Table 4 Facilitators and barriers of Health care workers’ opportunity to recommend HPV vaccine using the TDF^a

Social influences

Interpersonal relationships (F)

‘personal relationship…with a particular family’ Pediatrician 1, Tertiary HF

2

Involvement in social groups (F)

‘I have a youth program…I have spoken to youths about it’ Medical Social worker, Tertiary HF

2

Traditional beliefs about cancers (B)

‘People believe that cancer is a punishment from God…it is a spiritual problem so vaccine can never be a solution’ Nurse 1, Primary HC

2

Environmental context and resources

High cost of HPV vaccine (B)

‘it’s like it’s for elites…the price is high’ Health visitor, Tertiary HF

11

Vague Government/ hospital policy (B)

‘whether it is now a full policy by the federal government…I cannot say for now’ Family Physician 2, Tertiary HF

3

Availability and storage of HPV vaccine (B)

‘…availability has been a challenge’ Family Physician 1, Tertiary HF

2

Ignorance, rumors among the populace (B)

‘it is all the rumors and all the misconceptions about the vaccines, people have said it is a license to become promiscuous’ Pediatrician 2, Tertiary HF

5

Parents’ low risk perception about adolescents’ sexual activities (B)

‘some believe that my girl is not promiscuous now, so why would I?’ Family Physician 1, Tertiary HF

4