Africa, 11(2), 45–52.
Njuguna, D. W., Mahrouseh, N., Isowamwen, O. V., & Varga, O. (2021). Knowledge, Attitude and Practice of Main Stakeholders towards Human Papilloma Virus Infection and Vaccination in Mombasa and Tana-River Counties in Kenya: A Qualitative Study. Vaccines, 9(10). https://doi.org/10.3390/vaccines9101099
Ochomo, E. O., Tonui, P., Muthoka, K., Amboka, S., Itsura, P., Orang’o, E. O., Rosen, B., Loehrer, P., & Cu-Uvin, S. (2024). ‘Addressing HPV vaccine hesitancy: Unveiling concerns and building trust’ perspectives of adolescent girls and parents in Kisumu County, Kenya. Ecancermedicalscience, 18, 1735.
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015). A refined compilation of implementation strategies: Results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Science: IS, 10, 21. https://doi.org/10.1186/s13012-015-0209-1
Topazian, H. M., Dizon, A. M., Di Bona, V. L., Levitz, L., Ramos, S., Morgan, K., Kim, C. J., Richter, K., De Sanjose, S., & Smith, J. S. (2019). Adolescent providers’ knowledge of human papillomavirus vaccination age guidelines in five countries. Human Vaccines & Immunotherapeutics, 15(7–8), 1672–1677. https://doi.org/10.1080/21645515.2018.1558688
Tricco, A. C., Lillie, E., Zarin, W., O’Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., … Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Umutesi, G., Oluoch, L., Weiner, B. J., Bukusi, E., Onono, M., Njoroge, B., Mecca, L., Ngure, K., Mugo, N. R., & Barnabas, R. V. (2023). HPV vaccination in Kenya: A study protocol to assess stakeholders’ perspectives on implementation drivers of HPV vaccination and the acceptability of the reduced dose strategy among providers. Frontiers in Health Services, 3, 1233923. https://doi.org/10.3389/frhs.2023.1233923
Vermandere, H., Naanyu, V., Degomme, O., & Michielsen, K. (2015). Implementation of an HPV vaccination program in Eldoret, Kenya: Results from a qualitative assessment by key stakeholders. BMC Public Health, 15, 875. https://doi.org/10.1186/s12889-015-2219-y
Vermandere, H., Naanyu, V., Mabeya, H., Vanden Broeck, D., Michielsen, K., & Degomme, O. (2014). Determinants of Acceptance and Subsequent Uptake of the HPV Vaccine in a Cohort in Eldoret, Kenya. PLoS ONE, 9(10), e109353. https://doi.org/10.1371/journal.pone.0109353
Vermandere, H., Van Stam, M.-A., Naanyu, V., Michielsen, K., Degomme, O., & Oort, F. (2016). Uptake of the human papillomavirus vaccine in Kenya: Testing the health belief model through pathway modeling on cohort data. Globalization and Health, 12(1), 72. https://doi.org/10.1186/s12992-016-0211-7
Watson-Jones, D., Mugo, N., Lees, S., Mathai, M., Vusha, S., Ndirangu, G., & Ross, D. A. (2015). Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya. PloS One, 10(6), e0123701. https://doi.org/10.1371/journal.pone.0123701
World Health Organization (WHO). (2020). Global strategy to accelerate the elimination of cervical cancer as a public health problem. World Health Organization Cervical Cancer Strategy. https://www.who.int/
Zhang, S., Mugo, N., Ngure, K., & Bukusi EA, E. A. (2023). The Acceptability of Pharmacy-Based HPV Vaccination in Western Kenya among Pharmacy Clients and Providers. Vaccines, 11(12). https://doi.org/; https://doi.org/10.3390/vaccines11121808
Copyright (c) 2025 Vincent Kiprono Mukthar, PhD, Irene Chirchir
Ce travail est disponible sous la licence Creative Commons Attribution 4.0 International .
