File Type
Project Document
Publication Date
2025
Description
This final report examines barriers to and factors that support human papillomavirus (HPV) vaccination in selected Philippine sites. It presents findings from key informant interviews and an audit of HPV vaccination communication materials and practices. The report proposes a policy framework to improve program implementation and expand vaccination coverage, including outreach to out-of-school girls.
The study examined how health systems, community engagement, and coordination across sectors shape HPV vaccination in the Philippines. Guided by a Theory of Change, the research team interviewed 137 key informants representing 163 stakeholder positions across national and local levels. The study covered 10 sites with varying vaccination performance in Ilocos Norte, Abra, Santiago City, and Navotas City.
Vaccine hesitancy, supply and staffing constraints, gaps in vaccination data, and uneven local coordination hindered implementation. The study also identified gaps in reaching out-of-school girls. Promising practices included combining school- and community-based vaccination strategies, engaging parents and caregivers directly, and mobilizing barangay health workers and local champions. The proposed policy framework focuses on improving communication and strengthening coordination and support through capacity building and formal commitments from participating agencies.
Recommended Citation
Collado, Z., Yabut, H., Cleofas, J., Alibudbud, R., Tiongco, M., Ramos-Jimenez, P., Lantican, C., Navarro, M., Geluz, M., & Concepcion, G. (2025). HAPPI Phase II Learning and Other Learning-related Activities in Select Sites in the Philippines: Final Report. Retrieved from https://animorepository.dlsu.edu.ph/sdrc_res_proj/20
Comments
HAPPI Phase II: Strengthening Policy for HPV Vaccination Uptake in the Philippines
Principal Investigator(s): Dr. Zaldy Collado
Funding Agency: Jhpiego Philippines The HPV Vaccination Learning Project examined the systemic, behavioral, and social factors influencing human papillomavirus (HPV) vaccination uptake in the Philippines to identify strategies for improving program implementation, increasing vaccination coverage, and supporting cervical cancer prevention. The project comprised two complementary components funded by the Gates Foundation and the U.S. Centers for Disease Control and Prevention (CDC). The research covered selected high- and low-performing vaccination sites in Ilocos Norte, Abra, Santiago City in Isabela, and Navotas City. The Gates Foundation-funded component, HAPPI Phase II Learning and Other Learning-related Activities in Select Sites in the Philippines, employed a qualitative, Theory of Change-guided approach to examine health system performance, community engagement, and coordination among national agencies, local governments, schools, and health service providers. The study identified persistent challenges involving vaccine hesitancy, misinformation, supply and logistical constraints, limited health personnel, inadequate monitoring systems, and inconsistent local implementation. It also documented promising practices, including coordinated school- and community-based vaccination, direct engagement with parents, local leadership, and community outreach. The findings informed a proposed policy framework emphasizing communication strategies, institutional coordination, capacity building, and sustained support for more equitable HPV vaccination delivery. The CDC-funded component, Examining the Behavioral and Social Drivers of HPV Immunization, employed a mixed-methods approach using adapted Behavioral and Social Drivers (BeSD) assessment tools. The study conducted surveys with 400 caregivers and in-depth interviews with parents, adolescent girls, teachers, and barangay health workers. Findings revealed generally favorable attitudes toward vaccination and strong trust in health workers, although concerns about side effects, inconsistent health-worker recommendations, scheduling difficulties, vaccine stockouts, and gaps in service delivery continued to affect uptake. Schools emerged as important vaccination sites and sources of information, while barangay health workers supported community outreach, particularly for out-of-school girls. The project also field-tested and refined the BeSD instruments to improve their clarity, cultural appropriateness, and potential application in Philippine immunization programs. Together, the two components provided complementary evidence on the institutional and individual factors shaping HPV vaccination in the Philippines. The project emphasized stronger coordination among health agencies, schools, and local governments; improved communication and community engagement; more reliable vaccine delivery and monitoring; and targeted strategies for underserved and out-of-school adolescents. Its findings and proposed policy and assessment tools can support evidence-informed improvements in HPV immunization programs and contribute to national efforts toward cervical cancer prevention.