Girl’s Preference for Human Papilloma Virus Vaccination in secondary schools in Addis Ababa, Ethiopia, 2017: Discrete Choice Experiment

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Addis Abeba Universty


Background: There are three HPV vaccines that are safe and effective for protecting HPV infection. These are: bivalent which protect from HPV type 16 and 18, quadrivalent for HPV type 6, 11, 16 and 18, and nonavalent for HPV type 6, 11, 16, 18, 31, 33, 45, 52 and 58. About 7,000 new cervical cancer cases are diagnosed annually in Ethiopia. It is the second cause of cancer related death in women aged 15 to 44 year. Even thouge Ethiopia undergo a pilot for HPV vaccine implementation at two sites in Oromia Region, Jimma zone, Gomma woreda and Tigray Region Ahiferom Woreda with support of GAVI, there is no data that show a finding regarding the current status of receiver’s attitude, acceptance, and mainly girls’ preference for HPV vaccine. Objective: The aims of this study was to rank the contribution of the attributes for HPV vaccination; and to measure the willingness-to-pay, the trade-offs, and choices of girls between risk and benefits of the vaccination. Methods: The study was done by using discrete choice experiment (DCE). The data was collected from Februray to March 2017 among 4 different secondary schools in Addis Ababa. A total of 336 girls aged 15-18 year were included in the study. The vaccination program attributes considered in the choice experiment were: degree of protection against cervical cancer, duration of protection, age at vaccination, number of doses, risk of developing serious side effects, price of vaccine, and way of delivery. Each choice set of all determined options were put in to mixed logit model to determine the sign of the coefficient of each attributes. Trade-offs and WTP also determined. Results: From all participants, only six of them had been vaccinated for HPV. Doctors recommendation (34.9 %), mass-media campaign (81%) and positive familys’ opinion (80 %) were factors encouraging respondents to get the vaccination. Girls were willing to trade-off 5 % of protection against cervical cancer in order to get HPV vaccination which had protective duration of 25 years instead of 8 years. On average the respondents were willing to pay 153 ETB for an improvement in protection against cervical cancer from 70 % to 98 %. Conclusion: There was significant variationeof preference among girls for all HPV vaccine attributes. Degree of protection, number doses, and the risk of serious side effect were the three most important attributes which guide the choice of girls, while cost of the vaccine had been the least important factor. We found high level of tradd-offs level of protection against number of doses, seriouse side effects and place of delivery



Girl’s Preference for Human Papilloma