Preparing for HPV vaccination in South Africa: Key challenges and opinions

Background

Cancer of the cervix is an important public health problem in South Africa, accounting for 18.5% of all cancers, and the second most common cancer amongst adult women. The recent licensing of one of the human papillomavirus (HPV) vaccines in the USA began a new era in the fight against cervical cancer.  Although the vaccines are not currently available in the public sector in South Africa, it is here, and in other developing countries, where over 80% of cervical cancer cases occur, that the vaccine could be most beneficial.

 Objective

The main objective was to identify key challenges and barriers to the potential introduction of the HPV vaccine in the Western Cape Province, South Africa.

 Methods
Qualitative research was conducted at three levels: service provider, policymaker and community.  In-depth interviews were held with policy makers and key policy influential’s at national and provincial levels. Six focus group discussions were held with women between the ages of 25 and 58. Data analysis was conducted using content analysis. Dominant themes and range of responses were identified and synthesized into key findings that can be used to shape policy and programmatic recommendations.

 Results

Respondents expressed support for the HPV vaccine, underscored by difficulties associated with the current cervical screening programmes and the burgeoning HIV/AIDS epidemic in South Africa.  Key findings included information on: knowledge of cervical cancer and HPV, target groups and optimal age to immunise, where best to position and manage the HPV vaccine, cost, service delivery issues, and possible opposition to the HPV vaccine.

 Conclusions
The findings assist in identifying potential barriers and facilitating factors towards HPV vaccines that will contribute towards creating an environment conducive towards their introduction, when the HPV vaccine becomes available in South Africa.