The Mandsaur Model: A Blueprint for Scaling Up India's HPV Vaccination Drive?
A district in Madhya Pradesh reports 100% coverage in its HPV vaccination drive by using data analytics and behavioural science. We explain the model, its significance for India’s national cervical cancer campaign, and the challenges in replicating it.
Pre-requisite: Understanding the HPV Vaccination Landscape
To grasp the significance of the Mandsaur model, one must first understand the context of cervical cancer in India and the tools available to fight it. The national campaign launched in 2026 represents a major public health undertaking, built on decades of scientific and policy developments.
(1) KEY TERMS
- Human Papillomavirus (HPV) — A group of over 200 related viruses, some of which are spread through sexual contact and can cause cancers, most notably cervical cancer.
- Cervical Cancer — A type of cancer occurring in the cells of the cervix, overwhelmingly caused by high-risk HPV strains.
- Denotified Tribes (DNTs) — Communities originally notified as ‘criminal tribes’ under the Criminal Tribes Act, 1871. Though the Act was repealed in 1952, these communities, like the Banchhada tribe in Mandsaur, continue to face social stigma and exclusion from government services.
- Rashtriya Bal Swasthya Karyakram (RBSK) — A Government of India initiative launched in 2013 for early identification and intervention for health conditions in children from birth to 18 years.
- NTAGI (National Technical Advisory Group on Immunisation) — The highest advisory body on immunisation in India, which provides evidence-based recommendations to the government on vaccine policy.
(2) BACKGROUND & TIMELINE
The first HPV vaccines received regulatory approval in India in 2006-2008, but high costs limited their accessibility. A key development occurred in September 2022 with the announcement of India's indigenous quadrivalent HPV vaccine, Cervavac, by the Serum Institute of India, which improved affordability. Following recommendations from NTAGI, the Government of India launched a nationwide cervical cancer prevention campaign on February 28, 2026. The campaign's first phase aims to provide free HPV vaccinations to 1.15 crore girls aged 14-15 years. This initiative is a critical step towards meeting the World Health Organization's (WHO) global strategy to eliminate cervical cancer by 2030, which sets a "90-70-90" target: 90% of girls fully vaccinated by age 15; 70% of women screened by age 35 and again by 45; and 90% of women with pre-cancer treated.
(3) INSTITUTIONAL FRAMEWORK
The national HPV vaccination drive is spearheaded by the Union Ministry of Health and Family Welfare (MoHFW), which sets policy and coordinates procurement. Under India's constitutional framework, health is a state subject (Entry 6, List II, Seventh Schedule), making State Health Departments responsible for last-mile delivery. The Mandsaur model demonstrates the critical role of district-level administration in operationalising this mandate. It leveraged data from multiple government platforms, including the central RBSK and state-specific databases like the SAMAGRA social security platform of Madhya Pradesh, to identify and track beneficiaries.
The Main Explanatory: Deconstructing the Mandsaur Strategy
The Mandsaur district's approach to the national HPV vaccination campaign has gained attention for its rapid and comprehensive execution. By achieving its target in a short span, it offers a potential template for other districts facing similar challenges of data gaps, logistical hurdles, and community resistance.
### What is the public health challenge being addressed?
India faces a disproportionately high burden of cervical cancer, accounting for nearly a quarter of the global caseload. Official estimates indicate over 1.2 lakh new cases and approximately 80,000 deaths annually (Source: The Hindu, citing public health data). The scientific consensus is that nearly 95% of these cases are caused by persistent infection with high-risk strains of HPV, making cervical cancer a largely preventable disease.
The success of any large-scale vaccination programme hinges on overcoming significant ground-level barriers. These include low public awareness, social stigma surrounding sexual health, and vaccine hesitancy, which is often fuelled by misinformation about side effects like infertility. The Mandsaur model was designed to systematically address these execution challenges.
### What is the Mandsaur Model's core strategy?
The Mandsaur administration, led by the District Magistrate, identified the primary grassroots challenge not as vaccine hesitancy alone, but as “data invisibility.” The model’s core strategy was to first make every eligible girl visible to the health system and then deploy a data-driven, decentralised implementation plan. The administration began by targeting the most vulnerable and hardest-to-reach populations first, including girls from the Banchhada community, nomadic tribes, urban slums, and school dropouts.
