1. HPV VACCINATION Dr Frida Mghamba 2 nd East Africa WE CAN Summit 11 th September 2014

2. Outline Introduction Comprehensive approach for cervical cancer prevention and control HPV vaccination Demonstration project Lesson learned in HPV vaccination Role of GAVI and WHO

3. Introduction Cervical cancer is the abnormal uncontrolled growth of cells in the cervix. The cells of the cervix change in a way that leads to abnormal growth and invasion of other tissues or organs of the body. Nearly all cervical cancers are caused by HPV infection. There are more than 40 HPV types that can infect the genital areas of males and females The HPV types 16 and 18 account for about 70% of all HPV cervical cancers worldwide

5. Comprehensive Approach to cervical cancer prevention and control Primary prevention –Education: delay age of first sexual intercourse, use condoms, limit number of partners, avoid tobacco use –HPV vaccines Secondary prevention: early detection –Screening: Identify and treat precancerous lesions before they progress to cervical cancer –Early diagnosis: Identify and treat early cancer while chance of cure is still good (reduces cervical cancer mortality) Tertiary prevention: treatment and palliative care

6. HPV vaccination HPV vaccination is the primary preventive method for cervical cancers caused by HPV infection. It prevents women from acquiring HPV infection in the first instance, so there is no risk of an infection progressing to cervical cancer later in life. The vaccine is recommended by WHO for ages 9-13 years. The HPV vaccine is safe, very effective and provides complete immunity after two doses six months apart.

7. HPV vaccination demonstration project HPV demonstration project aims to demonstrate how the HPV vaccine targeting girls aged 9-13 years can be delivered in routine setting and its implication on coverage feasibility, acceptability and cost. Target age group for the HPV vaccination is school-going girls, school-based vaccination is one of the vaccination strategies adopted to achieve the best coverage rates. Data from the MOEVT show that girls with 9-13 years 95% are in grade IV therefore this programme target all girls in class IV with age 9 and above. The girls out of school due to various reasons was vaccinated with age of 9years..

8. RESULT OF HPV VACCINATION 1 st round of HPV vaccination was conducted on 5 th to 9 th May this year in Kilimanjaro region Total number of girls vaccinated in school was 17,222 out of 18,316 (94.0%) The girls vaccinated out of schools were 416 out of 597(69.70%). Overall coverage was 93%

9. HPV VACCINATION COVERAGE

10. CHALLENGES Misconception among parents/guardian Refusal because of religious belief in three religious schools Fund for operational for the 2 nd year

11. LESSON LEARNT Community health worker can be used as platform for reaching hard to reach and out of school Through micro planning resulted into good vaccination coverage, better resources utilization and avoidance of duplication Operational plan correctly resulted into appropriate proper distribution of vaccine and supplies Delivering of vaccine in school is cheap and cost effective strategies Targeted girls who were already vaccinated can be used as ingredient for change and increase acceptance among girls and community

12. ROLE OF GAVI AND WHO GAVI To provide financial support To supply HPV vaccines WHO To provide technique support in – Training –Supportive supervision –Monitoring and evaluation

13. Thank you