Nurses’ Experiences with Mothers during Human Papillomavirus (HPV) Vaccination in Selected Health Facilities in Edo State, Nigeria: A Qualitative Study

Abstract

Background: Human papillomavirus (HPV) vaccination prevents cervical cancer, but uptake remains low in Nigeria due to limited awareness and sociocultural concerns. Nurses’ interactions with mothers play a critical role in influencing acceptance and improving vaccination coverage. Aims: To explore nurses’ experiences with mothers during human papillomavirus (HPV) vaccination at selected health institutions in Edo State, Nigeria, and to identify barriers, facilitators, and recommended strategies for improving vaccine uptake. Study Design: Qualitative cross-sectional study guided by the Health Belief Model. Place and Duration of Study: University of Benin Teaching Hospital (UBTH), St. Philomena Catholic Hospital (SPCH), and Central Hospital (CH), Benin City, Edo State, Nigeria; 2024. Methodology: Eleven nurses were purposively recruited from immunisation clinics across three health institutions. Data were collected through individual in-depth interviews using a structured guide administered by a trained moderator. Interviews were audio-recorded, transcribed verbatim, and analysed using Braun and Clarke’s six-phase thematic analysis, supported by MAXQDA 2022 software. Thematic saturation was confirmed by the eleventh interview. An independent reviewer verified coding accuracy. Results: Four themes emerged: (1) markedly low acceptance and suboptimal utilisation of HPV vaccines, driven primarily by exclusion from the National Immunisation Programme (NIP) schedule; (2) intersecting barriers including prohibitive cost, misconceptions, limited awareness, vaccine stockouts, and cultural beliefs; (3) recommended uptake strategies encompassing community mobilisation, targeted health education for clients and nurses, and government-subsidised access; and (4) priority health education topics including HPV vaccine facts, sexually transmitted infections, cervical cancer, the role of mothers in vaccine decision-making, and the psychosocial and socioeconomic burden of cervical cancer. Conclusion: Structural, economic, and sociocultural barriers collectively suppress HPV vaccine uptake in Edo State. Formal integration into the NIP schedule, combined with community mobilisation, nurses’ capacity building, culturally sensitive health education, and supply-chain investment, is urgently required to reduce Nigeria’s cervical cancer burden.