Barriers to HPV vaccination in marginalized Roma communities in Slovakia

Daniela Filakovska Bobakova; Jana Plavnicka; Ingrid Urbancikova; Michael Edelstein; Danielle Jansen; Zuzana Dankulincova Veselska

doi:10.3389/fpubh.2023.1239963

Barriers to HPV vaccination in marginalized Roma communities in Slovakia

Front Public Health. 2023 Dec 5:11:1239963. doi: 10.3389/fpubh.2023.1239963. eCollection 2023.

Authors

Daniela Filakovska Bobakova^{1

2}, Jana Plavnicka¹, Ingrid Urbancikova³, Michael Edelstein⁴, Danielle Jansen⁵, Zuzana Dankulincova Veselska¹

Affiliations

¹ Department of Health Psychology and Research Methodology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.
² Olomouc University Social Health Institute, Palacky University in Olomouc, Olomouc, Czechia.
³ Department of Epidemiology, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.
⁴ Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel.
⁵ Department of Primary and Long-term Care, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.

Abstract

Introduction: Limited access to healthcare services leads to lower vaccination rates in marginalized Roma communities (MRCs). This study aimed to explore health system barriers to HPV vaccination faced by people from MRCs from multiple perspectives.

Methods: The qualitative study was conducted in Slovakia in 2021/22 with 43 community members and health professionals. Data were analyzed using a combination of content analysis and consensual qualitative research.

Results: A substantial barrier to vaccination is limited coverage of vaccination expenses for certain age categories by health insurance. Moreover, Slovakia faces a significant shortage of healthcare personnel, leading to work overload and a lack of capacity and motivation to address HPV vaccination. Impaired relationships between health care providers and people from MRCs lead to the avoidance of healthcare services, which contributes to insufficient delivery of information and a lack of awareness regarding HPV-related diseases and vaccination.

Conclusion: Strengthening the capacities of health care providers, expanding the age group covered by health insurance and providing tailored information to people from MRCs are necessary prerequisites to increase the availability of HPV vaccination and enable people to make informed decisions about HPV vaccination.

Keywords: HPV vaccination; access to health care; ethnic minority; health system barriers; marginalized Roma communities.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Health Services Accessibility*
Humans
Papillomavirus Infections* / prevention & control
Papillomavirus Vaccines* / administration & dosage
Roma*
Slovakia
Vaccination

Substances

Papillomavirus Vaccines

Grants and funding

This work was supported by the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement no. 964353, called SC1-BHC-33-2020 Addressing low vaccine uptake.