Date of Award


Document Type


Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Prof. Pauline Samia

Second Supervisor/Advisor

Dr. Rose Kamenwa

Third Supervisor/Advisor

James Orwa


Paediatrics and Child Health (East Africa)


Background: Cervical cancer is one of the most common preventable cancers causing morbidity and mortality in women especially in Sub-Saharan Africa. Three HPV vaccines have been approved for vaccination against HPV globally with Cervarix and Gardasil currently available in Kenya. Despite availability of free HPV vaccination and increased media campaigns the proportion of adolescent girls vaccinated against HPV remains low. Understanding the determinants of HPV vaccine uptake will inform strategies to improve the uptake at Aga Khan University Hospital, Nairobi.

Objectives: The aim was to identify the factors influencing HPV vaccine uptake among parents of adolescent girls. The secondary objective was to determine the proportion of adolescent girls vaccinated within the three months after reading the HPV vaccine brochure.

Methodology: A cross- sectional study was undertaken among parents/guardians of adolescent girls aged 9-18 years attending Aga Khan University Hospital Nairobi (AKUH, N). Data was collected using a questionnaire which included demographic data, knowledge of cervical cancer, knowledge of the HPV vaccine, vaccination status of their daughters and reasons for non-vaccination. Parents and guardians of adolescent girls who had not taken the HPV vaccine were provided with standardized written information regarding cervical cancer, HPV vaccine availability and utility. These parents/guardians were then contacted three months later through telephone calls to evaluate subsequent HPV vaccine uptake. Data was analyzed using frequencies and percentages for categorical data while means and medians were used for continuous data. Tests of association of the different variables with vaccine uptake were determined using Chi square test or Fishers’ test.

Results: A total of 432 parents/caregivers participated in the study. Majority of them (94.7%) had heard about cervical cancer, 84.9% of them had heard about the HPV vaccine and 48% had heard about the free vaccination campaign. The main sources of information included health care workers (41.1%), television (39.6%), social media (30.5%), and radio (20.2%). Only 13.2%(n=57) of the participants reported their daughters had been vaccinated prior to this study with 86% of those vaccinated initiating vaccination following the sensitization campaign. Among those not vaccinated, 46% were not sure, 42% were planning to get vaccinated while 12% were not planning to take the vaccine. Factors associated with vaccine uptake included level of knowledge (p=< 0.001) and age of the parents (p=0.030). Reasons commonly cited for not taking the vaccine included lack of information (72.8%), lack of awareness (45.7%), safety concerns (13.2%) and concerns about affordability (6.9%). A total of 306 participants were followed up three months later and 9.2% (n=28) of them reported their daughters had been vaccinated.

Conclusion: The uptake of HPV vaccine is low in this study population and parental level of knowledge and age was associated with increased uptake of the vaccine. Majority of the population cited inadequate information regarding the HPV vaccine as a reason for non-uptake.

Included in

Pediatrics Commons