Factors influencing parental acceptance of human papillomavirus vaccine to their daughters aged 9 to 13 years; case study: Nakawa division, Kampala district, central Uganda

Abstract

Background: The World Health Organization recommends routine vaccination of girls aged 9 to 13 years to prevent Human Papilloma Virus (HPV) infections and related diseases. This is because girls in this age bracket are thought to be less sexually active and having a better immune response to the vaccination. Ministry of Health in Uganda made HPV vaccination available and free of charge for all eligible categories of the population. Despite availability of the free HPV vaccination in the country, available research evidence shows low HPV vaccination coverage for the eligible girls with unclear reasons for parental rejection of the vaccine. This study assessed factors influencing acceptance of HPV vaccination among parents of children aged 9-13 years in Nakawa division, Kampala Capital City. Methods: A cross- sectional study using quantitative methods of data collection and analysis was employed. A sample of 384 mothers of girls aged 9 -13 years from Nakawa divisions Kampala capital city were interviewed after informed consent. Results: More than half of the parents, 224 (58.3%) who participated in the study had accepted the HPV vaccination for their children. The major factors related to acceptance of HPV vaccination among the parents included: Parental age; parents aged 35 years and below had higher odds of HPV vaccination acceptance than those above 45 years (AOR=5.911; 95.0% CI: 3.214-10.868; p<0.001), health facilities where parents were recruited from; parents recruited from Naguru hospital were twice as likely to accept HPV vaccine for their children compared to parents from Kiswa HC III (AOR=2.098, 95.0% CI: 1.238- 3.555, p=0.006). Parents affiliated to Catholic (AOR=0.026, 95.0% CI: 0.004-0.191, p<0.001) and Protestant (AOR=0.011, 95.0% CI: 0.001- 0.084, p<0.001) faiths were significantly less likely to accept HPV vaccine compared to parents who were Pentecostal. Parents who believed that the HPV vaccine was safe were 6 times more likely to accept HPV vaccination than parents who did not believe that the vaccine was safe for their children (AOR= 6.11, 95.0% CI: 1.783-21.000, p=0.004). Conclusions: There was low level of HPV vaccine acceptance among parents with just over half of the parents who participated in the study accepting HPV vaccination. Personal factors of age, religious affiliations, reading or hearing information about importance of HPV vaccine, and believing that knowledge about HPV vaccine was helpful coupled with institutional factors such as health facilities and safety of the HPV vaccine were the major factors influencing acceptance of HPV vaccination among the parents. Recommendations: Therefore, it was recommended that the Ministry of Health should consider integrating HPV vaccination in the current immunization cards as this would serve as a vital reminder for parents to bring back their daughters for HPV vaccination at age 9 years and for health workers for emphasis during routine immunization.