Data_Sheet_1_Planning, implementation, and sustaining high coverage of human papillomavirus (HPV) vaccination programs: What works in the context of low-resource countries?.pdf

Cervical cancer due to human papillomavirus (HPV) infection is a leading cause of mortality among women in low-resource settings. Many Sub-Saharan African countries have introduced HPV vaccination programs at the national level in the last few years. However, countries are struggling to maintain sustainable coverage. This study focuses on the introduction and sustainability challenges, context-specific key lessons learned, and mechanisms of action to achieve high sustainable coverage from low and lower-middle-income countries (LLMICs) that have introduced HPV vaccination programs by collating evidence from a literature review and key informant interviews. Local data availability was a challenge across countries, with the lack or absence of registries, data collection and reporting mechanisms. Multi-sectoral coordination and early involvement of key stakeholders were cited as an integral part of HPV programs and facilitators for sustainable coverage. Key informants identified periodic sensitization and training as critical due to high staff turnover. Health workforce mobilization was fundamental to ensure that the health workforce is aware of the disease etiology, eligibility requirements, and can dispel misinformation. Schools were reported to be an ideal sustainable platform for vaccination. However, this required teachers to be trained, which was often not considered in the programs. District-level staff were often poorly informed and lacked the technical and logistic capacity to support vaccination rounds and data collection. To improve the sustainability of HPV vaccination programs, there is a need for timely microplanning, efficient preparedness assessment, assessing training approaches, periodic training, finding innovative ways to achieve equity and adoption of a bottom-up approach to ensure that processes between districts and central level are well-connected and resources are distributed efficiently.

由于人乳头瘤病毒（HPV）感染导致的宫颈癌是低资源环境中女性死亡率的主要原因。近年来，许多撒哈拉以南非洲国家已在国家层面引入了HPV疫苗接种计划。然而，各国在维持可持续覆盖率方面正面临挑战。本研究聚焦于HPV疫苗接种计划的引入与可持续性挑战、特定情境下的关键经验教训以及行动机制，旨在从已引入HPV疫苗接种计划的低及低收入国家（LLMICs）中收集文献综述和关键信息提供者的证据，以实现高可持续覆盖率。各国普遍面临当地数据可获得性的挑战，包括登记处、数据收集和报告机制的缺乏或缺失。多部门协调和关键利益相关者的早期参与被视为HPV计划的重要组成部分，并有助于实现可持续覆盖率。关键信息提供者认为，由于人员流动性高，定期的意识提升和培训至关重要。动员卫生人力资源对于确保卫生人员了解疾病病因学、资格要求并消除错误信息是至关重要的。学校被报告为疫苗接种的理想可持续平台。然而，这需要培训教师，而这一点在计划中往往被忽视。区级工作人员通常信息不足，缺乏技术和后勤能力来支持疫苗接种轮次和数据收集。为了提高HPV疫苗接种计划的可持续性，需要及时进行微观规划、高效的准备情况评估、评估培训方法、定期培训，以及寻找创新方法来实现公平性和采用自下而上的方法，以确保区级和中央层级之间的流程紧密相连，资源分配高效。