School Leadership and HPV Vaccination: Assessing the Knowledge of Educators and Principals in Madibeng Primary Schools, South Africa

Introduction The Human Papillomavirus (HPV) vaccine programme has been administered in South African public ordinary and special schools since 2014 to Grade 4 female learners aged nine years and older through the Integrated School Health Programme (ISHP). Purpose This study aimed to assess the level of knowledge regarding HPV and the school-based HPV vaccination programme among primary school educators and principals in the Madibeng Local Area. Methods A quantitative cross-sectional survey was conducted among 132 educators and principals from 47 primary schools in the Madibeng Local Area selected via stratified random sampling. Data were collected using a self-administered pre-tested questionnaire and analysed using descriptive statistics in STATA version 13. Results Overall, 51.52% (n=68) of participants demonstrated excellent knowledge scores (≥75%), 43.18% (n=57) demonstrated moderate knowledge (50%--74%), and 5.30% (n=7) demonstrated low knowledge (<50%). The overall mean knowledge score was 73.97% (±16.10%). While general awareness of cervical cancer severity (98%) and early detection (95%) was high, critical knowledge gaps persisted regarding HPV transmission dynamics (57%), condom protection limitations (56%), post-sexual activity vaccination eligibility (54%), dosing intervals (42%), and public health facility availability (15%). Conclusion While general knowledge is moderate to high, substantive gaps regarding transmission, dosing, and access highlight the need for targeted health education interventions. Strengthening health literacy among educational leaders is vital for boosting vaccine uptake and supporting national cervical cancer elimination goals.