Improving HPV Vaccination Coverage Among Adolescent Girls in Mali and Côte d'Ivoire Through Community Health Worker Follow-up

The goal of this trial is to learn if a community health worker (CHW) follow-up program can improve HPV vaccination coverage among adolescent girls in Mali and Côte d'Ivoire. The main questions it aims to answer are: Does the CHW follow-up program increase the number of girls who get vaccinated against HPV? Does the CHW follow-up program help girls get vaccinated sooner? Researchers will compare girls who receive proactive CHW home visits and digital follow-up reminders to girls who receive standard community outreach, to see if the CHW follow-up program works to increase HPV vaccination. Participants will: Be visited at home by a community health worker, who will check their HPV vaccination status Receive an invitation to get vaccinated, and reminders and follow-up visits if not yet vaccinated (intervention group only, until crossover) Have their vaccination status recorded through routine community health records, with no additional tests, surveys, or clinic visits required After an initial assessment period, girls in the standard-outreach group will also begin receiving the CHW follow-up program.

Inclusion Criteria: * Female adolescent residing within a participating Muso Health catchment area in Mali or Côte d'Ivoire * Age-eligible for HPV vaccination under national immunization guidelines during the study period: 10 years of age in Mali; 9 to 14 years of age in Côte d'Ivoire * Not yet age-eligible at study launch but expected to reach the nationally recommended vaccination age during the study period Exclusion Criteria: * Residence outside the defined study catchment areas * Not identifiable or registered in the Community Health Toolkit (CHT) programmatic data system