ArticleBMC public health2026
HPV knowledge and willingness to receive HPV vaccine among female secondary school students in Ebonyi State, Nigeria: a pre-post evaluation of an educational intervention.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite high Human Papillomavirus (HPV) prevalence and the rank of cervical cancer as the second leading cause of cancer incidence and mortality among Nigerian women, HPV knowledge and vaccination remain poor, especially in rural settings in Nigeria. Ebonyi State is reported among the most affected areas, with HPV prevalence reaching 71.1%. This study evaluated the effectiveness of a school-based health education intervention on HPV knowledge and willingness to receive the HPV vaccine among female secondary school students in Ebonyi State.
methodsThis study utilised a pre- and post-test design. A total of 474 female students aged 9-14 years were selected from the three senatorial zones using multi-stage random sampling. The intervention included structured health education sessions on key topics delivered by trained health educators. An interviewer-administered questionnaire was used for data collection. Data analysis, including descriptive and inferential statistics (paired samples t-test and McNemar's test), was conducted using SPSS Version 26.
resultAt the pre-intervention stage, 83.5% of participants had low HPV knowledge. Following the intervention across the schools, 96% achieved high knowledge, with mean knowledge scores rising from 5.36 ± 6.26 to 23.41 ± 2.51 (p < 0.001). Among 193 participants who completed willingness items at both stages, willingness to receive HPV vaccine increased from 35.2% to 79.8% (p < 0.001). Only 10.6% of participants had been vaccinated. Lack of awareness, fear of side effects, vaccine unavailability, and parental objections were reported as reasons for poor vaccine uptake.
conclusionThis study demonstrates that school-based health education intervention is effective in improving HPV knowledge and willingness to receive HPV vaccine among female students. Translating these gains into actual vaccine uptake requires political commitment towards the integration of school-based health education interventions, engaging parents and guardians, and addressing barriers to vaccination, such as cost, vaccine availability, and safety concerns.
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