Group of Indian medical doctors, male and female standing isolated on white background

About This Guide

This guide is designed for medical society board, committee and volunteer leaders seeking to take action to prevent cervical cancer in India through increased rates of HPV vaccination for girls ages 9 to 14 years, the only vaccine approved that can prevent cervical cancer.

Female doctor preparing injection in clinic

Medical societies can use action steps and accompanying resources either as individual efforts or as part of a comprehensive education awareness initiative to support member physicians with recommending the HPV vaccine as cervical cancer prevention in their practices, routinely and with confidence.

The development of this guide and its resources were informed by research with physicians conducted by the Center for Social and Behavioral Change, Ashoka University and Cancer Foundation of India supported by a grant from the American Cancer Society’s Global HPV Cancer Free initiative. Learn more about the research that contributed to the development of this guide.

An action plan template is available to help prioritise activities.

Special note about the reference to physicians

The term ‘physicians’ as used in this guide refers to a range of doctors for whom HPV vaccination is relevant. This includes:

  • General Physicians
    usually the first point of contact for healthcare needs
  • Pediatricians
    who are closely associated with vaccination programs for children/adolescents
  • Gynaecologists
    most often screen for and diagnose cervical cancer

Challenges to HPV Vaccination in India

  • HPV vaccines have not been widely accessible to all girls across India. The vaccine was introduced in India in 2008 and is expected to be included in the Universal Immunisation Program (UIP) in 2023; but has thus far been primarily available only through the private market at additional out-of-pocket cost. As the national rollout of the free vaccine occurs, this challenge will be overcome.
  • Many physicians underestimate the incidence and risk of cervical cancer and HPV infection which leads them to not routinely recommend the vaccine.
  • Many physicians underestimate the HPV vaccine’s safety and effectiveness. This leads to hesitation to recommend the vaccine.
  • Physicians may hesitate to recommend HPV vaccination because HPV infections are primarily transmitted sexually or they feel it will be time consuming to counsel parents.

For more details about the challenges to HPV vaccination, read the research conducted with Indian physicians that informed the development of this guide.

The Role of Medical Societies in Increasing HPV Vaccination Among Adolescent Girls

Medical societies have a strong presence at national, state, and local levels. They are respected public health leaders in the physician community and valued partners to policy makers.

Professional organisations are recognised to be primary sources of the latest information on scientific research and guidelines, providers of continuing medical education, and authorities on standards of excellence for clinical practice.

Medical societies can create a much-needed sense of urgency among physicians and policy makers by voicing a strong position in support of cervical cancer elimination and including HPV vaccination as its priority initiative. This can help catalyse a) physicians across the country to strongly recommend the vaccine to parents and caregivers, and b) policy makers at national and state levels to include the HPV vaccine in publicly funded vaccination programs.

Actions At a Glance

To address current challenges to HPV vaccination uptake, this guide suggests three actions your medical society can take to motivate and support physicians to recommend the HPV vaccine routinely and confidently.

Alert physicians of their pivotal role in preventing cervical cancer through HPV vaccination of adolescent girls.

Cultivate physician champions who will advocate for increased administration of the HPV vaccine among both peers and parents.

Recognise and share successes in increasing HPV vaccination.

Medical workers gathered at a laptop

Action 1

Alert physicians of high risk of cervical cancer and their pivotal role in preventing it

Physicians are viewed as the most trusted source for medical information by parents and caregivers. A strong physician recommendation increases the likelihood of HPV vaccination, yet research has found that physicians underestimate the availability of a safe and effective modality to prevent it: the HPV vaccine. This misperception contributes to them not actively recommending the HPV vaccine to parents or caregivers of adolescent girls.

Medical societies should consider undertaking multiple activities to increase member physicians’ education and awareness of: (a) the extent and severity of cervical cancer in India, and (b) the impact of their recommendation in addressing it.

Actions to consider

Publish a letter to members describing the magnitude of the cervical cancer problem and urging them to follow recommended HPV vaccination guidelines with all 9 to 14-year-old girls in their practice.

Share key cervical cancer and HPV vaccination facts, statistics, and messages with members through frequent distribution of information, education, and communication (IEC) materials.

Remind physicians of the incidence and seriousness of cervical cancer and the HPV vaccine as a primary prevention tool through the medical society’s regular communication channels. Examples include: newsletters, websites, emails, social media platforms, conferences, podcasts, and webinars.

  • Include oncologists as speakers during education opportunities such as HPV presentations, medical conference webinars, and continuing medical education courses.
  • Host a live or recorded video or audio story with an expert(s) in cervical cancer prevention and disseminate it through channels such as Facebook Live, WhatsApp, YouTube, Instagram, and LinkedIn.
  • Leverage cervical cancer awareness events to promote facts about cervical cancer and the life-saving benefits of HPV vaccination. Examples include Cervical Cancer Awareness Month (January), World Cancer Day (February 4), International HPV Day (March 4), and International Women’s Day (March 8).

