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 openended 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.