Introduction

Cervical cancer remains a significant public health challenge globally, with an estimated 662,044 new cases and 348,709 deaths reported in 2022 [1,2]. The highest incidence and mortality rates are observed in sub-Saharan Africa, South America, and South-East Asia [1,3]. The human papillomavirus (HPV) serotypes 16 and 18 are the primary causes of cervical cancer [4]. HPV is the most common sexually transmitted infection, with over 50% of sexually active women at risk of at least one serotype in their lifetime, with most contracting it after their sexual debut [5,6]. In Nigeria, cervical cancer incidence is alarmingly high, with a rate of 26.5 per 100,000 women, ranking it as the second most common cancer and the leading cause of cancer-related deaths among women aged 15–44 years, with an estimated 13,676 new cases and 7,000 deaths annually [7].

Prophylactic HPV vaccine has demonstrated the ability to prevent up to 90% of HPV-related cancers, including cervical, anal, oropharyngeal, vaginal, penile and vulvar cancers [8–10]. The HPV vaccine, introduced in 2006, was recommended by the World Health Organisation (WHO) in 2009 for early vaccination of pre-teen girls before they become sexually active, and been shown to prevent at least 70% of cervical cancer cases [7,11]. Since its introduction, over 100 million girls in the world have been vaccinated globally, with 95% of recipients residing in high-income countries [12]. The global strategy to eliminate cervical cancer aims to vaccinate 90% girls by age 15 years, screen 70% of women with a high-performance test by age 35 years and again by age 45 years, and ensure that 90% of women identified with cervical disease receive treatment [12]. The 90-70-90 target inspires optimism in low- and middle-income countries (LMIC) like Nigeria.

Given the proven efficacy and safety of HPV vaccine [13,14], and in response to the global call for cervical cancer prevention, Nigeria launched a nationwide free HPV vaccination campaign (using the Gardasil brand of HPV vaccine) in October 2023. The initiative aims to vaccinate over 16 million school-aged girls by 2025 through mass administration of the vaccine in schools and communities [15]. While national data on the number of vaccinated girls is scarce, parental approval remains crucial for the success of the program. Evidence from pre-launch surveys in Nigeria suggest that many parents and caregivers of school-aged girls are willing to consent to the use of the HPV vaccine if offered free of charge [16,17]. However, misinformation and concerns about vaccine safety persists among certain groups of the population [18]. Early findings since the vaccine launch indicate that parents and caregivers with higher educational levels and better knowledge of the HPV vaccine are more likely to consent to vaccination for their daughters [19]. Yet, there is limited understanding of how parents and caregivers personally perceive the HPV vaccine and how their responses shape the success of the vaccination campaign. This study aims to explore the perspectives of parents and caregivers in Ilishan Town, Nigeria, regarding the HPV vaccination of their daughters, providing valuable insights for culturally sensitive interventions and broader vaccine uptake strategies to support the global strategy to eliminate cervical cancer.

Research aim

The aim of the study protocol is to describe the methodological approach for exploring the responses of parents and caregivers in Ilishan, Nigeria, to the free HPV vaccination program for their school-aged daughters.

Methods

Discussion

The findings from this study will provide valuable insight into how parents and caregivers of school-aged girls in Ilishan perceive the HPV vaccine and the factors that informed the vaccination decision for their daughters. Also, gathering first-person information of consenting parents and caregivers will shed more light into parents’ approach to disease prevention practices and protection for young girls. This understanding will be essential for public health experts and vaccinators in developing targeted public health interventions that address parental concerns, enhance information around vaccines, and ultimately, improve vaccine uptake. By considering the contextual factors that inform vaccination decisions, the study will contribute to the global effort to eliminate cervical cancer and promote the health and well-being of adolescent girls in Nigeria and similar settings. More broadly, it will provide additional contextual understanding that can help increase confidence in vaccination in general.

Limitations

The focus of this study on English- or Yoruba-speaking parents in Ilishan limits its generalizability to other regions or linguistic groups in Nigeria. However, given the demographic characteristics of the community, the findings are expected to be transferable to similar rural settings in the country. In addition, the purposive sampling strategy, which relies on school registers and contact through community gatekeepers, may inadvertently exclude certain parental perspectives, such as parents who are not accessible through schools, lack reliable telephone access, or are less engaged with formal educational or health systems. This may further limit the range of perspectives captured and should be considered when interpreting the findings. Additionally, some cultural nuances or expressions may be lost during translation from English to local language and vice versa. To mitigate this, the researcher will conduct transcription and translation carefully and include untranslatable words in parentheses.

Dissemination

We anticipate that results will be ready for publication by March 2026. Findings will be disseminated widely through publication in an academic journal, conference presentations, and a detailed report to research sponsors as well as to Ikenne Local Government, where parents and caregivers in Ilishan will be recruited. To ensure accessibility for local stakeholders, findings will also be shared through plain-language summary reports and brief presentations tailored to community and local government audiences. Participant quotes will be included where appropriate to illustrate key findings, while ensuring that privacy and confidentiality are fully protected. Results will additionally be shared through social media platforms, such as LinkedIn, X, and via blog posts to reach a broader audience. This multi-pronged dissemination strategy aims to maximize the visibility and impact of the study across academic, vaccination program, and health policy contexts, while ensuring that findings are accessible to the communities involved.

Supporting information