How story-telling is helping girls access the HPV vaccine in Ethiopia and Tanzania – Gavi, the Vaccine Alliance

Things that are important to girls shouldnt be decided by anybody other than girls, says Jitu, a member of the Ethiopia Youth Advisory Panel for Girl Effect, an international non-profit organisation that uses media and technology to unlock the power of girls and women.

The HPV vaccine has radical effects on cervical cancer rates in the UK, the incidence of cervical cancer among women in their 20s who had been offered the vaccine aged 12-13 was reduced by 87%. The HPV virus is responsible for about 90% of cervical cancers, so the vaccine hugely reduces the risk of developing the cancer later in life.

However, in Ethiopia and Tanzania, this incredible benefit is not reaching every girl.

Tanzania and Ethiopia both introduced HPV nationally for 14-year-old girls, with support from Gavi, the Vaccine Alliance, in 2018. While 78% of eligible girls were reported to have received a first dose by the end of 2019 in Tanzania, second dose coverage stood at 49%. The COVID-19 pandemic has further complicated vaccination efforts. In 2021 Ethiopia launched a vaccination campaign for girls who missed out on either of the doses due to school closures.

Liya Haile, Country Director for Girl Effect in Ethiopia, says, There are three key barriers to women getting vaccines. Gender barriers, including myths about how the vaccine affects women. There are social norm barriers, with girls feeling uncomfortable about going to health centres. And there are knowledge and logistical barriers, with many people not knowing what the HPV vaccine is for, or how to get it.

In a 2021 study of 400 parents in Addis Ababa, more than a quarter had never heard about the HPV vaccine, and over a third had a negative attitude towards it.

Edlawit, another member of Girl Effects Ethiopia Youth Advisory Panel explains further how social norms negatively impact girls:

For a girl in rural Ethiopia, a lack of information, access to medical facilities and traditional opinions make it increasingly difficult to identify, discuss, and seek help for any health-related issues. For girls in semi-urban and urban communities of Ethiopia, while access to medical facilities is much better, discussing health matters of those deemed private parts is generally frowned upon.

Girl Effect, with Gavi, are acting to change this through social and behaviour change communications.

Girl Effect uses a mix of approaches tailored to their target audience, and what that audience has access to. The team has already had great success in Ethiopia with Yegna, a youth brand reaching 9.8million people nationwide through its TV drama, social media, music and clubs. Yegna has used storytelling to engage and inform girls and women about the HPV vaccine and its benefits. Girl Effects impact survey found that girls who had watched Yegna were two times more likely to be aware of the HPV vaccine than non-watchers.

There is on the ground community engagement, too, partnering with government and non-government agencies who know their communities, and who are able to provide the infrastructure that enables access to healthcare.

Girl Effects Youth Advisory Panels are part of this community engagement. They have multiple roles, from assisting with researching, reviewing drama and social-media content, field visits to test youth services, designing marketing materials, to brainstorming new ways to engage young people.

Edlawit explains that the resulting communications should never be about scaring young people into action but instead helping them to make informed decisions. Im excited not to be a voice of doom and negativity but that of hope and a solution. There are so many scary diseases out there that make it seem like an unending cycle of fear and concern. Encouraging other girls about the HPV vaccine makes it one less disease to worry about for them.

As Gavi and Girl Effect move into the next phase, the goal is to address zero-dose children and those who are under-vaccinated. Young women are often the key decision makers when it comes to family health, particularly the health of babies and children in Ethiopia, the median age for women to have their first child is 20.

This kind of work, says Haile, is much more successful when organisations partner up and share expertise. Its a natural partnership, especially for the HPV vaccine. Gavi knows vaccinations, and no one knows girls like Girl Effect.

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How story-telling is helping girls access the HPV vaccine in Ethiopia and Tanzania - Gavi, the Vaccine Alliance

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