Community groups to increase Human papillomavirus (HPV) vaccination through Participatory Learning and Action, Reducing barriers and increasing community Mobilisation in Zambia (CHARMZ) project.

2020 ◽  
Author(s):  
Katarina Hoernke
Keyword(s):  
Cervical Cancer ◽  
Hpv Vaccination ◽  
Community Mobilisation ◽  
Structured Interviews ◽  
Community Based ◽  
Community Groups ◽  
Participatory Learning ◽  
Vaccination Uptake ◽  
Key Stakeholders ◽  
Participatory Learning And Action

Abstract Background Zambia has a high incidence of cervical cancer. Uptake of the human papillomavirus (HPV) vaccine has been low since it first became available in Zambia in 2013. Community mobilisation and engagement with civil society has been identified as a key component of HPV vaccination programs in low and middle-income countries. Of the evidence available on community-based interventions in the context of HPV, participatory approaches which work closely with local stakeholders to identify and overcome barriers to HPV vaccination uptake have shown promising results. This is a proposal for a community-based cluster randomised controlled trial to increase HPV vaccination uptake in Zambia through a participatory learning and action (PLA) cycle approach in community groups. PLA is an approach in which participants identify and prioritise problems, and subsequently develop, implement and evaluate solutions to improve the health needs of their community. Key stakeholders to be engaged in this project include government members, policymakers, healthcare, donors and relevant non-governmental organisations (NGO), religious leaders, and civil society members. Formative research will be carried out with key stakeholders through semi-structured interviews and focus group discussions. The community group intervention will be facilitated by local healthcare workers from the cervical cancer prevention program in Zambia (CCPPZ).Results Success will be indicated by an increase in HPV vaccination uptake. The primary outcome will be HPV vaccination rates measured quantitatively. Data will be gathered once at the start of the study, once midway through the PLA phase and once during the post-intervention phase. Questionnaires and semi-structured interviews will allow for measurement of secondary outcomes both quantitatively and qualitatively, including perceived (i) HPV vaccination and cervical cancer knowledge, (ii) acceptability, accessibility and equitability of the HPV vaccination, as well as (iii) attitudes of female group members towards other cervical cancer screening and treatment services.Conclusions There is a need to address the high cervical cancer disease burden in Zambia. This would be the first intervention aiming to increase HPV vaccination uptake in Zambia through a low-cost, sustainable and scalable community-based participatory learning and action cycle approach.

scholarly journals What works and why? Evaluation of a community nutrition programme in Kenya

2012 ◽  
Vol 16 (9) ◽  
pp. 1614-1621 ◽  
Author(s):  
Kirsten Havemann ◽  
Pat Pridmore ◽  
Andrew Tomkins ◽  
Kristine Dandanell Garn
Keyword(s):  
Child Survival ◽  
Intervention Programme ◽  
Community Based ◽  
Participatory Learning ◽  
Child Undernutrition ◽  
Participatory Learning And Action ◽  
Survival And Development ◽  
The Government ◽  
Nutritional Status Of Children ◽  
Nutrition Programme

AbstractObjectiveTo investigate the nutritional impact of a community-based programme that focused on social cohesion and action.DesignThe change in nutritional status of children aged 12–60 months was examined over a period of 3 years in Makueni District in Eastern Province of Kenya in six communities in which an intervention programme of Participatory Learning and Action was introduced and in ten communities in which only basic preparations were made but no intervention was started.SettingThe intervention was part of the Government of Kenya Community Based Nutrition Programme and was supported by the Government of Denmark.SubjectsChildren aged 12–60 months.ResultsAmong communities without intervention there were similar levels of underweight (mean Z-score: −1·63 v. −1·50 (NS); % with Z-score < –2: 36·6 % v. 34·5 % (NS)) and stunting (mean Z-score: −2·0 v. −1·99 (NS); % with Z-score < –2: 44·3 % and 47·4 % (NS)) at baseline and after 3 years. By contrast, among communities who had received interventions, there were significant improvements after 3 years in the levels of underweight (mean Z-score: −1·66 v. −1·37 (P < 0·02); % with Z-score < –2: 42·9 % v. 31·4 % (P < 0·035)) and stunting (mean Z-score: −2·05 v. −1·59 (P < 0·05); % with Z-score < –2: 52·7 % v. 39·7 % (P < 0·02)).ConclusionsThe results indicate considerable potential for using Participatory Learning and Action as a community-based approach to effectively address child undernutrition. It is suggested that these interventions are developed, implemented and evaluated more widely as a mean of tackling childhood undernutrition and improving child survival and development.

scholarly journals A community-based intervention in middle schools to improve HPV vaccination and cervical cancer screening in Japan

