Amplifying Girls’ Voices: Localized Human-Centered Design Approaches to HPV Vaccination in Nigeria and Indonesia

Cervical cancer prevention through HPV vaccination is gaining momentum globally, yet adolescent uptake remains uneven, in part related to entrenched social, behavioral, and gender-related barriers. This study applied a human-centered design (HCD) approach in Nigeria and Indonesia to elevate girls' and caregivers' voices in vaccine program design, and their suggested solutions to the identified barriers, were then validated among immunization stakeholders. Findings revealed persistent misinformation, gendered decision-making, and limited adolescent-friendly communication in both countries. In Nigeria, low awareness, maternal knowledge gaps, and male approval requirements were key barriers, alongside school and facility access issues. In Indonesia, girls faced fear, rumors, and low agency, while caregivers often lacked accurate information. Locally tailored solutions included peer and community engagement, story-based tools, improved access through trusted institutions, and stronger coordination across sectors. Across both countries, findings revealed a mismatch between community-preferred, interactive communication and stakeholder reliance on one-way messaging. Comparative insights underscore that localization and participatory engagement are critical to designing adolescent-centered HPV vaccination programs. Embedding such participatory approaches in HPV program design strengthens trust, fosters equity, and helps reimagine adolescent-centered immunization within social and behavioral change communication frameworks.