Abstract
BackgroundHuman papilloma virus (HPV) vaccination in Nigeria will require substantial financing due to high cost of HPV vaccine and inexistence of structures to support adolescent vaccination. Alternative sources are needed to sustain the government funded HPV vaccination programme. This study assessed Nigerian mothers’ willingness-to-pay (WTP) for HPV vaccine. We also compared the difference between the average WTP and estimated costs of vaccinating a pre-adolescent girl (CVG).MethodsWe conducted a quantitative, cross-sectional, survey-based study in which 50 questionnaires were distributed to each of 10 secondary schools located in two rural and one urban city in Anambra state. The questionnaires were then randomly distributed to girls aged 9–12 years of age to give to their mothers. Contingent valuation approach using the payment card technique was used to estimate the average maximum WTP among the survey participants. Correlates of WTP for HPV vaccination were obtained using multivariate logistic regression. Estimated CVG was obtained by adapting cost of HPV vaccine delivery in Tanzania to the Nigerian setting.ResultsA total of 438 questionnaires (88 %) were returned. The average WTP was US$ 11.68. This is opposed to estimated delivery cost of US$ 18.16 and US$ 19.26 for urban and rural populations respectively at vaccine price offered by the Vaccine Alliance (Gavi) and US$ 35.16 and US$ 36.26 for urban and rural populations respectively at the lowest obtainable public sector vaccine price. Demand for HPV vaccine was deemed high (91.6 %) and was significantly associated with respondents previously diagnosed of HPV infection.ConclusionDemand for HPV vaccine was high although short of estimated CVG. High demand for vaccine should be capitalized upon to increase vaccine uptake. Education on cervical cancer and provider-initiated vaccination should be promoted to increase vaccine uptake. Co-payment could be a feasible financing strategy in the event of national HPV vaccination.
Highlights
Human papilloma virus (HPV) vaccination in Nigeria will require substantial financing due to high cost of HPV vaccine and inexistence of structures to support adolescent vaccination
We compared the difference between the average WTP value and estimated cost of vaccinating a pre-adolescent girl (CVG) against HPV infection in Nigeria
This study aimed to establish how much Nigerian mothers are willing to pay for vaccination of their daughters against HPV infection
Summary
Human papilloma virus (HPV) vaccination in Nigeria will require substantial financing due to high cost of HPV vaccine and inexistence of structures to support adolescent vaccination. We compared the difference between the average WTP and estimated costs of vaccinating a pre-adolescent girl (CVG). Cervical cancer is the fourth most commonly diagnosed cancer and fourth leading cause of cancer related deaths among females worldwide [1]. While cervical cancer screening programmes have been effective in reducing cervical cancer incidence in developed countries, cervical cancer screening in Nigeria is still unpopular [2]. The two types of vaccines that prevent cervical cancer—GSK’s bivalent HPV vaccine (Cervarix) and Merck & Co. Inc.’s quadrivalent HPV vaccine (Gardasil)—are both licensed in Nigeria. The vaccines are highly effective in preventing persistent HPV infection and subsequent precancerous lesions due to infection with two types of HPV—types 16 and 18—that cause about 70 % of cervical cancer worldwide [2]
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