2014 ◽  
Vol 13 (1) ◽  
Author(s):  
Tomoko Ito ◽  
Remi Takenoshita ◽  
Keiichiro Narumoto ◽  
Melissa Plegue ◽  
Ananda Sen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Middle Schools ◽  
Cervical Cancer Screening ◽  
Hpv Vaccination ◽  
Community Based

scholarly journals Study protocol: Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047890
Author(s):  
Lisa J Whop ◽  
Tamara L Butler ◽  
Julia M L Brotherton ◽  
Kate Anderson ◽  
Joan Cunningham ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Torres Strait Islander ◽  
Hpv Vaccination ◽  
Immunisation Programme ◽  
Ethics Committee ◽  
Research Approach ◽  
Indigenous Research ◽  
Vaccination Uptake ◽  
School Based ◽  
Torres Strait

IntroductionAboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is delivered through the national school-based immunisation programme. While HPV vaccination uptake is high among Australian adolescents, there remain gaps in uptake and completion among Aboriginal and Torres Strait Islander adolescents. This study aims to gain a comprehensive understanding of the barriers and facilitators to HPV vaccination uptake and completion among Aboriginal and Torres Strait Islander adolescents in Queensland, Australia.Methods and analysisThe study will be guided by an Indigenist research approach and an ecological model for health promotion. Yarning, a qualitative Indigenous research method, will be conducted in up to 10 schools. Participants will include Year 7 (12/13 years old) Aboriginal and Torres Strait Islander adolescents; parents/caregivers; and local key informants and immunisation programme partners involved in the delivery of school-based HPV immunisation programme. Participants will be recruited through school representatives and investigator networks using purposive and snowball sampling and samples of convenience. Field notes, HPV vaccination clinic observations and sequential diagramming of the HPV vaccination process will be conducted. Thematic analysis of data will be led by Aboriginal and Torres Strait Islander researchers. Synthesised sequential diagrams of the process of HPV vaccination and qualitative themes summarising key findings will be produced.Ethics and disseminationThe Aboriginal Health and Medical Research Council of New South Wales Ethics Committee (1646/20), the Australian National University Human Research Ethics Committee (HREC, 2020/478), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (19-3484) and the Townsville Hospital and Health Service HREC (HREC/QTHS/73789) have approved the study. Dissemination will occur via conferences and peer-reviewed publications. Further dissemination will be determined in partnership with the Aboriginal and Torres Strait Islander Steering Committee, including Youth Representatives and Consultation Network.

scholarly journals Nurses’ and teachers’ perceived barriers and facilitators to the uptake of the Human Papilloma Virus (HPV) vaccination program in Iquitos, Peru: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255218
Author(s):  
Anna Clavé Llavall ◽  
Gilles de Wildt ◽  
Graciela Meza ◽  
Jasmine Tattsbridge ◽  
Laura Jones
Keyword(s):  
Cervical Cancer ◽  
Community Education ◽  
Ecological Model ◽  
Hpv Vaccination ◽  
Barriers And Facilitators ◽  
Vaccine Uptake ◽  
Vaccination Program ◽  
Papilloma Virus ◽  
Vaccination Uptake ◽  
Depth Interviews

Globally, over 300,000 women die of cervical cancer annually. Given that human papillomavirus vaccines are highly effective in the primary prevention of cervical cancer, it is important to explore the barriers and facilitators to vaccination uptake in areas where the burden of disease remains high. This study, informed by the socio-ecological model, aimed to qualitatively explore vaccination uptake via in-depth interviews with eleven nurses and ten teachers involved in vaccine delivery in Iquitos, Peru. The results highlighted that vaccine uptake was influenced by multiple factors including individuals’ knowledge and attitudes, community beliefs, geography, and policy level variables. Findings suggested that professionals were informed and supportive of the HPV vaccination program but perceived that parents were uninformed about the vaccine. There is a need for community education programs, for a revision of the process of obtaining parental consent, for improved communication between professionals and for involvement of grassroots staff in policy making.

scholarly journals Evaluation of a School-Based Cervical Cancer Vaccination Awareness Initiative

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 136s-136s
Author(s):  
O. James ◽  
O. Onigbogi ◽  
I. Okoye
Keyword(s):  
Cervical Cancer ◽  
Quantitative Methods ◽  
Hpv Vaccination ◽  
Effective Strategy ◽  
Hpv Vaccines ◽  
Nigerian Women ◽  
Vaccination Uptake ◽  
School Aged Children ◽  
Out Of Pocket Payments ◽  
School Heads

