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
7 affiliations
- 1Analytics and Implementation Research Team, Clinton Health Access Initiative, Boston, Massachusetts, United States of America
- 2Clinton Health Access Initiative, Tsinga Sous-Prefecture, Yaoundé, Cameroon
- 3Global Vaccines Delivery Team, Clinton Health Access Initiative, Boston, Massachusetts, United States of America
- 4Expanded Program on Immunization, Messa, Yaoundé, Cameroon
- 5School of Global Health and Bioethics, Euclid University, Bangui, Central African Republic
- 6Institute for Global Health, University of Siena, Siena, Italy
- 7Department of Environmental and Global Health, College of Public Health & Health Professions, University of Florida, Gainesville, Florida, United States of America
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.
Related
- Epidemiology of animal bites and post-exposure vaccination coverage in Davao City, Philippines: A five-year retrospective cohort study, 2019–2023
- Cost-effectiveness and budget impact analyses of strategies to improve measles vaccination coverage in Kenya
- Small Quantity Lipid-Based Nutritional Supplementation and Measles Vaccination Coverage in Children Aged 6-23\,Months: A Pragmatic Cluster-Randomized Trial
- Assessing a local vaccination initiative: Eight years of “Immuniser Lyon” in France
- Assessing the Capacity of Health Facilities to Deliver Concomitant HPV Vaccination and HPV-Based Cervical Screening Services to Vulnerable Populations – An Implementation Research Protocol
BibTeX
@article{griffith2026assessing,
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}},
author = {Bridget C. Griffith and Shariffatou Iliassu and Clarence Mbanga and Budzi Michael Ngenge and Sonali Patel and Justin C. Graves and Navpreet Singh and Shalom Ndoula and Andreas Ateke Njoh and Efouba Gisele and Shadrack Mngemane and Tosin Ajayi and Laure-Anais Zultak and Yauba Saidu},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0006349},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006349},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - 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
AU - Bridget C. Griffith
AU - Shariffatou Iliassu
AU - Clarence Mbanga
AU - Budzi Michael Ngenge
AU - Sonali Patel
AU - Justin C. Graves
AU - Navpreet Singh
AU - Shalom Ndoula
AU - Andreas Ateke Njoh
AU - Efouba Gisele
AU - Shadrack Mngemane
AU - Tosin Ajayi
AU - Laure-Anais Zultak
AU - Yauba Saidu
PY - 2026
DA - 2026/09/09
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0006349
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0006349
AB - 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.
SN - 2767-3375
ER -