Cervical cancer, primarily caused by persistent infection with high-risk strains of the Human Papillomavirus (HPV), represents a significant public health burden in Nigeria. As a leading cause of cancer-related deaths among women, the introduction of the HPV vaccine is critical in reducing the incidence and mortality of cervical cancer. The HPV Vaccine Introduction (HPVVI) project, funded by GAVI, aimed to support the Nigerian government in the successful rollout of the HPV vaccine in seven phase 1 states—Abia, Anambra, Bayelsa, Benue, Enugu, Jigawa, Taraba—and the Federal Capital Territory (FCT). This initiative was implemented between March 2023 and February 2024, with a focus on ensuring that programmatic data was collected and managed effectively to support real-time decision-making and post-campaign monitoring.
Assessments/MEL/Data Management:
As part of Sydani’s technical support, we ensured that comprehensive data management systems were in place to accurately track and report the progress of the HPV vaccine introduction. During the campaign, data collection was conducted on a daily basis, with Technical Assistants stationed across the states to guarantee timely and precise reporting. Each day, vaccination data, including the number of girls vaccinated, doses administered, and any potential issues or AEFI cases, were gathered and uploaded into the central database.
Sydani worked closely with state health officials to provide capacity-building sessions aimed at strengthening their data management skills. This included training on data collection tools, ensuring adherence to data quality standards, and leveraging the District Health Information System 2 (DHIS-2) platform for seamless reporting during and after the campaign. Post-campaign, we continued to monitor and manage HPV vaccination data by ensuring that all states consistently reported routine immunization data through DHIS-2, thus enabling accurate tracking of vaccine coverage and impact over time.
Result:
The data management systems implemented as part of this project ensured that data was reported promptly and accurately, both during the HPV vaccination campaign and in the subsequent routine immunization period. Daily campaign data was systematically collected across all participating states, facilitating real-time decision-making and adjustments as necessary. Post-campaign, routine HPV vaccination data continued to be effectively reported on DHIS-2, contributing to sustained monitoring of vaccination efforts. This comprehensive approach to data management improved the ability of national and sub-national health authorities to track vaccine uptake and evaluate the overall impact of the HPV vaccine introduction, laying the foundation for an expanded rollout in subsequent phases.
Commodity Supply Chain Management:
Sydani played a key role in the coordination and management of the vaccine supply chain in collaboration with UNICEF. This included ensuring that adequate stocks of HPV vaccines were available in all states before the campaign launch date. We conducted vaccine forecasting to estimate the quantities required for both the campaign and routine immunization over the next three years, targeting the 9-14-year-old cohort.
Throughout the campaign, Sydani closely monitored vaccine stocks at both state and national levels, responding swiftly to any shortages. In cases where states faced vaccine stockouts, we worked directly with UNICEF’s national team to facilitate emergency transfers of additional vaccines to ensure uninterrupted vaccination efforts. Additionally, we coordinated the redistribution of vaccines from states with surplus supplies to those experiencing shortages, ensuring optimal vaccine utilization.
Result:
Sydani’s proactive approach to vaccine forecasting and distribution ensured that all states had sufficient vaccines to meet the demands of the campaign and routine immunization. Stockouts were swiftly addressed through timely coordination with UNICEF, and vaccines were redistributed as needed to maintain uninterrupted immunization efforts. The efficient supply chain management not only supported the smooth execution of the HPV campaign but also laid the groundwork for future vaccination needs, contributing to the long-term success of the program.
Demand Generation:
In collaboration with UNICEF, Sydani developed a comprehensive demand generation strategy to increase public awareness and drive HPV vaccine acceptance across the target states. Key actions included:
• Conducting a baseline study to assess the level of awareness and potential acceptance of the HPV vaccine across the eight states, which revealed low awareness just a month before the scheduled launch.
• Using the findings, Sydani engaged with national stakeholders, leading to a strategic decision to postpone the HPV vaccine launch by one month. This allowed for more time to implement targeted awareness campaigns and community sensitization efforts.
• Designing and producing a range of communication materials for various platforms, including social media, radio, TV, flyers, banners, and other educational, information, and communication (EIC) content tailored to the specific contexts of the states.
• Rolling out state-level awareness campaigns using local influencers, radio broadcasts, TV spots, and digital content to reach diverse audiences and improve public perception of the HPV vaccine.
This extended sensitization period helped to build trust in the vaccine and informed communities about its importance in preventing cervical cancer.
Result:
The comprehensive demand generation campaign successfully increased public awareness, contributing to the project’s success. The strategic delay in the vaccine introduction, coupled with the enhanced communication efforts, resulted in the project surpassing its vaccination targets. Public awareness of the HPV vaccine increased significantly, ensuring a higher level of acceptance and uptake during the campaign. This achievement highlighted the critical role of effective demand generation in meeting immunization goals and advancing public health objectives.
Research (Implementation & Operational):
As part of the effort to ensure a successful HPV vaccine rollout, Sydani conducted a research study across the eight states under its purview to assess the level of public awareness and the potential acceptance of the vaccine. The research was crucial to understanding public perceptions about the HPV vaccine in the lead-up to its introduction. The key actions involved:
• Designing and executing a comprehensive study to gauge awareness levels and the history of vaccine acceptance in the targeted states.
• The study revealed a critical finding: only 20% of the population in these states were aware of the upcoming HPV vaccine introduction just one month before the scheduled launch.
Based on these findings, Sydani engaged with national stakeholders, leading to the decision to delay the HPV vaccine launch by one month to allow for intensified sensitization efforts. This adjustment was crucial in bolstering public awareness and acceptance of the vaccine.
Sydani initiated also designed a protocol aimed at gathering lessons learned from the HPV vaccine introduction. This protocol was developed to guide future phases of vaccine rollouts and to inform policy and strategy adjustments for wider national implementation.
Result:
The research conducted by Sydani provided vital insights that informed the national decision to delay the vaccine introduction, giving states additional time for public sensitization and ensuring the campaign’s success. The heightened awareness contributed to the country exceeding its vaccination targets during the MAC campaign, validating the effectiveness of research-driven decision-making in public health interventions. Furthermore, the lessons learned through this research will guide future HPV vaccine introductions, ensuring more efficient planning and execution in subsequent phases.
