Acceptance of HPV Vaccination: A Systematic Review of Knowledge, Attitudes and Barriers Among Healthcare Practitioners in Low‐ and Middle‐Income Countries

Background: Cervical cancer is one of the diseases that reflects global inequities. Vaccination against the human papillomavirus (HPV) is one of the main pillars of the World Health Organization (WHO) 2030 cervical cancer 90:70:90 elimination strategy. The role of healthcare practitioners in HPV vaccination acceptance cannot be overemphasized. This review investigated healthcare practitioners' knowledge, attitudes and barriers to promoting HPV vaccination in low- and middle-income countries (LMICs). Methods: A comprehensive search for relevant literature from 2006 to 2024 was conducted in the following databases: Web of Science, Scopus, MEDLINE, EMBASE, PsycINFO (via Ovid), Cochrane Library and CINAHL PLUS (via EBSCOhost). The included studies were published in the English language. Screening of eligible studies, data extraction and quality assessment were conducted in duplicate. The data was synthesise using narrative synthesis. Results: A total of 671 papers were identified from the database search, with seven studies meeting the criteria for inclusion. This review demonstrates varied levels of awareness, knowledge and attitudes of 136 healthcare practitioners in LMICs towards HPV vaccination. Although some studies demonstrated a positive attitude, others reported resistance towards the vaccine. The perceived barriers to HPV vaccination by healthcare practitioners identified were interpersonal, community-level and systemic in nature. Additionally, acceptance of HPV vaccination varied across the studies. Conclusions: This review highlights the need for capacity building programmes for healthcare practitioners in the area of HPV vaccination to enhance their knowledge and attitudes and develop contextually relevant interventions to eliminate the many barriers they encounter.