Background and context: Cervical cancer is the second most commonly-diagnosed cancer among Nigerian women, even though it is one of the most highly-preventable cancers. Worldwide, this most populated country in Africa ranks 10th in terms of cervical cancer mortality and 7 of every 10 Nigerian women diagnosed with cervical cancer annually die annually. With about 47.72 million women aged 15 years and above who are at risk for cervical cancer and median age of first sexual intercourse being 16 years, there is a huge opportunity to prevent cervical cancer deaths through HPV vaccination. Unfortunately, Nigeria has been unable to access GAVI funding for implementation of country-wide HPV vaccination. Hence, most of the HPV vaccination has been by the private sector, NGOs/CSOs and through out-of pocket payments. In spite of this, uptake of HPV vaccines have been reported to be as low as 8% in some studies. Aim: To determine the barriers to uptake of HPV vaccination among mothers of school-age children and opportunities to increase the uptake from the perspective of mothers. Strategy/Tactics: Use qualitative and quantitative methods to gather relevant information about HPV vaccination uptake from all stakeholders including school heads, teachers, school nurses, mothers/guardians and school associations. Program/Policy process: Through funds provided by the American Cancer Society (ACS) and GlaxoSmithkline, Nigeria, we had a one-day HPV vaccination awareness program targeted at school heads, distributed HPV vaccination consent forms, followed-up with awareness in school PTA meetings, gathered data through questionnaires, FGD and KII after a year to determine project effectiveness. Outcomes: Increased understanding of motivators and demotivating factors of HPV vaccination uptake among mothers of school-aged children, increased understanding of strategies to increase uptake and identification of allies in HPV vaccination advocacy. What was learned: 1. There is a need for consistent, “360 campaign” about HPV vaccination as an effective strategy for prevention of cervical cancer targeted at mothers. 2. Since government at federal and state level is unable to access GAVI funding for HPV vaccination, they do have a role to play in validating the effectiveness and safety of HPV vaccines, as well as the efforts of CSOs and NGOs to encourage parents to consent to HPV vaccination for their children. 3. Working in partnership with school associations could be an effective strategy to increasing HPV vaccination uptake among school-aged children. 4. Female teachers are viable advocates for increasing HPV vaccination uptake in schools, if their knowledge is increased and advocacy tools are provided. 5. There is a possibility that reluctance by the government to incorporate awareness of HPV vaccination into its cervical cancer prevention programs is due to its inability to meet the anticipated demand for free HPV vaccination.

scholarly journals Knowledge and acceptance of HPV vaccination and its associated factors among parents of daughters in Addis Ababa, Ethiopia: a community-based cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nebiyu Dereje ◽  
Abigia Ashenafi ◽  
Anteneh Abera ◽  
Efrata Melaku ◽  
Kaleb Yirgashewa ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Hpv Vaccine ◽  
Addis Ababa ◽  
Hpv Vaccination ◽  
Negative Attitude ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Study Participants ◽  
Knowledge And Acceptance

Abstract Background Cervical cancer is one of the most diagnosed and deadly cancers in women globally. Though vaccination is an effective way to reduce cervical cancer, people’s knowledge and acceptance of the vaccination remains a challenge in low and middle-income countries. Therefore, the aim of this study was to assess the level of knowledge and acceptance of Human Papilloma Virus (HPV) vaccination and its associated factors among parents of daughters in Addis Ababa, Ethiopia. Methods A community-based cross-sectional study was conducted among parents or guardians whose daughters are in the age group of 9–17 years and residing in Akaki-Kalty sub-city in Addis Ababa. A multistage sampling technique was used to select the study participants (n = 430). Face-to-face interview was conducted by using a structured questionnaire. Factors associated with the acceptance of HPV vaccination was identified by multivariable binary logistic regression and expressed by adjusted odds ratio (aOR), and respective 95% confidence interval. Results Complete response was obtained from 422 (98.1%) of the participants and their mean age was 39.0 years (SD ± 9.9). Out of the study participants, 41.7% and 72.0% had poor knowledge on cervical cancer and HPV, respectively. More than a quarter (27.0%) of the participants has never heard about HPV vaccine. One-third (36.5%) of the participants had negative attitude towards the HPV vaccine. Overall, 94.3% of the study participants were willing to vaccinate their daughters for HPV. Vaccine acceptability was associated with higher monthly income (aOR = 2.48, 95% CI 1.08–6.34), good knowledge on HPV (aOR = 2.32, 95% CI 1.56–4.87) and the vaccine (aOR = 2.24, 95% CI 1.12–8.60), and positive attitude towards the vaccine (aOR = 5.03, 95% CI 1.63—9.56). Conclusions The overall HPV vaccine acceptance was high. However, two out of five and one-thirds of the parents had poor knowledge on cervical cancer and negative attitude towards the HPV vaccine, respectively. Higher monthly income, good knowledge on HPV and the vaccine, and positive attitude towards the vaccine were associated with acceptance of HPV vaccination. To ensure sustainable acceptance of HPV vaccination, it is crucial to increase the community awareness in a sustainable manner.

scholarly journals Using Participatory Learning and Action in a Community-Based Intervention to Prevent Violence Against Women and Girls in Mumbai’s Informal Settlements

