{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T23:03:26Z","timestamp":1789513406171,"version":"build-2803163510"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":79,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"DOI":"10.1186\/s12905-026-04637-2","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T02:35:57Z","timestamp":1782700557000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging the service gap: health facility challenges in HPV vaccine uptake in rural Uganda"],"prefix":"10.1186","volume":"26","author":[{"given":"Mbonigaba Rukarama","family":"Evarist","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald Arineitwe","family":"Kibonire","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"4637_CR1","doi-asserted-by":"publisher","first-page":"101460","DOI":"10.1016\/j.gore.2024.101460","volume":"54","author":"S Reza","year":"2024","unstructured":"Reza S, Anjum R, Khandoker RZ, Khan SR, Islam MR, Dewan SMR. Public health concern-driven insights and response of low- and middle-income nations to the World Health Organization call for cervical cancer risk eradication. Gynecologic Oncol Rep. 2024;54:101460. https:\/\/doi.org\/10.1016\/j.gore.2024.101460.","journal-title":"Gynecologic Oncol Rep"},{"issue":"16","key":"4637_CR2","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.3390\/healthcare11162273","volume":"11","author":"M Rayner","year":"2023","unstructured":"Rayner M, Welp A, Stoler MH, Cantrell LA. Cervical cancer screening recommendations: now and for the future. Healthcare. 2023;11(16):2273. https:\/\/doi.org\/10.3390\/healthcare11162273.","journal-title":"Healthcare"},{"key":"4637_CR3","doi-asserted-by":"publisher","unstructured":"Alhamlan FS, Alfageeh MB, Al Mushait MA, Al-Badawi IA, Al-Ahdal MN. Human papillomavirus-associated cancers. In Microbial Pathogenesis: Infection and Immunity . Springer International Publishing. 2021:1\u201314. https:\/\/doi.org\/10.1007\/978-3-030-67452-6_1.","DOI":"10.1007\/978-3-030-67452-6_1"},{"key":"4637_CR4","doi-asserted-by":"publisher","first-page":"21","DOI":"10.25259\/CMAS_03_02_2021","volume":"19","author":"S Pimple","year":"2022","unstructured":"Pimple S, Mishra G. Cancer cervix: Epidemiology and disease burden. Cytojournal. 2022;19:21. https:\/\/doi.org\/10.25259\/CMAS_03_02_2021.","journal-title":"Cytojournal"},{"key":"4637_CR5","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.ejogrb.2022.12.001","volume":"281","author":"AM O\u2019Neill","year":"2023","unstructured":"O\u2019Neill AM, Dwyer R. Primary prevention of cervical cancer in women: Human papillomavirus vaccine. Eur J Obstet Gynecol Reproductive Biology. 2023;281:29\u201331. https:\/\/doi.org\/10.1016\/j.ejogrb.2022.12.001.","journal-title":"Eur J Obstet Gynecol Reproductive Biology"},{"issue":"1","key":"4637_CR6","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1080\/14737159.2023.2173580","volume":"23","author":"S Padavu","year":"2023","unstructured":"Padavu S, Aichpure P, Krishna Kumar B, Kumar A, Ratho R, Sonkusare S, Rai P. An insight into clinical and laboratory detections for screening and diagnosis of cervical cancer. Expert Rev Mol Diagn. 2023;23(1):29\u201340. https:\/\/doi.org\/10.1080\/14737159.2023.2173580.","journal-title":"Expert Rev Mol Diagn"},{"issue":"3","key":"4637_CR7","doi-asserted-by":"publisher","first-page":"e056722","DOI":"10.1136\/bmjopen-2021-056722","volume":"12","author":"J Asasira","year":"2022","unstructured":"Asasira J, Lee S, Tran TXM, Mpamani C, Wabinga H, Jung SY, Cho H. Infection-related and lifestyle-related cancer burden in Kampala, Uganda: Projection of the future cancer incidence up to 2030. BMJ Open. 2022;12(3):e056722. https:\/\/doi.org\/10.1136\/bmjopen-2021-056722.","journal-title":"BMJ Open"},{"issue":"3","key":"4637_CR8","doi-asserted-by":"publisher","first-page":"S120","DOI":"10.1016\/j.ijrobp.2021.07.274","volume":"111","author":"A Yaney","year":"2021","unstructured":"Yaney A, Mladkova N, Quick AM. Clinical and genomic determinants of survival in Ugandan women with cervical cancer. Int J Radiat Oncol Biol Phys. 2021;111(3):S120. https:\/\/doi.org\/10.1016\/j.ijrobp.2021.07.274.","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"4637_CR9","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.ygyno.2021.11.005","volume":"164","author":"J Huang","year":"2022","unstructured":"Huang J, Deng Y, Boakye D, Tin MS, Lok V, Zhang L, NCD Global Health Research Group. Global distribution, risk factors, and recent trends for cervical cancer: A worldwide country-level analysis. Gynecol Oncol. 