To achieve this, it converged multiple government databases—the Rashtriya Bal Swasthya Karyakram (RBSK), Madhya Pradesh's SAMAGRA social security platform, and the Ladli Laxmi Yojana. By cross-referencing these fragmented records using unique identifiers, officials created village-level “Master Line Lists.” According to Aditi Garg, the District Magistrate of Mandsaur, this process transformed scattered data into “actionable intelligence.” Door-to-door surveys subsequently verified these lists, ensuring that girls who had dropped out of school or were otherwise missed by official records were included.
### How did the model overcome implementation barriers?
The Mandsaur strategy relied on behavioural science, specifically the “Nudge Approach,” to break down resistance and inertia. Instead of asking families to choose to vaccinate, health workers informed them that their daughters were “due for vaccination,” framing it as a routine and expected part of healthcare. This subtle shift in communication, as per the administration's reports, reduced decision-making friction. To counter rumours about infertility, the campaign enlisted a diverse group of trusted local figures, including Gen-Z influencers, young doctors, national-level athletes, and religious leaders, who acted as voluntary ambassadors to dispel myths.
The model also leveraged social networks. Families who participated were publicly felicitated, and vaccinated girls were recognised as “peer champions.” Data on vaccination rates was shared at the Gram Panchayat and ward levels, fostering a sense of community collaboration. Furthermore, the HPV campaign was not run in isolation but was “bundled” with other ongoing health programmes. Vaccination drives were conducted during Routine Immunisation days and Pradhan Mantri Surakshit Matritva Abhiyan sessions, increasing contact points with the health system and making access more convenient for families.
### What were the reported outcomes and challenges to scalability?
The outcomes reported by the district administration were swift and comprehensive. In less than 40 days, Mandsaur achieved 100% of its vaccination target by conducting 493 vaccination sessions across 12 permanent and 27 temporary sites. This covered all identified eligible girls in 893 villages and 190 urban wards. While the model's success is notable, its replication across India faces several challenges.
First, the strategy was heavily dependent on high-quality, integrated, and digitised data from platforms like SAMAGRA. The availability and reliability of such granular data vary significantly across states. For instance, Australia's successful national HPV program, which has brought the country to the verge of eliminating cervical cancer, was built on a robust national health data registry, a system India is still developing. Second, the proactive leadership of the district administration was a key driver, meaning the model's success is tied to the capacity of local officials. Third, the specific “nudges” and community influencers that worked in Mandsaur’s socio-cultural context may not be directly transferable to other regions.
Conclusion: From a Local Success to a National Blueprint?
The Mandsaur model emerges at a critical juncture, as state governments design their implementation roadmaps for the national HPV vaccination campaign launched in February 2026. It provides a practical case study on translating a national policy objective into tangible, last-mile results. The model shifts the focus from high-level policy design to the nuances of execution, demonstrating that overcoming data gaps and vaccine hesitancy is possible with a locally-sensitive strategy that prioritises making every potential beneficiary visible to the health system.
In the next one to five years, lessons from Mandsaur are likely to influence public health programming in India. The Union Health Ministry may document and disseminate such best practices, encouraging other districts to adopt similar data-driven and behaviourally-informed approaches. The success of the campaign's first phase, which aims to vaccinate 1.15 crore girls, will likely be evaluated by 2027 to inform future expansion. The performance of early adopters like Mandsaur will be a key determinant in securing the political will and financial resources needed to meet the WHO's 2030 target of vaccinating 90% of girls by age 15.
The model's primary governance implication is that effective public service delivery in India hinges on the capacity and innovation of its district-level administration. It highlights a move away from a one-size-fits-all, top-down approach towards an adaptive, bottom-up implementation style that leverages local data and community trust. This success makes a strong case for empowering district magistrates and investing in local data infrastructure. Ultimately, the model shows that bridging the gap between policy intent and ground-level impact requires a blend of data science, behavioural psychology, and community engagement.