Support needs of teachers and health personnel towards a possible school-based HPV vaccination program: a qualitative study from Western India

Cervical cancer can be prevented through the HPV vaccine. School-based vaccination programmes (SBVP) have shown greater success globally. After initial campaign, India may roll-out HPV immunization under a national program. Stakeholder expectations for a possible SBVP for HPV in India remain unclear. This study examined the views, expectations and needs of teachers and health personnel towards supporting a possible SBVP for the HPV vaccine. In this qualitative study, data were collected through focus group discussions (FGDs) and in-depth interviews (IDIs) of teachers and health personnel from three western states in India (Maharashtra, Gujarat & Goa). One district was selected randomly, followed by random selection of one taluka. Two schools were purposively selected in each of the talukas: One urban, one rural. A total of 11 FGDs and 66 IDIs were conducted, engaging 76 school teachers and 65 health personnel at various levels. The data were then subjected to inductive thematic analysis. While both teachers and health personnel indicated willingness to support the HPV related SBVP, there were specific support needs of each group. Clear directives to assign responsibilities for each component, as well as mishaps, were expected. Needs relating to capacity building existed across the two groups, such as the need for vernacular language training materials and the ability to communicate effectively when responding to questions from parents about the vaccine. Amongst health personnel, issues included coordination between departments and schools, accommodating additional work towards SBVP, and catering to psycho-social support needs of young girls were some of the perceived challenges. It was also indicated that covering private schools may be difficult, as they tend to have less parental acceptance of government-led health programs. A successful SBVP for HPV would be dependent on joint planning and directives by the health and education ministries together, continued training that addresses myths surrounding the vaccine, community-generated IEC materials, and additional engagement plans for private schools. Study suggests SBVP is perceived as feasible, but its successful implementation would be contingent on addressing governance, capacity, communication, workload, and related barriers.