Integrating HPV vaccine service delivery with adolescent health programmes - Experiences and perspectives from selected countries in Africa.

Primary prevention of human papillomavirus (HPV) infection is particularly important in Africa, where there is a high and accelerating burden of cervical cancer. Stakeholders have increasingly called for integration of other services with HPV vaccination in low- and middle-income countries, yet successful and sustainable integration requires intensive resource inputs, and few countries in Africa have tested integrated approaches. We describe co-author experience and previously published assessments to present the experiences of four African countries, Senegal, Togo, Tanzania, and Lesotho, with integrating HPV vaccine services with other programmes and services. The resulting case series explores how countries are operationalizing the concept of integration and describes contextual factors for success and sustainability. A simple three-level framework for describing HPV vaccine integrated service delivery has emerged to guide future endeavors.