How one father’s love is helping shield Nigeria’s daughters from cervical cancer
The tragic loss of his wife to cervical cancer ignited Borno state immunisation officer Maina Modu's determination to protect not only his daughters, but all young girls in the state from the vaccine-preventable disease.
- 3 July 2024
- 6 min read
- by Zubaida Baba Ibrahim , Usman Abba Zanna
When Borno state immunisation officer Maina Modu, 55, first learned that the human papillomavirus (HPV) vaccine would be introduced in Nigeria, he was thrilled, counting down the days until it would become available. “I was even wishing my state will be among the first phases of the mass roll-out [in Nigeria],” Modu tells VaccinesWork.
That wasn’t to be: the first wave of Nigeria’s HPV drive, which kicked off in in October 2023, passed Modu's home state by – but he remained optimistic, knowing that by mid-year 2024, the cervical cancer-blocking vaccine would become available in Borno, too.
“[My wife’s death] pains me. Whenever I see the four children we had together I always remember her and I always remember the disease”
- Maina Modu, Immunisation Officer
In fact, he says he utilised the delay as an opportunity to educate his ten children about the vaccine's importance, assuring his girls that they would receive the shot as soon as it became available to them.
Painful memories
As a father of six daughters, Modu says he carries a deep sense of responsibility to protect girls from the threat of cervical cancer. It’s a threat he knows intimately, as the disease has already had a devastating impact on his family. In 2011, Modu lost his first wife to cervical cancer just months after she gave birth to their fourth child.
Cervical cancer is the second-most common cancer affecting Nigerian women. An estimated 12,000 women are diagnosed countrywide each year, and almost 8,000 die. In the vast majority of cases, cervical cancer is caused by HPV, a virus that is extremely common and transmitted through sexual contact. The vaccine is, as such, capable of blocking more than 90% of cervical cancers.
“[My wife’s death] pains me. Whenever I see the four children we had together I always remember her and I always remember the disease,” Modu says. “It impacted my life greatly and I generally think of how I can protect women. I have been reading about it [cervical cancer] as far back as 2011 so when I heard about the vaccine, I was very eager.”
Like so many diseases, cervical cancer is an inequitable threat. The risk of dying from it is higher among people with low socio-economic status. Studies have shown that rates of diagnosis with cervical cancer, as well as mortality rates from the cancer, are significantly lower in countries that score higher on the Human Development Index (HDI).
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The vaccine comes to Borno
To Modu’s delight, Nigeria’s HPV vaccine roll-out entered its second phase on 27 May 2024, expanding to Borno and the remaining 20 states. Among Modu's six daughters, two were eligible for the HPV vaccine, “and they were eager to receive it”, Modu recalls.
Modu had instilled in them the importance of vaccines and routine immunisation since they were young, and he shared with them the effects of cervical cancer, which had claimed the life of their mother. “As a result, they were well-informed of the risks [of the disease] and they had been looking forward to getting vaccinated.”
Beyond parental duty
Beyond his personal commitment to protecting his daughters, Maina Modu has been serving as a state immunisation officer for 30 years, and is playing a vital role in ensuring the successful roll-out of the jab to all eligible girls across his state.
As part of his responsibilities, Modu convened with his team to create a robust technical working group, capable of effectively managing the critical components of the vaccine roll-out, including supply chain logistics, demand generation and data management.
“Especially in human resources, we had to make sure that health care workers who would determine our success were readily available and fully trained,” Modu tells VaccinesWork.
As part of the second phase of the national roll-out, immunisation specialists like Modu were able to draw on lessons learned by other states during the first phase, particularly in terms of addressing vaccine-related myths and misinformation. These had proved to be a significant challenge during the first part of the roll-out, Modu explains.
One particular obstacle faced by Modu’s team was tackling misinformation surrounding the eligibility criteria for the HPV vaccine. The team had to create a comprehensive plan to not only mobilise the target demographic, but also educate the general public on the value of vaccinating the priority 9–14 age group, prior to the commencement of sexual activity. “We primarily do this by emphasising on the dangers of the disease,” Modu said.
Cervical cancer often manifests without early symptoms. As it progresses, the disease can produce pelvic pain and abnormal vaginal bleeding, and in more advanced stages, it can cause incontinence, leg swelling, and even bowel and bladder dysfunction.
Almost 400,000 girls protected
“The goal was to go deep. To reach every individual and every community, and create a demand for the vaccine,” he said, adding that it has been a success so far. “Our target was to reach 400,000 girls in the state, then we were asked by the national team, as a strategy for the roll-out, to reach at least 80% of our target. We are happy that we even exceeded [it], because we have successfully vaccinated 387,645 girls and the strategy [methods] we used were school outreach, community outreach and primary health care post sessions,” Modu told VaccinesWork. In total, more than 7 million girls were vaccinated against HPV in the first two weeks of Phase II of the national campaign.
“The goal was to go deep. To reach every individual and every community, and create a demand for the vaccine. Our target was to reach 400,000 girls in the state, then we were asked by the national team, as a strategy for the roll-out, to reach at least 80% of our target. We are happy that we even exceeded [it], because we have successfully vaccinated 387,745 girls.”
- Maina Modu, Immunisation Officer
The programme is making progress, but it’s part of Modu’s job to anticipate challenges that may arise as Nigeria’s HPV immunisation programme transitions from campaign mode to routine immunisation. Currently, he’s concerned that data entry into the DHIS2 system could present a hurdle, as there is a shortage of trained workers proficient in data entry. However, plans are underway to train data managers and routine immunisation providers in health facilities to address this gap “to avoid ‘there is vaccination but no data’,” he explains.
“As a father, you are the one to stand for your children…”
Two of Modu's six daughters have aged out of the eligibility bracket for the vaccine – but he remains dedicated to ensuring their continued safety from cervical cancer. He has made commitments to have them undergo regular cervical cancer screenings. Screenings are crucial in maintaining cervical health and detecting potential issues early on. Known as a smear test, the simple test is aimed at catching symptoms early, to head off the development of cervical cancer.
“Any related illnesses really, we will treat as early as possible,” Modu told VaccinesWork. “The remaining two [of my daughters] have not reached the required age, but I expect that in their routine immunisation they will also benefit from it.”
“As a father, you are the one to stand for your children. And what I expect from each father is to encourage their girls and personally take those within the age bracket to be vaccinated. Take them yourselves to make sure they are protected from human papillomavirus.”
