{
  "abstract": "Cameroon introduced the human papilloma virus vaccine (HPVV) into the routine immunization schedule in October 2020. By the end of 2022, coverage remained low. To increase coverage, Cameroon switched to a country-wide, gender-neutral vaccination (GNV) approach in 2023, coupled with a revamped delivery strategy of Community Dialogues (CDs) and Periodic Intensification of Routine Immunization (PIRIs) activities in selected health districts (HDs). We assessed the impact of these programmatic changes, notably the GNV approach, on HPVV coverage. This retrospective, cross-sectional study measured the effect of GNV and CDs+PIRIs on HPVV coverage among 9-year-old girls in Cameroon (2022–2023). Data on HPV vaccination from all 203 HDs were extracted from DHIS2, and coveragecalculated at the HD level based on the estimated population eligible of 9-year-old girls. Descriptive statistics and multiple regression models were employed to assess the impact of GNV on vaccination coverage, while adjusting for CDs+PIRIs, baseline (2022) coverage, region, urban/rural status. In 2023, of the 203 HDs, 115 (56.7%) conducted GNV only and 74 (36.5%) implemented GNV & CDs+PIRIs. Among age-eligible girls, there was an overall increase in HPV vaccination coverage, with coverage rising 39.2 percentage points from 2022 to 2023. Following multiple linear regression, there was a significant association between percentage point increase in HPVV coverage in HDs with GNV & CDs+PIRIs, compared to those with no GNV and no CDs+PIRIs in the adjusted model (β:44.5, 95%CI: 29.4, 59.6, p < 0.001). Furthermore, there was a significant association between increase in HPVV coverage in HDs with GNV only compared to those with no GNV or no CDs+PIRIs in the adjusted model (β:15.5, 95%CI: 1.23, 29.8 p < 0.001). Overall, the GNV approach was associated with an increase in HPVV coverage for girls, with greater magnitude and predicted precision when implemented alongside CDs+PIRIs.",
  "abstract_shown": true,
  "affiliations": [
    "Analytics and Implementation Research Team, Clinton Health Access Initiative, Boston, Massachusetts, United States of America",
    "Clinton Health Access Initiative, Tsinga Sous-Prefecture, Yaoundé, Cameroon",
    "Global Vaccines Delivery Team, Clinton Health Access Initiative, Boston, Massachusetts, United States of America",
    "Expanded Program on Immunization, Messa, Yaoundé, Cameroon",
    "School of Global Health and Bioethics, Euclid University, Bangui, Central African Republic",
    "Institute for Global Health, University of Siena, Siena, Italy",
    "Department of Environmental and Global Health, College of Public Health & Health Professions, University of Florida, Gainesville, Florida, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Bridget C. Griffith"
    },
    {
      "affs": [
        1
      ],
      "name": "Shariffatou Iliassu"
    },
    {
      "affs": [
        2
      ],
      "name": "Clarence Mbanga"
    },
    {
      "affs": [
        3
      ],
      "name": "Budzi Michael Ngenge"
    },
    {
      "affs": [
        4
      ],
      "name": "Sonali Patel"
    },
    {
      "affs": [
        5
      ],
      "name": "Justin C. Graves"
    },
    {
      "affs": [
        6
      ],
      "name": "Navpreet Singh"
    },
    {
      "name": "Shalom Ndoula"
    },
    {
      "name": "Andreas Ateke Njoh"
    },
    {
      "name": "Efouba Gisele"
    },
    {
      "name": "Shadrack Mngemane"
    },
    {
      "name": "Tosin Ajayi"
    },
    {
      "name": "Laure-Anais Zultak"
    },
    {
      "name": "Yauba Saidu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/er4a7s2nfstj5.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pgph.0006349",
  "fulltext_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006349",
  "id": "er4a7s2nfstj5",
  "issns": [
    "2767-3375"
  ],
  "landing_url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006349",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Cervical Cancer and HPV Research"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Vaccination and immunization"
    ],
    [
      "plos",
      "/Earth sciences/Geography/Economic geography/Low and middle income countries"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Vaccination and immunization"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Infectious disease control/Vaccines"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Sexually transmitted diseases/Human papillomavirus infection"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/Human papillomavirus infection"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Gynecological tumors/Cervical cancer"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Preventive medicine/Vaccination and immunization"
    ],
    [
      "plos",
      "/Medicine and health sciences/Urology/Genitourinary infections/Human papillomavirus infection"
    ],
    [
      "plos",
      "/People and places/Geographical locations/Africa/Cameroon"
    ],
    [
      "plos",
      "/Physical sciences/Mathematics/Statistics/Statistical methods/Regression analysis/Linear regression analysis"
    ],
    [
      "plos",
      "/Research and analysis methods/Mathematical and statistical techniques/Statistical methods/Regression analysis/Linear regression analysis"
    ],
    [
      "plos",
      "/Social sciences/Economics/Economic geography/Low and middle income countries"
    ],
    [
      "plos",
      "/Social sciences/Economics/Finance"
    ]
  ],
  "openalex": "W7212004515",
  "pdf_url": "https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0006349&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-09",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/er4a7s2nfstj5.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:56Z",
      "native_id": "10.1371/journal.pgph.0006349",
      "source": "plos",
      "url": "https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006349"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
    },
    {
      "field": "mathematics",
      "origin": "plos:statistical methods",
      "subfield": "statistics"
    },
    {
      "field": "medicine",
      "origin": "plos:infectious diseases",
      "subfield": "infectious-disease"
    }
  ],
  "title": "Assessing the impact of a gender-neutral approach to HPV vaccination on vaccination coverage for nine-year-old girls in Cameroon: A retrospective, cross-sectional study",
  "title_text": "Assessing the impact of a gender-neutral approach to HPV vaccination on vaccination coverage for nine-year-old girls in Cameroon: A retrospective, cross-sectional study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:56Z",
  "url": "https://research.draconitic.com/paper/er4a7s2nfstj5",
  "venue": "PLOS Global Public Health",
  "versions": []
}