Lesotho: Enhancing Human Papillomavirus (HPV) vaccination to protect girls against cervical cancer

 “It was a no-brainer,” says 34-year-old ‘Malihaelo Qhobela of her decision to allow her 13-year-old daughter, Lihaelo, to be vaccinated against human papillomavirus (HPV) at Soofia International School in Lesotho’s Butha-Buthe District.

HPV, a sexually transmitted disease, is the leading cause of cervical cancer, a major health issue in Lesotho. Approximately, 541 women are diagnosed with cervical cancer each year and 362 die from the disease in the country.

“I was aware of the gravity of the situation, so it brings me great joy to know that my daughter is now protected, thanks to this vaccine,” Qhobela adds. “Safeguarding our girls against cervical cancer is everything.”

Liahelo is one of the more than 139 000 girls between the ages of 9 and 14 to have been vaccinated against HPV since Lesotho’s Ministry of Health launched a new nationwide campaign in 2022 with support from World Health Organization and other partners. This equates to 93% coverage, surpassing the 90% target set at the campaign’s outset, as well as the 91% coverage achieved during a previous campaign that was halted in 2015 due to financial constraints. Around 35 000 girls older than the target age range have also been vaccinated.

In a country characterized by rugged mountainous terrain and a predominantly rural population, reaching girls where they are has been integral to the campaign’s success. To that end, mobile vaccination teams were deployed to hard-to-reach areas, while temporary vaccination sites were set up in schools, as well as in other important community nodes including churches.

Health inspectors and village health workers were at the forefront of a vigorous social mobilization process, going door to door to engage communities, address vaccine hesitancy, and ensure no girls were left behind. “Some of the parents were reluctant, but I went around explaining, making them aware of the dangers of this disease,” says ‘Mampotseng Letuka, a 61-year-old village health worker in Berea District’s Koali village. “I was so happy to see the fruits of my labour of gathering as many girls as I could, just the joy of seeing them being vaccinated in great numbers.”

In addition to serving as key vaccination sites, schools played a similarly significant role in terms of sensitization and mobilization of the learners for vaccination. “We appointed focal persons who would sensitize the learners, the teachers and the whole school community on the vaccinations,” says ‘Mopei Selikane, District Education Manager for Berea.

“There was very good social mobilization across the board, whereby community structures were mobilized, village health workers were mobilized and so were the schools,” reiterates Lepolesa Mpholo, a public health nurse in Berea District. “That is what made this initiative so successful.”

WHO supported Lesotho’s Ministry of Health in training 450 health workers across all 10 of Lesotho’s districts before the vaccine’s reintroduction, helping to ensure a smooth rollout, as well as providing on-the-ground technical support throughout the campaign. The Organization also facilitated the mobilization of US$ 320 000 in financial support from Gavi, the Vaccine Alliance, to cover operational cost for the HPV vaccination campaigns.

‘Mathoora Semela, a nurse clinician at St. David’s Health Facility in Berea, was one of the health workers to benefit from the WHO-supported training. She used her newly acquired knowledge to sensitize and vaccinate scores of girls in her community. “I feel proud to have been a part of this process,” she says. “I am very happy that we are helping girls and young women to stay cervical cancer free.”

Through this safe, efficient and cost-effective intervention, Lesotho has now aligned itself with WHO’s Global Strategy, which aims to eliminate cervical cancer by 2030. “We commend the Government of Lesotho, particularly Ministry of Health efforts for reintroducing the HPV vaccine and including the vaccine in routine immunizations, while simultaneously scaling up cervical cancer screening and treatment,” says Dr Mary Stephen, acting WHO Representative in Lesotho. “I am convinced that such efforts will lead to a Lesotho where no woman or girl dies of cervical cancer.”   

For learners back at Soofia International School, nestled in the scenic foothills of the Butha-Buthe mountain, the sky is the limit. When 16-year-old Leboleli Ntlobo graduates, she dreams of becoming a data scientist. She received the HPV vaccine during the campaign’s first round back in 2022. “I am very happy that I am vaccinated,” she says, “and I look forward to a cervical-cancer-free future.”

Distributed by APO Group on behalf of World Health Organization (WHO) – Lesotho.