Promote the use of in-clinic visual reminders that can serve as conversation starters with parents and caregivers. These could be in the form of posters depicting the risk and burden of cervical cancer, recommended ages for HPV vaccination, and/ or facts about the HPV vaccine.

Collaborate with other national medical societies and cancer centres on HPV vaccination activities to show broad support and increase impact.

Key messages

As physicians, it is our responsibility to recommend the HPV vaccine and explain to people why it is essential that all young girls receive it. Use these messages to guide conversation.

  • HPV, or human papillomavirus, is a common virus that causes almost all cervical cancer.
  • HPV vaccination is cervical cancer prevention.
  • The HPV vaccine is safe and provides long lasting protection against cervical cancer.
  • HPV vaccination works best when given to girls on-time, between ages 9 and 14.
Mature medicine worker talking and sharing team motivation.

Action 2

Cultivate HPV vaccination physician champions

Physician champions supporting a health issue or clinical approach have been found to be highly effective in facilitating implementation and adoption of evidence-based practices [19]. Endorsement of the HPV vaccine’s safety and effectiveness by well-known, respected physician leaders (referred to as champions) significantly increases physician trust in the vaccine and motivates physicians to recommend the vaccine to their patients. HPV vaccination champions model strong prevention behaviour in their practice. They act as mentors to peers and endorse HPV vaccination as cancer prevention at every opportunity.

Actions to consider

Identify champions

  • Champion characteristics include being widely known and well-respected, having personal interest and commitment to cervical cancer prevention, fluency in local language(s), and good communication skills.
  • Recruit champions who will have influence with your target physician group taking into account geography, patient population, and languages spoken.

Engage champions

  • Train champions on using key messages when communicating about the HPV vaccine.
  • Identify and plan opportunities for champions to promote the HPV vaccine. Examples include: videos on medical society’s website, participation in cervical cancer awareness events, educational webinars and conferences, and inclusion in newsletter articles.
  • Provide champions with resources to help them reach their target audiences.
  • Use medical society or partner communication platforms (videos, Facebook Live recordings, podcasts, blog posts, e-mail blasts, op-eds and newsletter articles) to help champions conduct their HPV vaccination education and outreach.

Support champions

  • Regularly check-in with champions to track their efforts and provide additional support as needed.
  • Reinforce continual use of HPV vaccination key messages for physicians.
  • Report back to champions on the impact of their efforts such as the number of views their video received or number of participants who attended a webinar.
  • Recognise the work of champions. For example, highlight them with photos and quotes on why they think advocating for the HPV vaccine is important. Acknowledge their contributions and efforts during association member meetings and webinars.

Ideas for champion activities

  • Raise awareness about HPV vaccination at local medical society events and through medical society’s digital communication platforms (i.e., website, social media, email blasts, podcast, newsletter, etc.).
  • Deliver presentations to physicians at local and national medical conferences and webinars on HPV vaccination and/or counselling parents on HPV vaccination (contact us for sample presentations).
  • Represent the medical society as a spokesperson for cervical cancer prevention and HPV vaccination in traditional media (TV, radio, and print) and social media channels using key messages.
  • Promote HPV vaccination on personal social media platforms.
Asian Indian male physician holding report file in hand and giving consultation to a smiling female.

Action 3

Recognise and share successes in increasing HPV vaccination

Increases in HPV vaccination will take time, effort, and commitment from your medical society’s leadership and its members. Identifying and acknowledging progress will encourage continued change and re-energise member engagement along the way.

Actions to consider

Recognise early adopters. Identify individual physicians and clinics who are changing their behaviour and attitudes toward HPV vaccination. Simple ways to identify early adopters include peer nominations and member surveys. Provide a certificate of recognition for display in clinics.

Create an award to be presented at the medical society’s annual conference for physicians or clinics that have shown extraordinary leadership in HPV vaccination and cancer prevention activities.

Feature successes through multiple communication channels like newsletters, e-mails, conferences, videos.

Our Research

Cervical Cancer Prevention Through HPV Vaccination: An Action Guide for Medical Societies in India and its resources were informed by behaviour change communications research with physicians on their perceptions about cervical cancer and HPV vaccination.

Resources

Cervical Cancer Prevention Through HPV Vaccination: An Action Guide for Medical Societies in India offers medical societies resources – fact sheets, provider education and training materials, clinic posters, and more – to motivate and support physicians to recommend the HPV vaccine routinely and confidently. Some of these tools can be customised with your organisation’s logo, as desired.

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