ArticleFrontiers in public health2026
Early implementation and contextual determinants of the human papillomavirus vaccine rollout and uptake in Nigeria: a mixed-methods study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In 2023, Nigeria introduced the Human Papillomavirus (HPV) vaccine into routine immunization to reduce the high burden of cervical cancer. However, limited evidence exists regarding early vaccine availability, uptake, and the contextual factors influencing implementation across health facilities. Methods: This study employed a sequential explanatory mixed-methods design (quan + QUAL) across five Nigerian states (Oyo, Jigawa, Kano, Lagos, and Rivers). Data collectors conducted monthly visits to assess HPV vaccine availability and reviewed the facility register to assess HPV vaccine uptake. Subsequently, in-depth interviews were conducted with healthcare workers to explore contextual determinants of vaccine delivery and acceptance. Qualitative data were analyzed using reflexive thematic analysis and reported in accordance with COREQ guidelines. Result: Overall, 13 of the 52 (25%) facilities included in this study did not record a single HPV vaccine availability and uptake throughout the entire 4 months period. HPV vaccine availability varied substantially across states and facilities, with only 8/17 facilities in Oyo reporting availability compared to 6/11 in Jigawa across all 4 months. Uptake also varied widely, ranging from 0 to 308 doses per facility over the 4 months, with higher uptake observed in parts of Rivers State. Qualitative themes supported these findings, demonstrating that HPV vaccine uptake evolved as communities increasingly understood its relevance through local narratives, trusted health worker endorsement, and peer influence. Despite a structured rollout, frontline preparedness and vaccine uptake were shaped by variability in training, outreach-driven delivery, trust in healthcare workers and community influencers, as well as sociocultural barriers, misconceptions, and household power dynamics. Conclusion: Overall, our study reinforces that improving HPV vaccine coverage requires more than expanding stock; it demands reliable access, responsive service delivery models, and socially grounded communication strategies that foster community legitimacy. Addressing both structural constraints and contextual determinants will be essential to prevent HPV vaccination from remaining concentrated in a few facilities and instead embed it as a routine, equitable public health intervention.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.