The MWAN Experience In Scaling-Up HPV Vaccination In Nigeria: Challenges, Lessons Learned, And Future Directions

Background: cervical cancer remains a major public health concern in Nigeria due to low HPV vaccine coverage and limited access to screening and treatment. In response, the Nigerian FMOH launched a three-phase nationwide rollout of free routine HPV vaccination targeting girls aged 9 to 14 years; however, the initial phase encountered considerable hesitancy and rejections. Objective: this paper examines the proactive steps taken by the Medical Women's Association of Nigeria (MWAN) to ensure successful implementation during the Phase-2 rollout and subsequent routine phase. Methods: MWAN employed a multifaceted strategy integrating robust advocacy, targeted community engagement, and strategic collaborations with key stakeholders—including IVAC, DCL, Paediatric Association of Nigeria, Pathfinder, NPHCDA, SPHCDA, and various CSOs. This approach involved comprehensive stakeholder engagement, capacity building for healthcare workers, extensive public enlightenment, community mobilization, technical support, and continuous knowledge-sharing initiatives. Key Findings: collaborative efforts resulted in the training of 30 MWAN members, 34 CSOs, 17 youth leaders, and 493 community-based HPV Vaccine Champions across 21 Phase-2 states. In addition, 695 medical practitioners were engaged to promote HPV vaccine uptake through clinical practice. Vaccine coverage improved markedly in Phase 2, rising to 96% from 80% in Phase 1. Challenges—including misinformation, distrust in government and health systems, resistance from educational and religious leaders, healthcare workforce training gaps, and cultural barriers—were effectively addressed through positive information dissemination, targeted re-sensitization, and the use of HPV ambassadors. Key lessons include the critical importance of early stakeholder engagement and leveraging peer networks to drive awareness and acceptance. Conclusion: MWAN's strategic interventions advanced the HPV vaccination rollout in Nigeria and offer a replicable model for effective immunization programs. Sustained collaboration among government agencies, NGOs, media, and community leaders is essential to overcoming vaccination barriers and reducing the burden of cervical cancer nationwide.