The project aimed to identify factors influencing parents’ decisions regarding human papillomavirus (HPV) vaccination for their children. The study, which used focus group discussions and in-depth interviews, explored parents’ attitudes and beliefs regarding HPV, as well as barriers to HPV vaccination.
The results of this three-week survey, conducted in late 2023, will inform future public awareness campaigns to promote HPV and maintain confidence in HPV vaccination.
HPV vaccination in Turkmenistan
Since 2016, Turkmenistan has included the HPV vaccine in its routine immunization schedule for 9-year-old boys and girls. Although national vaccination coverage remains high, a slight decline has been observed in both urban and rural areas: from 99.2% in 2021 to 98.5% in 2023.
With a young population increasingly using the internet for information, it is crucial that evidence-based answers to vaccination-related questions are readily accessible. However, limited online information regarding vaccines allows misinformation to spread, potentially impacting vaccination rates in the future.
The Ministry commissioned the WHO to conduct a qualitative research study to understand parents’ knowledge of HPV, the diseases it causes, and the effectiveness of vaccination in preventing these diseases. The study also aimed to identify any questions or concerns parents had regarding HPV vaccination, to ensure transparent and accessible information.
The study, jointly conducted by Ministry and WHO experts, aimed to develop targeted interventions to improve HPV vaccine knowledge among the public and health professionals. Focus groups and in-depth interviews were conducted with healthcare providers, parents, and public sector employees to assess their knowledge, attitudes, and the behavioral factors influencing HPV and general childhood vaccine uptake.
The study was conducted in both urban areas, including the capital, and rural areas in two regions. Data collection and analysis were carried out using the COM-B framework, which considers three key components: ability, opportunity, and motivation to change behavior.
Results of the study
The study found that attitudes towards HPV vaccination were generally positive, partly due to positive attitudes towards vaccination in general and the preparedness measures taken by health authorities before the HPV vaccine introduction in 2016.
These steps involved informing and training healthcare workers to administer the vaccine and answer questions, as well as educating parents and children regarding the benefits of HPV vaccination in preventing infection. The emphasis was on the role of vaccination in preventing the spread of the virus, not just cervical cancer.
Despite high levels of knowledge and trust in the vaccine, study participants demonstrated certain knowledge gaps and potential susceptibility to misinformation. Based on these findings, the researchers recommended several measures, including:
- Providing up-to-date information on childhood vaccinations through a single online portal to ensure accessibility and availability to the public;
- Training healthcare professionals to effectively communicate with parents regarding HPV and other vaccines as part of routine immunization; and
- Utilizing existing facility-level data and ongoing activities to implement local, community-based interventions to effectively address the minority of parents who delay or refuse vaccination.
Based on these recommendations, the Ministry is currently developing an action plan that includes regular training for health personnel and providing information to parents through online resources and individual counseling.
To maintain high demand for vaccination in the future, the Ministry also plans to test an educational module for 10- to 12-year-olds called “Immune Patrol” in several schools. The WHO developed “Immune Patrol” to improve health literacy, resilience to misinformation, and knowledge regarding the immune system and vaccination. The WHO will provide technical support to the Ministry in implementing the action plan and piloting the “Immune Patrol” package in 2024 and beyond.
Understanding Parents’ Decisions on HPV Vaccination in Turkmenistan
The World Health Organization (WHO) recently conducted a comprehensive study in Turkmenistan to delve into the factors influencing parents’ choices regarding human papillomavirus (HPV) vaccination for their children. The study, which incorporated focus group discussions and in-depth interviews, aimed to gain a nuanced understanding of parental attitudes, beliefs surrounding HPV, and barriers to HPV vaccination. The findings of this three-week survey, conducted in late 2023, will serve as a vital foundation for future public awareness campaigns and initiatives to maintain and enhance confidence in HPV vaccination.
HPV Vaccination Landscape in Turkmenistan
Turkmenistan has recognized the importance of HPV vaccination and incorporated it into its routine immunization schedule since 2016, targeting boys and girls aged 9 years. The country boasts a high national vaccination coverage rate, with a slight downward trend observed in both urban and rural areas, from 99.2% in 2021 to 98.5% in 2023. This trend highlights the need for ongoing efforts to maintain high vaccination rates, especially considering the increasing reliance on the internet for information among the young population.
The limited availability of official online information regarding vaccines creates opportunities for the spread of misinformation, which can negatively impact vaccination rates in the future. Recognizing this, the Ministry of Health in Turkmenistan commissioned WHO to conduct a qualitative research study aimed at understanding parents’ knowledge, attitudes, and concerns regarding HPV vaccination.
This collaborative study, conducted by experts from the Ministry and WHO, sought to design targeted interventions to improve HPV vaccine knowledge among the public and healthcare professionals. The study involved focus groups and in-depth interviews with healthcare providers, parents, and public sector employees to assess participants’ knowledge, attitudes, and behavioral determinants of HPV vaccine uptake, as well as childhood vaccines in general.
The study encompassed both urban areas, including the capital city, and rural regions in two distinct provinces. Data collection and analysis were conducted using the COM-B framework, a comprehensive model that considers three key components influencing behavior change: **ability**, **opportunity**, and **motivation**.
Key Findings and Insights
The study revealed generally positive attitudes towards HPV vaccination, partly driven by a positive stance towards vaccination in general. This positive sentiment can be attributed, in part, to the thorough preparedness measures undertaken by the Ministry of Health prior to the introduction of the HPV vaccine in 2016.
These proactive steps included extensive training and information sessions for healthcare workers to equip them with the knowledge and skills to administer the vaccine effectively and address parental queries. Additionally, comprehensive educational campaigns were launched to inform parents and children regarding the benefits of HPV vaccination, emphasizing its critical role in preventing the spread of the virus and protecting once morest HPV-related cancers, not just cervical cancer.
Despite the high levels of knowledge and trust in the vaccine, the study identified knowledge gaps and a potential susceptibility to misinformation among participants. Based on these findings, the researchers proposed several essential measures:
- **Centralized Online Information Portal:** Creating a single online portal providing up-to-date information on childhood vaccinations to ensure accessibility and availability to the public.
- **Enhanced Healthcare Professional Training:** Implementing training programs for healthcare professionals to improve their communication skills and enable them to have effective conversations with parents regarding HPV and other vaccines as part of routine immunizations.
- **Community-Based Interventions:** Utilizing existing facility-level data and ongoing activities to implement local, community-based interventions to effectively address the small percentage of parents who delay or refuse vaccination.
Moving Forward: Action Plan and Educational Initiatives
Building on these recommendations, the Ministry of Health is currently developing a comprehensive action plan to strengthen HPV vaccination efforts. This plan includes ongoing training for health personnel and providing parents with access to reliable information through online resources and individual counseling sessions.
To further maintain and enhance the high demand for vaccinations, the Ministry plans to pilot an educational module called “Immune Patrol” [Immunpatrouille] in several schools targeting children aged 10 to 12 years old. WHO has developed “Immune Patrol” to improve health literacy, build resilience once morest misinformation, and enhance knowledge regarding the immune system and vaccination. WHO will provide technical support to the Ministry in implementing the action plan and pilot testing the “Immune Patrol” package in 2024 and beyond.
