How can the uptake of HPV vaccination be increased in school going girls? a qualitative study with multiple stakeholders in Ganjam, Odisha.

Abstract

Objectives: Cervical cancer remains a significant public health challenge in low- and middle-income countries like India. Despite the efficacy of HPV vaccination, its uptake remains suboptimal. This qualitative study aimed to explore parental attitudes, knowledge, and decision-making regarding HPV vaccination for school-going adolescents in Ganjam, Odisha, to inform effective intervention strategies.

Methods: This qualitative study utilized semi-structured interviews, conducting Focus Group Discussions (FGDs), In-Depth Interviews (IDIs), and Key Informant Interviews (KIIs) of total 47 participants. Data were collected from December 2024 to January 2025 in Ganjam, Odisha. Data were analyzed using thematic analysis, aided by MAXQDA 2020 software.

Results: Five core themes emerged: Knowledge and Awareness Gaps (low awareness, confusion with other vaccines, information needs); Attitudes Towards HPV Vaccination (mixed institutional trust, accountability demands); Barriers to HPV Vaccination (cultural/social hesitancy, fear-driven hesitancy, individual and systemic barriers); Role of School Authorities (education and communication gaps); and Potential Collaborative Strategies (community engagement, policy and systems alignment). Participants showed positive sentiments towards trusted sources and community engagement, while negative sentiments were associated with fear, cultural norms, and systemic challenges.

Conclusions: HPV vaccine uptake is hindered by knowledge gaps, cultural/fear-driven hesitancy, and systemic barriers. Improving coverage and health literacy in resource-limited settings requires intensive communication, school-based education, paternal involvement, intersectoral collaboration, and policy changes, including UIP integration.