2022;164(1):85\u201392. https:\/\/doi.org\/10.1016\/j.ygyno.2021.11.005.","journal-title":"Gynecol Oncol"},{"issue":"2","key":"4637_CR10","doi-asserted-by":"publisher","first-page":"e197","DOI":"10.1016\/S2214-109X(22)00501-0","volume":"11","author":"D Singh","year":"2023","unstructured":"Singh D, Vignat J, Lorenzoni V, Eslahi M, Ginsburg O, Lauby-Secretan B, Vaccarella S. Global estimates of incidence and mortality of cervical cancer in 2020: A baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. Lancet Global Health. 2023;11(2):e197\u2013206. https:\/\/doi.org\/10.1016\/S2214-109X(22)00501-0.","journal-title":"Lancet Global Health"},{"issue":"2","key":"4637_CR11","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1002\/ijc.35369","volume":"157","author":"Z Li","year":"2025","unstructured":"Li Z, Liu P, Yin A, Zhang B, Xu J, Chen Z, Song K. Global landscape of cervical cancer incidence and mortality in 2022 and predictions to 2030: The urgent need to address inequalities in cervical cancer. Int J Cancer. 2025;157(2):288\u201397. https:\/\/doi.org\/10.1002\/ijc.35369.","journal-title":"Int J Cancer"},{"issue":"1","key":"4637_CR12","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1186\/s12905-023-02511-z","volume":"23","author":"RM Nakayita","year":"2023","unstructured":"Nakayita RM, Benyumiza D, Nekesa C, Misuk I, Kyeswa J, Nalubuuka A, Kumakech E. Factors associated with uptake of human papilloma virus vaccine among school girls aged 9\u201314 years in Lira City northern Uganda: A cross-sectional study. BMC Women\u2019s Health. 2023;23(1):362. https:\/\/doi.org\/10.1186\/s12905-023-02511-z.","journal-title":"BMC Women\u2019s Health"},{"issue":"4","key":"4637_CR13","doi-asserted-by":"publisher","first-page":"e0003106","DOI":"10.1371\/journal.pgph.0003106","volume":"4","author":"M Laban","year":"2024","unstructured":"Laban M, Nanyonjo G, Wambuzi M, Ssetaala A, Basalirwa G, Muramuzi D, Mirzazadeh A. Uptake of Human Papilloma Virus vaccine among young women living in fishing communities in Wakiso and Mukono districts, Uganda. PLOS Global Public Health. 2024;4(4):e0003106. https:\/\/doi.org\/10.1371\/journal.pgph.0003106.","journal-title":"PLOS Global Public Health"},{"issue":"6","key":"4637_CR14","doi-asserted-by":"publisher","first-page":"e0253735","DOI":"10.1371\/journal.pone.0253735","volume":"16","author":"J Rujumba","year":"2021","unstructured":"Rujumba J, Akugizibwe M, Basta NE, Banura C. Why don\u2019t adolescent girls in a rural Uganda district initiate or complete routine 2-dose HPV vaccine series: Perspectives of adolescent girls, their caregivers, healthcare workers, community health workers and teachers. PLoS ONE. 2021;16(6):e0253735. https:\/\/doi.org\/10.1371\/journal.pone.0253735.","journal-title":"PLoS ONE"},{"issue":"6","key":"4637_CR15","doi-asserted-by":"publisher","first-page":"e0269655","DOI":"10.1371\/journal.pone.0269655","volume":"17","author":"L Patrick","year":"2022","unstructured":"Patrick L, Bakeera-Kitaka S, Rujumba J, Malande OO. Encouraging improvement in HPV vaccination coverage among adolescent girls in Kampala, Uganda. PLoS ONE. 2022;17(6):e0269655. https:\/\/doi.org\/10.1371\/journal.pone.0269655.","journal-title":"PLoS ONE"},{"issue":"1","key":"4637_CR16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12905-023-02511-z","volume":"23","author":"RM Nakayita","year":"2023","unstructured":"Nakayita RM, Benyumiza D, Nekesa C, Misuk I, Kyeswa J, Nalubuuka A, Murungi T, Udho S, Kumakech E. Factors associated with uptake of human papilloma virus vaccine among school girls aged 9\u201314 years in Lira City northern Uganda: a cross-sectional study. BMC Women\u2019s Health. 