“This Is Something Every Woman Needs. . .So Why Is It That Expensive?”: Examining Privileges and Inequities in Access to a Privately Funded HPV Vaccination Program in Ghana
Bibliographic record
Abstract
The age-standardized incidence and mortality rates for cervical cancer in Ghana is 27.4 and 17.8 per 100,000 women, respectively. Currently, HPV vaccination is available only through privately funded programs, leading to inequitable access and uptake. This study examined how intersecting identities, and social locations contribute to inequities in the privately-funded HPV vaccination program in Ghana. We used an intersectionality-guided qualitative case study design. Data collection included non-participant observation of the clinic context and semi-structured interviews with HPV vaccine recipients ( N = 13). We found that participants’ access to HPV vaccination was shaped by socioeconomic privileges, including the ability to afford the vaccine. Their narratives revealed significant challenges in accessing HPV vaccination and highlighted how intersecting identities contribute to inequities in the privately funded program. Participants reported a general lack of HPV vaccination information in Ghana and often learned about the vaccine through incidental means. Conservative sociocultural norms surrounding sex, sexuality, and reproductive health were significant barriers, particularly in facilitating adolescent-parent discussions about HPV vaccination. Given the inequities reported by vaccine recipients, there is a critical need for education campaigns that raise awareness of the benefits of HPV vaccination, alongside strategies to support socioeconomic empowerment. Addressing these barriers through an inclusive public health policy will help prevent replicating the inequities seen in the privately-funded program and reduce HPV-related diseases, particularly cervical cancer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.007 |
| Scholarly communication | 0.003 | 0.006 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".