Behavioral and Social Drivers of HPV Uptake among Out-of-School Adolescent Girls in Selected Regions of Ethiopia

Project Overview

Cervical cancer, primarily caused by Human Papillomavirus (HPV), remains one of the most deadly cancers affecting women in Ethiopia. Despite the introduction of the HPV vaccine in 2018 for girls, uptake remains critically low, especially among out-of-school adolescent girls in underserved populations.
To address this gap, this project investigates the behavioral and social factors influencing the uptake of the Human Papillomavirus (HPV) vaccine among out-of-school adolescent girls aged 9–14 in Ethiopia’s Afar, Somali, Gambella, and Benishangul-Gumuz regions.
Led by EHEPA in collaboration with UNICEF Ethiopia, this study aims to generate actionable insights to improve vaccine demand, delivery, and equity.

Objectives

 To determine the prevalence of HPV vaccine uptake among out-of-school adolescent girls aged 9–14 years.
 To examine levels of confidence in HPV vaccine safety and benefits among parents/caregivers.
 To identify behavioral and social drivers (motivation, risk perception, trusted sources, decision-making autonomy) influencing HPV vaccine uptake.
 To explore structural and service delivery factors (availability, consent procedures, documentation, access points) affecting HPV vaccination
 To analyze factors significantly associated with HPV vaccine uptake and parental confidence

Conceptual Framework

The study is guided by the WHO & UNICEF Behavioral and Social Drivers (BeSD) of Vaccination Framework, which examines:

 Thinking & Feeling: Awareness of HPV and HPV vaccine, perceived disease risk,
vaccine confidence, including perceived benefit, safety, and trust.

 Social norms/processes: Influence of family, peer, religious leaders, teachers, health
workers’ recommendations, and gender norms

 Motivation: Intention to receive recommended vaccines (girls) and Intention to vaccinate
(parents/caregivers) and decision-making autonomy.

 Practical Issues: Availability, affordability, ease of access, satisfaction, service quality,
and respectful treatment by health workers.

Regions Covered: Afar, Somali, Gambella, Benishangul-Gumuz

These dimensions collectively shape vaccine uptake and inform targeted strategies to improve demand and delivery.

Study Outcomes:

 Quantitative data have been conducted using KOBO tool box from June to August, 2025.
 The data were carefully imported, cleaned, and checked for completeness and accuracy and analyzed using STATA version 17.
 The key findings have been documented and presented using clear narration, tables and graphs.
 A virtual seminar has been delivered by the project officer and co-investigator addressing the key findings of this study during the 37th seminar organized by EHEPA https://ehepa.org/seminar
 Based on the finalized report, two manuscript has been prepared to publish the study findings.

Funding & Collaboration

This project is generously funded by UNICEF Ethiopia and ethically approved by the Ethiopian Public Health Association (EPHA) Institutional Review Board. It reflects EHEPA’s commitment to advancing Adolescent Sexual and Reproductive Health, equity, and evidence-based public health promotion through evidence generation.