Macedonia - Working Meeting on Comprehensive Cervical Cancer Prevention and Control in UNFPA EECARO and ASRO Countries

1. WORKING MEETING ON
COMPREHENSIVE CERVICAL CANCER
PREVENTION AND CONTROL IN UNFPA
EECARO AND ASRO COUNTRIES
Antalya, Turkey 18-20 May 2011

2. MAGNITUDE AND BURDEN OF CERVIVAL
CANCER IN MACEDONIA
(incidence and mortality rates, estimated cases and deaths per year, other data)
Very high incidence and mortality
rates (2nd in Europe
297 detected cases in 2008
141 deaths in 2008

3. MAGNITUDE AND BURDEN OF CERVIVAL
CANCER IN MACEDONIA
(incidence and mortality rates, estimated cases and deaths per year, other data)

4. NATIONAL PROGRAMME for
HPV VACCINATION
HPV vaccination programme is part of the national programme
for prevention of cervical carcinoma (2009, 2010, 2011)
Contains two elements:
(1) Regular HPV vaccination programme initiated October 2009
for all school girls 12 (obligatory and free of charge)
(2) Catch-up programme for girls and women 9-26 years of age
(free of charge)

5. HPV VACCINATION PROGRAMME
DESCRIPTION
Programme based on the need for primary and secondary prevention.
Target age:
• Obligatory vaccination programme for 12 years old girls
(6th grade – elementary school)
b) Catch-up vaccination campaign for 9-26 years (free of charge)
Modality of implementation:
• School-based (obligatory vaccination programme)
• Health facilities (health centers, accredited private ob-gyn hospitals
and ob-gyn doctor’s offices) for catch-up vaccination programme
• Funded by the Government of Republic of Macedonia.
Coverage :
- 2009: 30,8%
-2010: 36.5%

6. CHALLENGES ACTIONS TAKEN
Achieve higher coverage / vaccination
rates through:
• Increase higher public awareness
for primary prevention of cervical
cancer
• Decrease prejudice about the
vaccine based on misconceptions
about its effects and possible side
effects
• Counteract with evidence anti-
vaccine campaign(s) carried out by
religious, pro-life and other groups
• Increase knowledge and counseling
skills of relevant health care workers
1. Campaign (video clips in the media,
posters, leaflets, educational lectures)
2. Educational instructions for primary
care doctors
3. Conversations with parents and girls
with experts/volunteers etc.
HPV VACCINATION PROGRAMME
CHALLENGES AND ACTIONS TAKEN

7. HPV VACCINATION PROGRAMME
LESSONS LEARNED
1. As this is a new vaccine, lower than expected response rates were
achieved;
2. Personal prejudice and lack of adequate information among parents,
teachers and health care professionals is key to lower response rates;
3. Active engagement by government, schools, NGO’s, health
professionals, media and other relevant stakeholders is necessary if the
programme is to achieve optimum results in the future.

8. HPV VACCINATION PROGRAMME
WAYS FORWARD/FUTURE PLANS
1. Vaccination campaign will be implemented in two stages: one at the
beginning of 2011 and another at the beginning of the school year;
2. Well-known person(s) will be used to promote the vaccine (singer or
actress of younger age)
3. A “leading” person – doctor or health worker for every vaccination
district will be appointed to advocate for the HPV vaccine as the
primary prevention method of cervical cancer.