3 questions to Jessica Posner Odede, CEO of Girl Effect

Interview with Jessica Posner Odede, CEO of Girl Effect

Focus 2030 : As an organization operating in Kenya, Nigeria, India, South Africa, Ethiopia, and Tanzania to tackle the barriers faced by young girls in accessing their basic rights, such as education and health, Girl Effect is well positioned to understand the obstacles young girls face in getting access to vaccines. Based on your field experience, what are the main challenges girls need to overcome to benefit from health services, and vaccines in particular ?

Jessica Posner Odede : 

Negative attitudes and social norms often prevent girls from accessing the HPV vaccine, even when it is available. Cervical cancer usually occurs later in life, so adolescent girls and their parents often feel it is irrelevant to them. They have rarely heard about HPV or the vaccine or how this links to cervical cancer. This is coupled with more complicated issues like myths that exist around vaccinations (worrying that the HPV vaccine will make them infertile). Without information being available, misconceptions or harmful rumors can circulate.

The perceived quality of care influences the utilization of immunization services, especially for girls. Where healthcare providers are not trained and sensitized on youth friendly approaches and services, they can become a barrier to access and utilization of health services.

Immunization programmes are at times designed without the meaningful involvement of girls, thus limiting their agency in the journey towards immunization. Meaningful inclusion through innovative strategies that put girls at the center of intervention design, implementation and monitoring, are key to overcoming barriers to health information and services access.

Without the appropriate social support, girls may lack access to necessary health services including vaccines. In cases where parents and caregivers for example need to consent to girls getting vaccinated, without correct knowledge, they too become a barrier to access.

Our 2024 research in Tanzania and Ethiopia indicates that awareness and knowledge of HPV, cervical cancer and the HPV vaccination remains low among girls of age 9-14 years. Only 10-11% report being aware of what HPV is and that it can cause cervical cancer.

Building resilient demand is vital for the long-term sustainability of HPV vaccine uptake. To do this, you have to talk to girls themselves.

That is why before implementing any intervention, Girl Effect conducts formative research to get insights from girls and those around including parents, teachers, health workers, religious leaders etc. To get more authentic insights we have co-created with girls, TEGA (Technology Enabled Girls Ambassadors), a mobile based research programme that allows girls themselves to collect real-time insights into the lives of their peers.

Focus 2030 : Gavi is providing HPV vaccines to multiple countries to fight cervical cancer in developing countries. Beyond the deployment of vaccines in countries, to be successful, vaccination campaigns need to address multiple barriers. Could you indicate how your organization engages with girls to design services and contribute to behavior change ? Can you provide an overview of the types of actions you are leading to engage the public, and girls in particular, to facilitate access to vaccines ?

Jessica Posner Odede : Immunization doesn’t exist in a silo, so Girl Effect holistically addresses barriers to vaccination alongside issues like sexual and reproductive health, education and nutrition. Unlike other vaccines, the HPV vaccine is administered to girls during adolescence, and is often their first health intervention since childhood. As such, the HPV vaccine is an opportunity to inform girls about the benefits not only of vaccines, but also of other health interventions, at a crucial time in their lives. This can help set them on a path to adopting positive, health-seeking behaviours.

Girl Effect firmly believes in girls’ strength and recognises them as autonomous individuals whose ideas, perspectives and skills can help inform, inspire and shape work. It’s with their advice and support that we can deliver effective programmes that are relevant, culturally responsive, and impactful. Girls aren’t just end-users. They are our informers, our inspiration, and our co-creators, whose opinions are valued and whose ideas we bring to life. Some examples of how we engage girls but also the public to facilitate health services access are the following :

• Human Centered Design : we convene development experts, tech innovators and youth advisers to meet girls, parents, health care workers and community leaders to co-design solutions. From these co-creation workshops and focus group sessions we design behavior change communications approaches to drive behavior change. We don’t make assumptions so that’s why this approach is important to us.

• Multi-sectoral partnerships and engagement. In every country, we engage with various layers of the health system. This includes NGOs, local governments, service providers, media, and other actors. In particular, we work with governments at every stage of our programs to ensure that we are creating sustainable, long-term solutions that can scale. We launched a “Girl Focus Toolkit” in 2020. The toolkit aims to support Ministries of Health and other partners to deliver HPV immunization programmes, providing a resource that will live on beyond Girl Effect’s interventions. It includes a set of creative and strategic resources that aim to encourage and enable others to develop their own girl-focused approach to HPV vaccine communications.

• Girl Creators : co-design products and solutions with our team. Our creators help design & create SBCC content and play a pivotal role in driving conversations about health, particularly vaccines.

• Youth Advisory Panel (YAP) members : voices and ideas are integrated into our program design, implementation, and accountability of our work. From safeguarding to content creation to evaluations, YAPs are at the heart of our engagement approach.

Focus 2030 : Your organization has partnered with Gavi for the last eight years to promote access to vaccines. What are the key results you have observed ? What kinds of interventions do you consider worth replicating in other countries ?

Jessica Posner Odede : 

In the last 8 years, we have engaged 3.7 million girls and had a ripple effect to appeal to a broader audience, almost 31 million people across Tanzania, Ethiopia, Rwanda and Malawi, influencing support groups and enabling discussions within the family.

Our partnership has significantly improved awareness about the benefits of the HPV vaccine as well as knowledge about dosage, and reversed the myth that HPV vaccination causes infertility. Using media formats such as chatbots, radio and television dramas or talk shows, our content has busted myths, fought misinformation and inspired conversation about the importance of vaccination programmes and health more broadly. In Ethiopia, those who watch our TV drama are 32% more aware of cervical cancer & 3x as likely to know of the HPV vaccine. Of those aware of the vaccine, 50% say they learned it from our TV drama – more than from health professionals (22%). Readers of our magazine in Malawi were 32% more likely to have had the first dose of the HPV vaccine than non-readers.

Based on lessons learned, our partnership has scaled to additional locations, most recently in Nigeria, in support of the Government’s HPV Phase 2 launch. Some of the interventions we are replicating include : the use of digital technology to enhance community interventions, radio and Tv dramas to not only engage young people but also parents and community members with the aim of shifting social norms.

We have also expanded our work to include routine immunization and additional audiences such as young male and female caregivers, out-of-school girls and zero-dose communities who are usually left behind. We are increasing our focus in promoting learning within the immunization, gender equity, SRH sectors through dissemination of research, identification of best practices and innovations.

NB : The opinions expressed in this interview do not necessarily reflect the ideas of Focus 2030.