Development, Implementation, and Evaluation of a National Cross-generational Strategy to Support Introduction of the Human Papillomavirus (HPV) Vaccine and Utilization of Cervical Cancer Screening in Nepal
Support: Henry Ford Health/ Global Health Initiative, USA
Collaboration: Family Welfare Division
Sites: Dhading, Bhaktapur, Kavre and Sindhupalchowk
Status: On-going
Objective: This study is designed to adapt/develop a context-driven strategy to decrease risks of
HPV infection and cervical cancer in Nepal through an integrated vaccination and cervical
cancer screening campaign. The program is designed to address a cross-generational approach to
encourage vaccination of young girls and screening of their mothers, aunts, grandmothers and
other women in the communities.
Methodology/Activities: The proposed study combines qualitative and quantitative
methodologies and utilizes an implementation science approach. The study follows a five-phase
approach: (1) assessment through surveys and interviews to identify barriers, (2) development of
healthcare provider training and community mobilization strategies, (3) implementation of
training and interventions, (4) evaluation through baseline and post-intervention surveys, and (5)
dissemination through stakeholder engagement and workshops.
As part of the project, baseline survey was conducted among 404 healthcare workers, 483
mothers and 479 girls (Age 9 to 14) providing critical insights into existing knowledge, attitudes
and practices related to HPV and cervical cancer prevention. Also, the dissemination workshop
of baseline survey was completed to share findings and gather stakeholder feedback. Along with
that, Training of Trainers (TOT) program was organized on Healthy Girls Healthy Women for
22 nurses of Bhaktapur and Sindhupalchowk district for the prevention of HPV and Cervical
cancer in Nepal. Also training on HPV, HPV vaccine and Cervical cancer was conducted by
TOT trainees for 185 Female Community Health Volunteers, 160 Health care workers and 31
members of mother’s group of their community. We have successfully distributed 4000 copies of
HPV Awareness Educational Materials (Flyers) each of 800 copies for teachers, 1600 copies for
students and 1600 copies for parents of intervention districts, further amplifying community-
level awareness and engagement. Additionally, 1300 participants will be surveyed to assess HPV
vaccine awareness and cervical cancer screening knowledge after the training and awareness
program. This multi-level approach has laid a strong foundation for scaling up integrated HPV
vaccination and cervical cancer screening efforts in Nepal.
Expected Outcome: Increased awareness and confidence in HPV vaccination and cervical
cancer screening among healthcare providers, parents, and adolescent girls. Higher HPV vaccine
uptake and improved utilization of cervical cancer screening services in intervention areas.
Enhanced healthcare provider capacity for HPV-related counseling and service delivery.