Perceptions of Healthcare Workers on the Human Papilloma Virus Vaccines at Selected Health Facilities in Nairobi, Kenya

Abstract

Human papilloma virus is a common sexually transmitted viral infection that affects both men and women .A strong association has been found between presence of HPV and occurrence of cervical cancer. HPV infection is a public health concern and therefore the use of HPV vaccines that would reduce infection with HPV and consequently reduce cervical cancer incidence would be of utmost importance. The main objective of the study was to determine the healthcare worker’s perception on the HPV vaccines at Nairobi Women’s Hospital and Mbagathi District Hospital in Nairobi. The study was a descriptive cross sectional study with mixed methodology where self administered questionnaires amongst doctors and nurses while key informantinterviews were carried out with key informants in both hospitals. A total of 107 participants responded to questionnaires and data obtained. Health worker perception of HPV vaccines was assessed using qualitative data collected from open-ended questions administered to all 107 participating health workers and additional data from in-depth key informant interview among health workers (n = 10) in-charge of different service. The 10 key informants included medical officers (n = 2), a clinical officer and nurses (n = 7). Eighty six per cent of the health workers were aware that HPV is a sexually transmitted virus. While all 33 health workers at Nairobi Women’s Hospital were aware that HPV is a sexually transmitted virus, 15 health workers from Mbagathi reported either not knowing what caused HPV (n = 5) or responded that HPV is caused by poor hygiene (n = 10). Most health workers in Mbagathi (87.7%) and Nairobi Women’s (97%) recognised that HPV was associated with cervical cancer and there was no significant differences in knowledge of the association between HPV infection and cancer at the two hospitals (OR = 4.4, 95% CI 0.5-36.5). However, the health workers differed in the perception of the mechanism of HPV association with cancer of the cervix. While, health workers at Nairobi women’s predominantly reported that HPV causes cancer of the cervix (OR = 25.8, 95% CI 8.6-76.8, p < 0.001), compared to their colleagues at Mbagathi were health workers at Nairobi women’s were likely to report that HPV predisposes infected individual to cancer of the cervix (OR = 0.1, 95% CI 0.02-0.2, p < 0.001).There were differences in health workers responses on the target groups for HPV vaccination depending on the hospital they were based in Seventy eight percent (78%) percent of health workers at Nairobi Women’s Hospital thought the vaccine should target both boys and girls while most workers at Mbagathi reported that the vaccine targets girls (39.2%) and women (35.1%). The target age groups for vaccination according to health workers varied with those at Nairobi Women’s Hospital giving 0-5 years (27.3%) and 25-30 years (30.3%). Those at Mbagathi gave 11 and 25 years (11-15 years at z17.6%; 16-20 years at 28.4%; and 21-25 years at 17.6%). There were no differences in attitude towards vaccination in terms of recommending HPV to clients (81.8% versus 81.1%) and recommending or receiving vaccine if funding were made available to subsidise HPV vaccine costs (93.9% versus 82.4%).With regard to practices health workers at Nairobi women’s Hospital were more likely to report having received HPV vaccine (69.7% versus 2.7%), administered (87.9% versus 4.1%) and recommended (87.9% versus 17.6%) HPV vaccine to a client compared to health workers at Mbagathi. This study concludes that the knowledge, perceptions and the practices of health workers relating to HPV is largely dependent upon the sector at which they operate and not on their level of education and the professional training thereof.