Abstract
Healthcare providers' (HCPs) recommendations for the Human Papillomavirus (HPV) vaccine are likely to increase the vaccination uptake. However, little is known about Ghanaian HCPs' general practices regarding HPV vaccination. We used Multi-Theory Model (MTM) constructs (i.e. participatory dialogue, behavioral confidence, environment, social and emotional transformation) to examine Ghanaian HCPs' attitudes towards HPV vaccination and their vaccination recommendation practices. We conducted three, 60-minute focus group discussions (FGDs) with HCP in the second-largest government hospital in Ghana. Sixteen semi-structured open-ended questions based on MTM constructs were used to guide the FGDs. We explored HCPs' general knowledge about HPV, vaccination recommendation behavior, physical environment, and socio-cultural factors associated with the HPV vaccination. Data from the FGDs were transcribed and thematically coded using NVivo software. The sample of (n = 29) HCPs consisting of males (n = 15) and females (n = 14) between the ages of 29 and 42 years participated in the FGDs. Our analyses showed that HCPs (a) rarely offered HPV vaccination recommendations, (b) showed varied understanding about who should be vaccinated regarding age eligibility, gender, and infection status. Perceived barriers to HPV vaccination include (a) low urgency for vaccination education due to competing priorities such as malaria and HIV/AIDS; (b) lack of data on HPV vaccination; (c) lack of awareness about the vaccine safety and efficacy; (c) lack of HPV vaccine accessibility and (d) stigma, misconceptions and religious objections. HCPs expressed that their motivation for counseling their clients about HPV vaccination would be increased by having more knowledge about the vaccine's efficacy and safety, and the involvement of the parents, chiefs, churches, and opinion leaders in the vaccination programs. The study's findings underscore the need for a comprehensive HPV vaccination education for HCPs in Ghana. Future HPV vaccination education programs should include information about the efficacy of the vaccine and effective vaccination messages to help mitigate HPV vaccine-related stigma.
Highlights
Human Papillomavirus (HPV) causes several cancers, including cervical, anal, penile, and oropharyngeal cancer, as well as genital warts and recurrent respiratory papillomatosis [1]
We explored Healthcare providers’ (HCPs)’ general knowledge about HPV, vaccination recommendation behavior, physical environment, and sociocultural factors associated with the HPV vaccination
The sample of (n = 29) HCPs consisting of males (n = 15) and females (n = 14) between the ages of 29 and 42 years participated in the focus group discussions (FGDs)
Summary
Human Papillomavirus (HPV) causes several cancers, including cervical, anal, penile, and oropharyngeal cancer, as well as genital warts and recurrent respiratory papillomatosis [1]. HPV-related cancers accounted for almost 20% of cancer deaths in Ghana [2] These data show that HPV diseases are a menace to public health in LMICs in general and Ghana in particular. HPV vaccines (Cervarix, Gardasil, and Gardasil 91) have strong and demonstrated efficacy for protecting against HPV-related diseases in other countries. The availability of these vaccines has been associated with a decrease in HPV related cancers including cervical dysplasia, the precursor of cervical cancer [3,4,5,6]. Healthcare providers’ (HCPs) recommendations for the Human Papillomavirus (HPV) vaccine are likely to increase the vaccination uptake. We used Multi-Theory Model (MTM) constructs (i.e. participatory dialogue, behavioral confidence, environment, social and emotional transformation) to examine Ghanaian HCPs’ attitudes towards HPV vaccination and their vaccination recommendation practices
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