A framework policy analysis of single-dose HPV vaccination adoption in East Africa: a rapid review

This peer-reviewed paper analyzes how Ethiopia, Uganda, and Tanzania adopted single-dose HPV vaccination schedules. The study uses the Health Policy Triangle Framework to examine policy context, content, process, and actors, drawing on 24 peer-reviewed and grey literature sources published up to December 2024. 

Key findings

• Political will to address cervical cancer as a public health priority was central to HPV vaccine policy revision across all three countries.
• WHO recommendations, including the 2022 endorsement of a single-dose HPV vaccination schedule, were important triggers for national policy review.
• National Immunization Technical Advisory Groups played a central role in reviewing evidence and advising ministries of health.
• Evidence on cervical cancer burden, vaccine efficacy, implementation feasibility, and potential economic benefits supported decision-making.
• Existing cervical cancer control plans and prior HPV vaccine introduction processes helped facilitate the transition to single-dose schedules.
• Delivery challenges, including vaccine supply constraints, school-based outreach costs, workforce limitations, and administrative data quality, shaped country decisions.
• The review found broadly similar policy pathways across Ethiopia, Uganda, and Tanzania.

Thumbnail image credit: Gavi