By Gatonye Gathura
Lack of parental support, especially from mothers was the main cause of poor uptake of the first ever free cervical cancer vaccine in Kenya.
A report published on 11th May 2018 shows of the 3,000 girls in the piloting, 63 per cent went for the second dose but only 40 per cent took the third and final dose.
The pilot project was carried out between May 2012 and March 2013 among school girls aged 9 to 14 from primary schools in Eldoret town.
The final report says teachers and parents especially mothers could have done more to support the girls to take the three recommended doses.
Of the 3,000 girls taking part in the pilot, only three had both parents with 2,154 or 72 per cent having a female parent alone while 843 had a male parent only.
The study reports that girls with a male parent only were more likely to take up to the third dose compared to girls with a female parent alone.
“We would have expected higher compliance with girls living with mothers but instead found male parents more likely to have their girls achieving the whole dose,” says the report.
The researchers from Moi University, Eldoret and Ghent University, Belgium, also attribute the low vaccine uptake to poor teacher knowledge and distance to the vaccination center.
The vaccine was offered at the Moi Teaching and Referral Hospital, Eldoret.
Parents, caretakers and teachers, the report says had poor understanding of cervical cancer and linked it with modern lifestyle and wayward sexual behaviour.
Few of the parents, the report says had heard about the vaccination opportunity and felt uncomfortable discussing cervical cancer.
“Teachers needed support from health care workers to address questions from parents and there was distrust towards the vaccine.”
The pilot was supposed to inform policy on the future national roll out of cervical cancer vaccine in Kenya.
Based on the poor turnout in Eldoret, the ministries of health and education in 2013 carried out another pilot in Kitui County.
To overcome the problem of travelling to the health facility experienced in Eldoret, for Kitui it was decided the vaccinations be carried out within the schools.
A report of the Kitui pilot by the Ministry of Health to the donors, Global Alliance for Vaccines and Immunisation (Gavi) showed it to have had huge success reaching more than 86 per cent of the targeted girls.
However, the report had described the cost of reaching each girl in school to be too high and unsustainable for a national roll out.
The compounded cost of delivering the vaccine through schools to each girl was put at Sh 4,600 ($44.77) but described as too much to sustain in a national programme.
“This was deemed as not sustainable if rolled out as a national programme,” the project team wrote to GAVI.
During the International Childhood Cancer Day on February 15 this year, the head of the National Vaccines and Immunisation Programme Dr Collins Tabu, said the national rollout for the cancer vaccine will be done in 2019.
Dr Tabu said the vaccine will target 2.4 million girls aged 9 to 14 countrywide at no cost. This time around the vaccine will be carried out within the schools.
But unlike in Eldoret where the girls were getting three doses the national rollout will involve two doses in a process recommended by the World Health Organisation.
But this has been debatable with arguments that in areas of high malaria and worm infections three doses would offer better protection.
Some facts on cervical cancer
- 530,000 incidents worldwide annually
- 260,000 deaths annually
- 2nd most frequent cancer among women in Kenya.
- 2500 annual incidents in Kenya and about 1500 deaths
- Three vaccines available Gardasil 4, Gardasil 9 and Cervirax
- Fist piloting in Kenya done in Eldoret among 3000 girls in 2011/12
- Second piloting done in Kitui County in 2013 among 20,000 girls
- National roll-out planned for 2019 involving two dose vaccine