2023;23(1):1\u20138. https:\/\/doi.org\/10.1186\/s12905-023-02511-z.","journal-title":"BMC Women\u2019s Health"},{"issue":"8","key":"4637_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0300155","volume":"19","author":"V Nakibuuka","year":"2024","unstructured":"Nakibuuka V, Muddu M, Kraehenbuhl JP, Birungi C, Semitala FC, Tusubira AK. Uptake of human papilloma virus vaccination among adolescent girls living with HIV in Uganda: A mixed methods study. PLoS ONE. 2024;19(8):1\u201317. https:\/\/doi.org\/10.1371\/journal.pone.0300155.","journal-title":"PLoS ONE"},{"issue":"2","key":"4637_CR18","doi-asserted-by":"publisher","first-page":"355","DOI":"10.4269\/ajtmh.25-0503","volume":"114","author":"S Ggingo","year":"2025","unstructured":"Ggingo S, Obore S, Musaba M, Wandabwa J, Kiondo P. Factors Associated with Human Papillomavirus Vaccination Uptake Among Adolescent Girls in Uganda. Am J Trop Med Hyg. 2025;114(2):355\u20139.","journal-title":"Am J Trop Med Hyg"},{"key":"4637_CR19","doi-asserted-by":"publisher","first-page":"101651","DOI":"10.1016\/j.pmedr.2021.101651","volume":"24","author":"KE Wijayanti","year":"2021","unstructured":"Wijayanti KE, Sch\u00fctze H, MacPhail C. Parents\u2019 attitudes, beliefs and uptake of the school-based human papillomavirus (HPV) vaccination program in Jakarta, Indonesia\u2013A quantitative study. Prev Med Rep. 2021;24:101651. https:\/\/doi.org\/10.1016\/j.pmedr.2021.101651.","journal-title":"Prev Med Rep"},{"issue":"11","key":"4637_CR20","doi-asserted-by":"publisher","first-page":"e068212","DOI":"10.1136\/bmjopen-2022-068212","volume":"12","author":"L Elit","year":"2022","unstructured":"Elit L, Ngalla C, Afugchwi GM, Tum E, Domgue JF, Nouvet E. Assessing knowledge, attitudes and belief toward HPV vaccination of parents with children aged 9\u201314 years in rural communities of Northwest Cameroon: A qualitative study. BMJ Open. 2022;12(11):e068212. https:\/\/doi.org\/10.1136\/bmjopen-2022-068212.","journal-title":"BMJ Open"},{"key":"4637_CR21","doi-asserted-by":"publisher","first-page":"359","DOI":"10.2147\/PHMT.S312039","volume":"12","author":"D Feyisa","year":"2021","unstructured":"Feyisa D. Cold chain maintenance and vaccine stock management practices at public health centers providing child immunization services in Jimma Zone, Oromia Regional State, Ethiopia: Multi-centered, mixed method approach. Pediatr Health Med Ther. 2021;12:359\u201372. https:\/\/doi.org\/10.2147\/PHMT.S312039.","journal-title":"Pediatr Health Med Ther"},{"issue":"4","key":"4637_CR22","doi-asserted-by":"publisher","first-page":"869","DOI":"10.3390\/vaccines11040869","volume":"11","author":"B Davies","year":"2023","unstructured":"Davies B, Olivier J, Amponsah-Dacosta E. Health systems determinants of delivery and uptake of maternal vaccines in low-and middle-income countries: A qualitative systematic review. Vaccines. 2023;11(4):869. https:\/\/doi.org\/10.3390\/vaccines11040869.","journal-title":"Vaccines"},{"issue":"11","key":"4637_CR23","doi-asserted-by":"publisher","first-page":"872","DOI":"10.5603\/GP.a2021.0228","volume":"93","author":"D Trojnarska","year":"2022","unstructured":"Trojnarska D, Baran R, Babczyk D, Jach R. A survey of knowledge, attitudes and awareness of the HPV and HPV vaccine among obstetricians and gynecologists across Poland. Ginekologia polska. 2022;93(11):872\u201380. https:\/\/doi.org\/10.5603\/GP.a2021.0228.","journal-title":"Ginekologia polska"},{"issue":"1","key":"4637_CR24","doi-asserted-by":"publisher","first-page":"e0001406","DOI":"10.1371\/journal.pgph.0001406","volume":"3","author":"SE MacDonald","year":"2023","unstructured":"MacDonald SE, Kenzie L, Letendre A, Bill L, Shea-Budgell M, Henderson R, Nelson G. Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review. PLOS Global Public Health. 2023;3(1):e0001406. https:\/\/doi.org\/10.1371\/journal.pgph.0001406.","journal-title":"PLOS Global Public Health"},{"key":"4637_CR25","doi-asserted-by":"publisher","first-page":"598625","DOI":"10.3389\/fpubh.2021.598625","volume":"9","author":"T Milondzo","year":"2021","unstructured":"Milondzo T, Meyer JC, Dochez C, Burnett RJ. Misinformation drives low human papillomavirus vaccination coverage in South African girls attending private schools. Front Public Health. 