Mathematical models hold the potential to generate valuable evidence for shaping vaccination policies. However, maximizing their impact requires a deeper understanding of how modelling efforts can be aligned with the real-world priorities of policymakers and health officials. This study explores how structured engagement with stakeholders can help co-identify decision-relevant questions that are amenable to quantitative modelling. The focus is the human papillomavirus (HPV) vaccination programme in Mozambique.
We conducted semi-structured interviews with stakeholders involved in the HPV vaccine programme to identify key knowledge gaps in their decision-making context, i.e., practice. These were translated into research questions that informed the application of a mathematical model. An evidence brief was developed to synthesize and contextualize findings, and follow-up interviews were conducted to reflect on the utility of the evidence. Qualitative data were analysed inductively to identify emergent themes.
Stakeholders identified four priority questions: optimal vaccine delivery strategy, distributional impact, vaccine economics, and comparison with other prevention methods. They emphasized the value of tailored evidence—particularly at the provincial level—for informing financial planning, resource allocation, and advocacy. The approach facilitated collaboration between researchers and stakeholders, helped uncover previously untapped data sources, and improved the policy relevance of the modelling outputs.
This study demonstrates how co-identifying modelling questions with decision-makers can help ensure that evidence generated through mathematical models is context-specific, and policy-relevant. This type of engagement enabled clearer alignment between model development and decision-making needs—offering lessons for future applications of modelling in public health policy.
Competing Interest StatementThe authors have declared no competing interest.
Funding StatementPC and TH acknowledge funding from the MRC Centre for Global Infectious Disease Analysis (reference MR/X020258/1), funded by the UK Medical Research Council (MRC). This UK funded award is carried out in the frame of the Global Health EDCTP3 Joint Undertaking. The study was part of a doctoral study programme (for PC) that was supported by the London Interdisciplinary Social Science Doctoral Training Programme (LISS DTP), funded by the Economic and Social Research Council (ESRC). Additional seed funding was provided by the MRC Centre for Global Infectious Disease Analysis to finance data collection in the country. The funding sources had no involvement in conducting the research.
Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.
Yes
The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
Ethical approval was obtained from Imperial College London (ICREC reference: 21IC7033) and the Institutional Review Board of the Manhiça Health Research Centre (CISBS-CISM/076/2021). Approval from the Bioethics Committee in Mozambique was not required for this study.
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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).
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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.
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Data AvailabilityThe data collected for the purpose of this study cannot be shared due to ethical restrictions.
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