Community and health workers’ perspectives on introducing HPV vaccination in a nonrollout district of Rajasthan, India: A qualitative study

BACKGROUND: Human papillomavirus (HPV) vaccination has not yet been introduced through the public health system in India. Understanding how communities and frontline providers perceive HPV vaccination before rollout is important for designing the introduction strategies. This study was aimed to explore community and health workers’ perspectives on introducing HPV vaccination in a nonrollout district of Rajasthan. MATERIALS AND METHODS: This qualitative study was conducted in Rajasthan, India, from March 2024 and June 2025. Data were collected through six focus group discussions with parents of adolescent girls and frontline health workers, and 10 in-depth interviews with Medical Officers and school teachers. Discussions were conducted in Hindi, audio-recorded, transcribed, and translated into English. Data were analyzed using a hybrid deductive-inductive thematic approach, guided by constructs of the Health Belief Model and allowing new themes to emerge. Reporting followed COREQ guidelines. RESULTS: Five interrelated themes emerged. Cervical cancer was perceived as a serious but distant risk. HPV vaccination was conditionally acceptable when framed as cancer prevention and endorsed by the government and doctors. Decision-making was family-based, with mothers as information seekers and fathers often perceived as final decision-makers. Schools and government health facilities were preferred delivery platforms. Health workers expressed willingness to support vaccination but reported gaps in confidence and counselling preparedness. CONCLUSION: In this nonrollout setting, perspectives on HPV vaccination reflected uncertainty rather than resistance. Addressing timing perceptions, family decision-making, and frontline communication needs may support smoother introduction of HPV vaccination in similar districts.