Building HPV Vaccine Confidence with and for Healthcare Workers in Nigeria: A Co-Design Study

Abstract Background Cervical cancer, primarily caused by human papillomavirus (HPV), is a global public health concern, particularly affecting women in low- and middle-income countries, including Nigeria. The HPV vaccine prevents cervical cancer, yet uptake remains low due to supply and confidence barriers. While vaccine confidence among women and girls, and their families has received wide attention, less attention has focused on healthcare workers (HCWs), despite their key role in improving uptake. Co-designing interventions with HCWs could yield better-tailored programs addressing context-specific communication and information needs. Here, we describe the co-design process with HCWs in Nigeria, the strategies and delivery mechanisms identified, and provide methodological reflections. Methods We conducted a co-design study guided by human-centred design and the Ideate, Design, Evaluate, and Share (IDEAS) framework, in Oyo and Jigawa states, Nigeria, between September 2024 and September 2025. Co-design participants included doctors, nurses, and community health extension workers, recruited using purposive and snowball sampling. Data were collected through participatory workshops using audio recordings, field notes, and visuals of co-produced materials, and analysed using content analysis, with findings iteratively refined and validated with participants across workshops. Results Through a series of five workshops and three rounds of sense checks involving 45 HCWs, participants identified gaps in access to HPV vaccine knowledge, difficulty addressing rumours, and a lack of confidence in counselling. In response, we jointly developed content for intervention approaches: in-person and digital. The in-person intervention is planned to be delivered in the health facility by a trained HPV champion. The digital intervention in planned to be delivered through WhatsApp. Both use four short educational videos, which were co-designed with the HCWs, to increase HCWs’ knowledge and confidence in the HPV vaccine, covering: 1) general knowledge on cervical cancer, HPV, and HPV vaccine; 2) counselling parents on HPV vaccine, and 3) strategies for addressing rumours around the HPV vaccine. Conclusion The co-design study enabled successful development of co-designed videos, and in-person and digital intervention delivery strategies to strengthen HPV vaccine confidence among HCWs in Nigeria.