ASSESSING THE IMPACT OF PUBLIC HEALTH CAMPAIGNS ON THE UPTAKE OF HPV VACCINATION IN NIGERIA

CHAPTER ONE INTRODUCTION 1.1 Background of the Study Cervical cancer remains the most common form of cancer associated with the Human Papillomavirus (HPV). Globally, it accounts for approximately 500,000 new cases and 273,000 deaths each year (World Health Organization [WHO], 2022). A large percentage—up to 80%—of these new cases are recorded in developing countries like Nigeria. Without proper intervention, this number is expected to continue rising. In high-income nations where structured, population-wide screening programs for cervical precancerous conditions have been implemented, the incidence of cervical cancer has been reduced by 80%. Unfortunately, this success has not been replicated in many low- and middle-income countries due to limited budgets and competing healthcare priorities. Cervical cancer is a major contributor to cancer-related deaths among women worldwide, with the majority of cases occurring in less affluent regions, and it is predominantly caused by HPV (WHO, 2022). Nigeria, in particular, has one of the highest cervical cancer rates in Sub-Saharan Africa. Yet, due to a range of barriers—including logistical issues, cultural constraints, and financial challenges—many women lack access to preventive healthcare services (Adewole et al., 2020). Clinical research has shown that widespread HPV vaccination can considerably reduce the incidence of both cervical and other HPV-related cancers, thus making it a highly effective preventive measure (Dunne & Park, 2021). However, the rate of HPV vaccination in Nigeria remains significantly low, raising concerns about the effectiveness of public health strategies and the challenges hindering vaccine adoption (Ugwu et al., 2019). Public health campaigns are pivotal in improving health outcomes by raising awareness, combating misinformation, and promoting healthy behaviors. Although several campaigns have aimed at increasing HPV vaccine awareness in Nigeria, their success is influenced by factors such as how messages are communicated, the media platforms used, and the campaign structure. Studies show that HPV awareness in Nigeria, especially in rural areas with limited healthcare access, is still very poor despite efforts by various health organizations (Okeke et al., 2020). According to Anyanwu and Okonkwo (2020), this awareness gap suggests that public health campaigns need to be evaluated and possibly revised to better connect with diverse demographic groups and address cultural sensitivities surrounding the vaccine. Cultural values and societal norms strongly influence health-related behaviors in Nigeria, particularly regarding attitudes towards vaccines. HPV vaccination is often misinterpreted as encouraging early sexual activity in young girls, which contradicts the deeply held beliefs of many Nigerian communities (Eze et al., 2021). Religious and community leaders play a crucial role in shaping public opinion, and their endorsement—or lack thereof—can significantly affect vaccine uptake (Okafor & Ume, 2019). Research has shown that when community leaders actively support vaccination initiatives, trust in and acceptance of these programs tend to improve, highlighting the importance of inclusive, culturally-sensitive health interventions (Ibrahim et al., 2018). Another key challenge to HPV vaccine uptake in Nigeria is vaccine hesitancy, a global issue worsened by myths and misinformation. Vaccine hesitancy has consistently undermined public health efforts, with false beliefs about vaccine safety and efficacy contributing to low vaccination rates (Fadeyi et al., 2022). In a country like Nigeria, where access to credible information is limited, misinformation about HPV vaccines can spread rapidly, discouraging people from getting vaccinated (Anyanwu & Okonkwo, 2020). To improve vaccine acceptance, public health efforts must transparently and actively counter these myths (WHO, 2022). Additionally, healthcare professionals play a crucial role in advocating for HPV vaccination. Trusted by the public as reliable sources of medical advice, their recommendations are among the most persuasive motivators for vaccination (Ugwu et al., 2019). Nonetheless, Nigerian healthcare workers often face obstacles such as limited knowledge about HPV-related diseases and inadequate resources to support widespread vaccination campaigns (Adewole et al., 2020). Strengthening their capacity through targeted training and support could significantly enhance the success of public health campaigns. Given the high prevalence of HPV-related illnesses in Nigeria, it is vital to evaluate how effective public health campaigns are at improving HPV vaccine coverage. 