Within the framework of a WHO-European Union joint project on immunization in central Asia, the WHO Country Office in Turkmenistan and the Ministry of Health and Medical Industry of Turkmenistan jointly conducted the country's first qualitative research study.

The project aimed at identifying factors influencing parents' decisions related to human papillomavirus (HPV) vaccination for their children. Consisting of focus-group discussions and in-depth interviews, the research provided an understanding of parents' attitudes and beliefs about HPV as well as barriers to HPV vaccination.

The results of the research conducted over 3 weeks in late 2023 will serve as the basis for activities to increase public awareness about HPV and sustain confidence in HPV vaccination in the future.

HPV vaccination in Turkmenistan

Turkmenistan included the HPV vaccine in its routine immunization schedule starting in 2016, for boys and girls at 9 years of age. Although national vaccination coverage remains high, a slight downward trend has been observed in both urban and rural areas: from 99.2% in 2021 to 98.5% in 2023.

With a relatively young population increasingly turning to the internet for information, it is important that evidence-based answers to potential questions about vaccination are readily available. However, official online information about vaccines remains limited, creating an opportunity for misinformation to spread with the potential to decrease vaccination uptake in the coming years.

The Ministry asked WHO to conduct a qualitative research study to identify what parents know about HPV, the diseases it can cause, the effectiveness of vaccination in preventing these diseases, and especially what questions or concerns they have on HPV vaccination that need to be addressed in a transparent and accessible manner.

The study, conducted jointly by experts from the Ministry and WHO, aimed to develop targeted interventions to better inform the public and health-care workers about HPV vaccines. Focus groups and in-depth interviews with health-care providers, parents and staff of public organizations were conducted to identify participants' knowledge, attitudes and behavioural determinants for uptake of HPV vaccine and childhood vaccines in general.

The study was conducted in cities, including the capital, as well as in rural sites in 2 regions. Data collection and analysis were conducted using the COM-B framework, which looks at 3 key components: capability, opportunity and motivation for behaviour change.

Study outcomes

Study findings revealed that attitudes toward HPV were generally positive, partially due to positive attitudes toward vaccination in general but also due to preparatory steps taken by health authorities prior to introducing the HPV vaccine in 2016.

These steps included informing and training health workers to administer and answer questions about the vaccine and to inform parents and children about the benefits of HPV vaccination in preventing HPV infection, emphasizing its role in preventing the spread of the virus rather than only in preventing cervical cancer.

Despite high levels of knowledge and trust in vaccination, study participants did reveal certain gaps in knowledge and potential vulnerability to misinformation. Based on the findings, researchers proposed several measures, including:

• making up-to-date information on childhood vaccination available through a single online portal to ensure accessibility and availability for the public;
• training health workers to increase their capacity to effectively communicate with parents on HPV and other vaccines in the routine immunization schedule; and
• using existing facility-level data and ongoing activities to conduct local, community-based interventions to effectively engage the minority of parents delaying or rejecting vaccination.

Based on these recommendations, the Ministry is developing an action plan that will include regular training for health workers and provision of information to parents via online resources and individual consultations.

With an eye to sustaining high demand for vaccination in the future, the Ministry is also planning to pilot an education module for 10-12-year-olds called Immune Patrol in several schools. WHO developed Immune Patrol to increase health literacy, resistance to misinformation, and knowledge about the immune system and immunization. WHO will provide technical support to the Ministry to implement the action plan and to pilot the Immune Patrol package in 2024 and beyond.

Public link

Please use the above public link if you want to share this noodl on another website.