Patterns, distributions and predictors of human papillomavirus vaccination coverage among girls across 31 African countries

Cervical cancer is a leading cause of cancer-related deaths among women in sub-Saharan Africa, with Africa accounting for approximately 23% of global cervical cancer mortality. Despite the proven efficacy of human papillomavirus (HPV) vaccines in the prevention of cervical cancer, coverage remains far below the 90% global target. This study assessed HPV vaccination trends, regional differences, and the effect of vaccination programme duration on HPV vaccination coverage among girls and young women in Africa. Country data on HPV immunisation were obtained from the World Health Organization Immunization Portal. Descriptive statistics were used to estimate mean coverage (standard deviation), variation, and regional distribution in percentages. Linear regression analyses examined the association of HPV immunisation programme duration with vaccination coverage. By 2024, only 31 of 54 (56%) African countries had integrated HPV vaccination into their routine immunisation schedules, mostly targeting girls aged 9–14 years. The mean first-dose and last-dose coverage across the 31 countries were 64% (SD: 25.4) and 55% (SD: 27.3) respectively. The lowest coverage rates for the first and last doses were in Mali (15%), Gambia (15%) and Morocco (3%), whereas Cape Verde, Burkina Faso, Uganda, United Republic of Tanzania, and Mauritius achieved over 90% for both doses. Regionally, first and last-dose coverage were 77% and 61% in Eastern and Southern Africa, 63% and 60% in West and Central Africa, and 52% and 27% in North Africa, respectively. Across the 31 countries, HPV immunisation programme duration was positively associated with first-dose coverage (coefficient = 2.97, 95% CI: 0.28–5.66, p = 0.032), with each additional year of the programme associated with a 3% increase in vaccination coverage. In 2022, second-dose coverage was significantly associated with both programme duration (β = 4.192, SE = 1.278, 95% CI: 1.53–6.85, p = 0.004) and first-dose vaccination coverage (β = 0.321, SE = 0.133, 95% CI: 0.04–0.59, p = 0.025). HPV vaccination coverage in Africa is increasing slowly but remains below the target. However, longer programme duration is associated with higher uptake, highlighting the need for sustained investment and strengthened programme delivery to meet global vaccination targets.