The Ministries of Health, Education, Gender and Local government have committed to improving the coverage of the Human Papillomavirus (HPV) vaccine in Uganda. This was at the National Symposium for Multi-Sectoral Stakeholders' renewed commitment towards increasing HPV Vaccination coverage, that was held at the Golf Course Hotel in Kampala.
The essence of this commitment is to revitalize the engagement between the four Ministries namely: Health, Education and Sports, Gender and Local government and renew commitment and advocacy for HPV at both the national and sub-national levels.
Prior to the symposium, the Ministry of Health (MoH) through the Uganda National Expanded Program on Immunization (UNEPI) oriented a team of national supervisors on the revised HPV delivery strategy, assigned district teams to ensure effective oversight and tasked each team to implement activities geared at increasing and sustaining uptake of the second dose of HPV (HPV2) in all districts.
UNEPI will further ensure that all materials including the revised HPV delivery guide, school health register, health facility plan, Information, Education and Communication materials used to sensitize the public are in place.
The State Minister of Education and Sports, Hon Charles Bakabulindi represented the First Lady of the Republic of Uganda as Guest of Honour at the event. He highlighted the need for a multisectoral approach to tackle cervical cancer saying, "the Ministry of Education and Sports will support the Ministry of Health in sensitization and rallying schools to ensure the children are immunized against HPV."
Hon Bakabulindi further called on health workers to reach out to the patients and not wait for the patients to approach them for services. This, he said, would improve on the disease prevention targets in the country.
In the same spirit, the Minister of State for Health in Charge of General Duties Hon Sarah Opendi reiterated Hon Bakabulindi's words on a multisectoral approach noting that MoH requires assistance from other sectors to improve HPV immunization coverage. "Ministry of Education can help with advocacy, Gender with approaching mothers and the local government to convene the locals," she said.
However, Hon Opendi decried the misinformation regarding the vaccine and called on local leaders to tackle the issue.
The World Health Organization (WHO) was represented by Dr Annet Kisakye, the Immunization Focal person, who said that, globally, the East African region carries the highest burden of cervical cancer. She further mentioned that Uganda is among the five countries with the highest rates in Africa with 8 out of every 10 women seen at the Uganda Cancer Institute suffering from cervical cancer.
Dr Kisakye enumerated various avoidable risk factors that predispose women to cervical cancer including early marriages, multiple sexual partners, multiparity, sexually transmitted illnesses including HIV infection, tobacco use, vitamin deficiency and of course HPV infection.
In November 2015, Uganda introduced HPV vaccine in its immunization schedule in all districts. However, coverage of the second dose has remained low after three years since introduction. HPV was introduced as a routine vaccine to be delivered during every static and outreach immunization sessions but intensified through Integrated Child Health Days during the months of April and October where health workers conduct school-based outreaches.
Yet, the observed practice is that primarily only the first dose of HPV is administered during April with a few second doses administered subsequently. In October both the first and second doses were provided. During the other months of the year, very little HPV-1 and 2 were administered. As of December 2017, annualized coverage of HPV1 was at 85% and HPV2 was at 41% according to the District Health Information System (DHIS 2), indicating the need for increased coverage to improve HPV2 uptake.