2021;9:598625. https:\/\/doi.org\/10.3389\/fpubh.2021.598625.","journal-title":"Front Public Health"},{"issue":"1","key":"4637_CR26","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1186\/s12887-023-04174-z","volume":"23","author":"GK Bitariho","year":"2023","unstructured":"Bitariho GK, Tuhebwe D, Tigaiza A, Nalugya A, Ssekamatte T, Kiwanuka SN. Knowledge, perceptions and uptake of human papilloma virus vaccine among adolescent girls in Kampala, Uganda; a mixed-methods school-based study. BMC Pediatr. 2023;23(1):368. https:\/\/doi.org\/10.1186\/s12887-023-04174-z.","journal-title":"BMC Pediatr"},{"issue":"6","key":"4637_CR27","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1177\/15248399211046611","volume":"23","author":"TA Holroyd","year":"2022","unstructured":"Holroyd TA, Yan SD, Srivastava V, Srivastava A, Wahl B, Morgan C, Jennings MC. Designing a pro-equity HPV vaccine delivery program for girls who have dropped out of school: Community perspectives from Uttar Pradesh, India. Health Promot Pract. 2022;23(6):1039\u201349. https:\/\/doi.org\/10.1177\/15248399211046611.","journal-title":"Health Promot Pract"},{"issue":"4","key":"4637_CR28","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1097\/CEJ.0000000000000866","volume":"33","author":"D Trojnarska","year":"2024","unstructured":"Trojnarska D, Jach R. Primary prevention of HPV-related diseases from the patients\u2019 perspective in Poland. Eur J Cancer Prev. 2024;33(4):299\u2013308. https:\/\/doi.org\/10.1097\/CEJ.0000000000000866.","journal-title":"Eur J Cancer Prev"},{"issue":"1","key":"4637_CR29","doi-asserted-by":"publisher","first-page":"2402122","DOI":"10.1080\/21645515.2024.2402122","volume":"20","author":"D Bakare","year":"2024","unstructured":"Bakare D, Gobbo E, Akinsola KO, Bakare AA, Salako J, Hanson C, King C. Healthcare worker practices for HPV vaccine recommendation: A systematic review and meta-analysis. Hum Vaccines Immunotherapeutics. 2024;20(1):2402122. https:\/\/doi.org\/10.1080\/21645515.2024.2402122.","journal-title":"Hum Vaccines Immunotherapeutics"},{"key":"4637_CR30","doi-asserted-by":"publisher","first-page":"802947","DOI":"10.3389\/fpubh.2022.802947","volume":"10","author":"CM Karanja-Chege","year":"2022","unstructured":"Karanja-Chege CM. HPV vaccination in Kenya: The challenges faced and strategies to increase uptake. Front Public Health. 2022;10:802947. https:\/\/doi.org\/10.3389\/fpubh.2022.802947.","journal-title":"Front Public Health"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-026-04637-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-026-04637-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-026-04637-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:29:05Z","timestamp":1789511345000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12905-026-04637-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4637"],"URL":"https:\/\/doi.org\/10.1186\/s12905-026-04637-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7597029\/v1","asserted-by":"object"}]},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"assertion":[{"value":"12 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study was conducted in accordance with the Declaration of Uganda National Council for Science and Technology and all applicable ethical guidelines for research involving human participants. Clearance to conduct this study was obtained from the Department of community at Kabale University under registration number 2018\/MPH\/1659\/W. Further ethical approval was granted by office of District Health officer Rukiga District after getting final clearance for data collection obtained from the Uganda National Council for Science and Technology (UNCST), reference number MUST-2022-511. Informed consent was obtained from all participants prior to their involvement in the study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not Applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"456"}}