Thesis:

Determinants of HPV-vaccines acceptability among guardians of girls aged 9-17 years in Laikipia county, Kenya

Human papillomavirus (HPV) is a sexually transmitted infection (STI) and a leading contributor to cervical cancer in women. To address this public health concern, many countries have implemented prophylactic three-dose HPV vaccination programs targeting girls aged 9 years and above, administered through schools and health facilities. Kenya introduced HPV vaccination into its routine immunization schedule on October 18, 2019, becoming the 16th African country to do so. Guardians knowledge, beliefs, and perceptions about the HPV vaccine may influence its acceptance and uptake for their daughters. However, in Kenya, there is limited data on the factors that determine HPV vaccine acceptability among guardians of girls aged 9–17 years. The study aimed to assess HPV vaccine acceptability among guardians of girls aged 9–17 years in Laikipia County and to examine how guardians’ knowledge, perceptions, and socio-demographic characteristics influence their willingness to accept the vaccine. A cross-sectional analytical study design was employed, with data collected using researcher-administered structured questionnaires. A sample of 473 households with girls aged 9-17 years were interviewed (N=473). Pretesting was done among 30 guardians in Laikipia West subcounty to ensure validity and reliability. Participants in this study gave consent before participating in the study, and all necessary approvals were sought. All ethical standards and regulations were adhered to throughout the study. Data analysis was done through SPSS version 29. Descriptive statistics, including frequencies and percentages, were used to summarize participants' knowledge, perceptions, and vaccine acceptability. Logistic regression analysis, with a 95% confidence interval and a p-value < 0.05, was employed to identify associations between dependent and independent variables. The findings of the study revealed that majority of the respondents had a good knowledge level (84.1%), held positive perception (74.2%) as well as high HPV vaccine acceptability (66.4%). Factors significantly associated with HPV vaccine acceptability included duration lived in current residence [AOR = 0.35, 95%CI: 0.12, 1.00, p = 0.050)], occupation [AOR = 8.19, 95% CI: 3.05, 21.96, p < 0.001], and medical insurance [AOR = 0.46, 95% CI:0.24,0.88, p = 0.019]. Additionally, overall knowledge ([AOR = 2.02, 95% CI: 0.94, 4.32, p = 0.042]) and perception ([AOR = 11.08, 95% CI: 5.70, 21.57, p < 0.001]) were statistically associated with vaccine acceptability. The study concluded that demographic, socioeconomic, and attitudinal factors play a critical role in influencing guardians' decisions regarding HPV vaccination for their daughters. Despite some barriers to vaccination, the majority of respondents expressed willingness to have their daughters vaccinated. It is recommended that the Ministry of Health strengthen community-based campaigns and incorporate the HPV vaccine into the National Immunization Program. Moreover, guardians involvement in school-based vaccination programs should be prioritized to enhance uptake.