Communication strategies to improve human papillomavirus (HPV) immunisation uptake among adolescents in sub-Saharan Africa: a systematic review and meta-analysis

ObjectivesDeveloping countries face the greatest cervical cancer disease burden and mortality with suboptimal immunisation uptake. This review explores the communication strategies adopted, successes, challenges and lessons learnt in sub-Saharan countries to enhance human papillomavirus (HPV) immuni...

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Bibliographic Details
Published in:	BMJ open Vol. 13; no. 4; p. e067164
Main Authors:	Oketch, Sandra Y, Ochomo, Edwin O, Orwa, Jeniffer A, Mayieka, Lilian M, Abdullahi, Leila H
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 03-04-2023 BMJ Publishing Group LTD BMJ Publishing Group
Series:	Original research
Subjects:	Adolescent Africa South of the Sahara Cervical cancer Communication community child health Disease prevention Female Health Education - methods Human papillomavirus Human Papillomavirus Viruses Humans Immunization Meta-analysis Papillomavirus Infections - prevention & control Papillomavirus Vaccines Parents - education primary care public health Systematic review Teenagers Uterine Cervical Neoplasms - prevention & control Vaccination Vaccines Womens health Africa South of the Sahara United States > US Sub-Saharan Africa Africa primary care public health community child health
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Summary:	ObjectivesDeveloping countries face the greatest cervical cancer disease burden and mortality with suboptimal immunisation uptake. This review explores the communication strategies adopted, successes, challenges and lessons learnt in sub-Saharan countries to enhance human papillomavirus (HPV) immunisation.DesignSystematic review and meta-analysis.Data sourcesPubMed, Hinari, Cochrane Library, Trip database, CINAHL, Web of Science, Scopus and seven grey resources were searched through May 2022.Eligibility criteriaWe included observational studies addressing communication strategies for HPV immunisation uptake.Data extraction and synthesisTwo independent reviewers used standardised methods to search, screen and code included studies. Data extraction and assessment of risk of bias were done in duplicate to enhance validity of the results. Meta-analysis was conducted using the random-effects model. Findings were summarised and synthesised qualitatively.ResultsCommunication intervention to facilitate decision-making achieved uptake rate of 100% (95% CI 0.99% to 1.00%), followed by intervention to enable communication, which achieved 92% (95% CI 0.92% to 0.92%). Communication intervention to inform and educate achieved 90% (95% CI 0.90% to 0.90%).Targeting both healthcare workers and community leaders with the communication intervention achieved 95% (95% CI 0.91% to 0.98%), while teachers and school boards achieved 92% (95% CI 0.84% to 1.01%). Targeting policymakers achieved 86% (95% CI 0.78% to 0.93%).Based on the method of communication intervention delivery, use of training achieved an uptake rate of 85% (95% CI 0.84% to 0.87%); similarly, drama and dance achieved 85% (95% CI 0.84% to 0.86%). However, use of information, education and communication materials achieved 82% (95% CI 0.78% to 0.87%).ConclusionHPV vaccine communication is critical in ensuring that the community understands the importance of vaccination. The most effective communication strategies included those which educate the population about the HPV vaccine, facilitate decision-making on vaccine uptake and community ownership of the vaccination process immunisation.PROSPERO registration numberCRD42021243683.
Bibliography:	Original research ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2022-067164