Study protocol for integrated service delivery to improve adolescent health and HPV vaccination in Lao PDR: A quasi-experimental mixed-methods study

1.BackgroundThe Lao Peoples Democratic Republic (PDR) faces the challenge of high cervical cancer incidence and low HPV vaccine coverage, alongside broader adolescent health concerns like high adolescent pregnancy rates and inadequate Sexual and Reproductive Health (SRH) literacy. The integration of HPV vaccination with adolescent health services aims to address these issues comprehensively, increasing vaccine uptake and improving overall adolescent health outcomes. MethodsThis study will employ a quasi-experimental design with mixed methods to assess the impact of integrating HPV vaccination with adolescent health services in two districts of Louangnamtha province in Laos. The study population includes girls aged 10-13 years for HPV vaccination and boys and girls aged 10-13 years for other adolescent health services. The intervention district will receive an integrated service package comprising HPV vaccination and adolescent health services delivered through school-based, facility-based, and outreach approaches. The comparison district will continue with its standard HPV vaccination and routine adolescent health service delivery. The intervention will be for 7 months from 2024 November to 2025 May. Quantitative data on HPV vaccine uptake, SRH knowledge and attitudes, and utilization of adolescent health services will be collected at baseline, midline, and endline. Qualitative data on barriers and facilitators to implementation, provider workload and capacity, and stakeholder perceptions will be collected through in-depth interviews and focus group discussions at endline. ResultsThe study outcome is the evidence on the impact of integration on change in HPV vaccine uptake, change in SRHR knowledge and attitude, utilization of adolescent health services, healthcare providers workload and capacity, and stakeholders opinions regarding the integrated intervention. RecommendationsThe studys findings will inform policies and practices in Lao PDR. Study Registrations1) ClinicalTrials.gov ID NCT06650956, 2) OSF Pre-registration: https://doi.org/10.17605/OSF.IO/MGEQ7