ABSTRACT
Objectives: Rwanda was the first country in Africa to introduce the human papillomavirus (HPV) vaccine.
This was achieved through multi-year school-based campaigns. Our study evaluated the impact of the
HPV vaccine introduction on the country’s immunisation programme and health system.
Methods: Thirty key informantswere interviewed at national and district levels, and in participating schools.
Twenty-seven health facilities completed a questionnaire exploring the effects of the new vaccine introduction
on six health system building blocks, as defined by the World Health Organization. Routine
service activity data were collected during a 90-day period around the introduction.
Results: Routine vaccination activities were not disrupted during the delivery, likely due to a strong Expanded
Program on Immunization, appropriate planning and a well-resourced operation. Opportunities
were seized to co-deliver other interventions targeted at children and adolescents, such as health promotion.
Collaboration with the Ministry of Education was strengthened at national level. Although there
were some temporary increases in staff workload, no major negative effects were reported.
Conclusion: Despite its delivery through school-based campaigns, the HPV vaccine integrated well into
the immunisation programme and health system. The introduction had no major negative effects. Some
opportunities were seized to expand services and collaborations.