1.2 Statement of the Problem HPV poses a significant public health challenge due to its link to several forms of cancer, particularly cervical cancer, which continues to be a leading cause of cancer-related deaths among women in countries like Nigeria (WHO, 2022). Despite the proven effectiveness of the HPV vaccine in preventing such cancers, the vaccination rate in Nigeria remains critically low. Public health campaigns are essential for raising awareness, dispelling myths, and encouraging vaccine uptake. However, there is limited understanding of how effective these campaigns have been in reaching target audiences and boosting vaccination rates in Nigeria (Eze et al., 2021). Several obstacles—including inadequate public awareness, entrenched cultural beliefs, and logistical challenges—hinder the success of these initiatives (Anyanwu & Okonkwo, 2020). Furthermore, social and religious factors contribute to misinformation and vaccine hesitancy, affecting public perception and acceptance of the vaccine (Okafor et al., 2019). Despite the ongoing public health efforts, there has been little assessment of their real impact on behavior change and vaccination coverage. Thus, this study seeks to examine the effectiveness of public health campaigns in improving HPV vaccination rates in Nigeria. 1.3 Objective of the Study The general objective of this study is to examine the effectiveness of public health campaigns in improving HPV vaccination rates in Nigeria. The specific objectives are to: i. Assess the level of awareness regarding HPV vaccination in Nigeria. ii. Evaluate the influence of public health campaigns on HPV vaccine uptake in Nigeria. iii. Analyze the effectiveness of various communication platforms used in HPV vaccination campaigns in Nigeria. iv. Identify the challenges impeding HPV vaccination uptake despite the ongoing public health initiatives in Nigeria. 1.4 Research Questions The following research questions will guide the study: i. What is the current level of awareness about HPV vaccination in Nigeria? ii. What impact have public health campaigns had on HPV vaccination rates in Nigeria? iii. How effective are the various communication strategies employed in HPV vaccination campaigns in Nigeria? iv. What are the key challenges hindering HPV vaccine uptake despite active public health campaigns in Nigeria? 1.5 Significance of the Study The results of this research can inform strategies that promote support from community and religious leaders—an essential factor in fostering trust and overcoming vaccine hesitancy. In addition, the study’s insights can help healthcare professionals address misinformation more effectively and become stronger advocates for HPV vaccination within their communities. The findings will also be of academic value by enriching existing literature, enhancing library resources, and serving as a valuable reference for future researchers. 1.6 Scope of the Study This study is focused on evaluating the effectiveness of public health campaigns in increasing HPV vaccination rates in Nigeria. Specifically, it will examine the current level of HPV vaccine awareness, the influence of public campaigns on vaccination rates, the efficacy of different communication methods, and the barriers that continue to limit vaccine uptake. Geographically, the study is limited to Makurdi, Benue State. 1.7 Limitations of the Study As with any research effort, this study faced certain limitations. Time Constraint: The researcher had to balance this study with other academic responsibilities, such as attending lectures and participating in school activities. Financial Constraint: The cost of printing, typesetting, acquiring relevant literature, and data collection posed financial challenges. Material Availability: Sourcing adequate literature was difficult due to the limited availability of resources on the subject matter, which posed a constraint on the depth of the study. 1.8 Definition of Terms Human Papillomavirus (HPV): A collection of viruses commonly spread through sexual contact and known to cause cancers such as cervical, throat, and anal cancers. Certain strains are particularly responsible for most cervical cancer cases. HPV Vaccination: A preventive medical measure involving immunization to protect against HPV infection and reduce the likelihood of HPV-related cancers, especially cervical cancer. Public Health Campaigns: Coordinated efforts, often led by governmental or health organizations, designed to inform and educate the public about health issues, encourage positive behaviors, and enhance public health outcomes. Vaccine Uptake: The proportion of individuals within a targeted population who receive a specific vaccine. For this study, it refers to the number of people who receive the HPV vaccine. Vaccine Hesitancy: The unwillingness or refusal to receive vaccines despite their availability, often fueled by distrust, misinformation, cultural norms, or concerns over vaccine safety. Cultural Beliefs: The shared customs, values, and traditions within a community that influence individuals' attitudes and behaviors toward health practices, including vaccinations.