Mozambique’s doctors join race to reach girls who missed out on vaccination against cervical cancer
Private and hospital doctors are taking up the campaign – and there are signs are that they’re making inroads.
- 18 March 2025
- 4 min read
- by Ashley Simango
“We still have work to do,” says Firmino Jaqueta, public health chief for Mozambique’s central Manica Province. He’s talking about Mozambique’s campaign to protect girls from cervical cancer with the human papillomavirus (HPV) vaccine – a project the country kicked off in 2021.
By 2024, 80% of eligible girlshad received a dose of the vaccine. Medical experts call that statistic impressive but also point to the flipside: the “missing” 20% who remain needlessly at risk.
Doctors aboard
When Mozambique’s public HPV vaccine campaign first kicked off four years ago, the Ministry of Health saw to it that word would spread via public radio, at traditional village assemblies, from church pulpits, at Friday addresses in mosques, and in school-based sessions. But progress was initially lethargic, for a complex mix of reasons.
Since 2023, however, Mozambique’s health system has redoubled its efforts to reach the girls who missed their shot at protection in the campaign’s early phase.
Central to this effort has been getting family doctors – whether working in private practice or making ward rounds in public hospitals – on the side.
It’s a multifaceted approach, says Dr Rassul Bernardo, a physician running a private practice in Manica. Some women have missed out on taking the vaccine due to complacency. Most are simply unaware or prevented by circumstances connected with poverty.
So, from January last year, whenever female clients come in with their daughters for HIV tests or with symptoms of malaria, for instance, he makes a policy of asking them if their girls have had the HPV vaccine.
Dr Irene Carlos, a physician in Chimoio too, agrees on the necessity of this effort after seeing a few of her patients fall ill with cervical cancer. “I was surprised that some of [my] well-to-do clients – teachers, clerks – have not heard of the HPV vaccine and its necessity for their daughters,” she said.
Public hospitals
The HPV catch-up mission has also filtered down to trainee student doctors serving in public hospitals as part of their training. Melinda Apia, a trainee doctor from University Eduardo Mondlane, and who is on a clinical posting at Chimoio Provincial Hospital, has answered the call.
She reports “gladly” asking every mother whether their daughters have taken the HPV vaccine yet. “Even for mothers who have given birth, I calmly jot for them down on paper a reminder that when their daughters grow up a bit” – the vaccine is recommended for girls aged 9 to 14 years – “they should take the HPV vaccine”.
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According to Dr Flavio Meque, the former chief clinical officer for Manica, a non-negotiable priority for Mozambique’s HPV programme is to ensure that girls who can’t afford to visit private doctors are also vaccinated. That number includes not only the most vulnerable cohort – cervical cancer is more common in poor populations – but also the vast majority. Most Mozambicans rely on public hospitals and clinic, with only a tiny minority affording for-profit private care.
Rallying student doctors serving in public hospitals that serve millions of the poor is critical, says Dr Meque: “It makes the most impactful results on the ground.”
Meet Bongi Dube
Many obstacles to HPV uptake persist. One of them is enduring ignorance about the importance of the vaccine – a deceptively simple way to describe an often far more complex challenge.
In Espungabera, a town in the south of Manica province, VaccinesWork met Bongi Dube, a mother of one young daughter, who said her child was unvaccinated against HPV due to her own lack of health education.
In fact, much of Dube’s life has been marked by a day-to-day battle for survival so immediate that far-sighted preventive healthcare could understandably seem abstract by comparison. When Dube was young, she was pressured into a forced marriage to an elderly man who was already married to two other women in Tete, the northern Mozambique province near Malawi. She finally found the courage to flee the marriage and headed as far as she could – to Espungabera, where she began to rebuild her life. “I never knew what the HPV vaccine is, to be honest,” she says.
On a routine visit to Espungabera District Hospital in January 2025, the trainee doctors who were on duty sat her down and spoke to Dube in the local Ndau language. They explained the benefits of the vaccine and the protection it could guarantee her daughter. “I was happy to hear it, but the trauma of my forced marriage made me suspicious of people,” she says.
It was when her pastor assured her that the young doctors meant well and that the vaccine was for her daughter’s good, that she finally lowered her guard. She returned to the hospital the next day and enrolled her daughter.
Jaqueta, the public health chief, says family doctors serving in their private practices and those doing locum work in public hospitals are vital to the national effort to beat back cervical cancer – not least because they can engage with parents and girls in a relaxed moment. They are frontline heroes many times over, Jaqueta says – “this time for HPV”.
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