Optimizing and applying lessons learnt from Rwanda’s HPV vaccination program to Zimbabwe

Background: Every two minutes, one woman dies of cervical cancer; a preventable disease, explicitly reflecting the world’s inequities. Infection with a high risk or oncogenic human papillomavirus is the main cause of precancerous and cancerous cervical lesions. Sub-Saharan Africa has the highest burden of cervical cancer but has a history of lagging behind high income countries when introducing new vaccines. A high HPV vaccination coverage can potentially protect unvaccinated individuals as a result of herd immunity. Guidelines recommend that girls who are between nine and 14 years old receive two doses of the HPV vaccine. The World Health Organization 90-70-90 targets were created to eradicate cervical cancer as a public health problem. Objectives: This documentary review seeks to find the lessons learnt from Rwanda’s HPV vaccination that can be adjusted and applied to the Zimbabwean context. Objective one is to identify the lessons learnt from Rwanda’s introduction of HPV vaccination from available literature. Objective two is to discuss the applicability of the lessons learnt from Rwanda’s experience into the Zimbabwean context. Methods: A documentary review will be conducted, focusing on Zimbabwe and Rwanda – two countries that have introduced the HPV vaccine national scale up. Secondary data will be collected from available literature. Literature will be sourced from multiple electronic databased including PubMed, JSTOR, Google, the International Journal of Cancer and Thammasat University’s online library. Findings: Knowledge, attitudes and perceptions towards cervical cancer and cervical cancer prevention, community mobilization, training, costs and target population play a crucial factor in the outcome of a HPV vaccine campaign. Conclusions: The burden that cervical cancer has in SSA is large but can be tackled when consistent political will, resources and correct strategies are in place. Rwanda has proved that it is possible to reach the WHO 90-70-90 targets – consistently. There will be no missed opportunities to vaccinate girls due to confusion regarding the target population during overlapping first and second vaccination campaigns if girls are always targeted by the grade they are in. Community buy in is imperative. Zimbabwe’s general population has to be aware of the HPV vaccination campaign and the benefits thereof. Key stakeholders such as the media and churches will help to ensure that vaccine hesitancy is reduced. Other lessons include integrating the HPV vaccination campaigns with other campaigns thereby contributing towards the campaign’s sustainability.