2020 ◽  
Vol 19 ◽  
pp. 160940692097223
Author(s):  
Proshant Chakraborty ◽  
Nayreen Daruwalla ◽  
Apoorwa Deepak Gupta ◽  
Unnati Machchhar ◽  
Bhaskar Kakad ◽  
...  
Keyword(s):  
Violence Against Women ◽  
Informal Settlements ◽  
Development Programs ◽  
Access To Services ◽  
Community Based ◽  
Collaborative Process ◽  
Participatory Learning ◽  
Participatory Learning And Action ◽  
Women And Girls ◽  
Violence Prevalence

For over 3 decades, participatory learning and action (PLA) techniques have been prominent in formative and evaluative studies in community-based development programs in the Global South. In this paper, we describe and discuss the use of PLA approaches at the beginning of a community-based program for prevention of violence against women and girls in Mumbai’s urban informal settlements. We adapted six PLA techniques as part of a formative community mobilization and rapid needs assessment exercise, addressing perceptions of violence prevalence, sources of household conflict, experiences of safety and mobility, access to services, preferences for service and support, and visualization of an ideal community free from violence. We describe the collaborative process of developing and implementing PLA techniques and discuss its relevance in generating contextual and grounded understandings of violence as well as in identifying factors which can potentially enable and constrain interventions.

scholarly journals Sustainability of community-based women’s groups: reflections from a participatory intervention for newborn and maternal health in Nepal

2018 ◽  
Vol 54 (4) ◽  
pp. 731-749 ◽  
Author(s):  
Annemijn E C Sondaal ◽  
Kirti M Tumbahangphe ◽  
Rishi Neupane ◽  
Dharma S Manandhar ◽  
Anthony Costello ◽  
...  
Keyword(s):  
Leadership Capacity ◽  
External Support ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Participatory Learning ◽  
Participatory Learning And Action ◽  
Local Embeddedness ◽  
Group Members

Abstract Participatory community-based women’s group interventions have been successful in improving maternal and newborn survival. In rural Makwanpur, Nepal, exposure to these Participatory Learning and Action groups resulted in a thirty-percent reduction in neonatal mortality rate and significantly fewer maternal deaths. It is often theorised that participatory approaches are more likely to be sustained than top-down approaches, but this is rarely evaluated after the withdrawal of external support. We sought to understand how participatory learning and action (PLA) groups in Makwanpur fared after the supporting non-governmental organisation withdrew their support as well as factors affecting their sustainability. We used mixed methods, conducting a cross-sectional survey of 239 groups, thirty focus group discussions with group members and thirty key informant interviews within twelve–seventeen months after support was withdrawn. Eighty percent of groups were still active which suggests that PLA groups have a high chance of being sustained over time. Groups were more likely to be sustained if the group had local importance and members continued to acquire new knowledge. However, the participatory nature of the group and local embeddedness were not enough to sustain all groups. They also needed leadership capacity, a unifying activity such as a fund, and a strong belief in the value of their meeting to sustain. These key factors should be considered when seeking to enable sustainability of participatory interventions.

scholarly journals Describing the end-of-life doula role and practices of care: perspectives from four countries

2020 ◽  
Vol 14 ◽  
pp. 263235242097322
Author(s):  
Marian Krawczyk ◽  
Merilynne Rush
Keyword(s):  
End Of Life ◽  
Small Body ◽  
The United States ◽  
International Perspective ◽  
Structured Interviews ◽  
Community Based ◽  
The United Kingdom ◽  
Key Stakeholders ◽  
New Information ◽  
Global North

Background: End-of-life doulas are emerging as a potentially important new form of community-based caregiving in the global North, yet we know little about this form of care. The aim of our study was to solicit the perspective of key stakeholders and early innovators in community-based end-of-life care about the development and practices of end-of-life doulas. Methods: We conducted 22 semi-structured interviews with participants in four countries where end-of-life doulas are most active: Australia, Canada, the United States, and the United Kingdom. Findings: This article focuses on participants’ description of the end-of-life doula role and attendant practices, and our findings provide the first detailed taxonomy of the end-of-life doula role and specific services on the basis of the perspective of subject experts in four countries. We situate our findings within literature on the professionalization of caregiving, with particular attention to nomenclature, role flexibility and boundary blurring, and explicit versus tacit knowledge. We also discuss the importance of jurisdictional considerations as the end-of-life doula movement develops. Discussion: We speculate that the end-of-life doula role is potentially experiencing common developmental antecedents similar to other now-professionalized forms of caregiving. Our findings contribute substantial new information to the small body of empirical research about the end-of-life doula role and practices, provide critical firsthand insight as the movement develops, and are the first research to explore end-of-life doulas from a comparative international perspective.

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