Key players and determinants improving human papillomavirus vaccination coverage in Cameroon: a cross-sectional nationwide health workers survey
Human papillomavirus (HPV) is a significant sexually transmissible infection associated with over 90 % of cervical cancers, most of which could be prevented by vaccination. Despite the merit of the HPV vaccine, coverage remained less than 20 % in Cameroon until the onset of single-dose vaccination for adolescent boys and girls in 2023, when the country recorded 57 % and 26 % HPV vaccination coverage for girls and boys, respectively. This study investigated the drivers of caregivers and the key community players that facilitated their work to enhance the uptake of the HPV vaccine in Cameroon. A nationwide cross-sectional survey was conducted from August 2023 to July 2024 using an online questionnaire developed in Kobo Toolbox. Study participants included healthcare personnel from the country's ten regions, districts, and health facilities. SPSS was used in data analysis. The Chi-square test was used to identify differences in vaccination drivers. Multiple logistic regression analyses were performed, and the results were reported with 95 % confidence intervals and a 5 % significance level. In total, 1225 health workers (HW) were sampled. Most participants were aware of the HPV vaccine and willing to promote its uptake (83 %). HW knowledge of HPV was statistically significantly associated with increased HPV vaccination uptake by adolescents (OR = 3.2, 95 %CI: 1.6-6.4, P = 0.01). A strong association was also found between HW working at the vaccination unit and the vaccination of adolescent girls (OR = 2.5, 95 %CI: 1.7-3.5, p < 0.01). The key actors reported by HW to favor vaccination were parents (29 %), traditional authorities (29 %), religious leaders (19 %), and teachers (19 %). Key vaccination sites included community (50 %), schools (29 %), and health facilities (20 %). Investigating the drivers of HPV vaccination in Cameroon in 2023, this research shows the crucial role HW's knowledge of HPV plays in promoting HPV vaccination. Additionally, parents, traditional leaders, and teachers were identified by HW as key players in promoting vaccination.