INTRODUCTION:
Cervical cancer remains a leading cause of morbidity and mortality among women in South Africa, despite being largely preventable through timely human papillomavirus (HPV) vaccination. National data show low HPV vaccine uptake, particularly in rural districts such as Matatiele in the Eastern Cape. Outreach nurses are at the forefront of implementing the national school-based HPV vaccination programme; however, limited evidence exists on their experiences and perspectives regarding the factors that influence vaccine uptake. This study aims to explore the perspectives of outreach nurses on the behavioural and social determinants of HPV vaccine uptake among age-eligible girls in a resource-limited district in South Africa.

METHODS:
A qualitative exploratory study will be conducted using semi-structured interviews with outreach nurses involved in the delivery of the school-based HPV vaccination programme in Matatiele, Eastern Cape. Participants will be purposively selected from the Matatiele school health team. Data will be collected until thematic saturation is reached and analysed thematically using Braun and Clarke’s reflexive approach, guided by the World Health Organization’s Behavioural and Social Drivers (BeSD) framework, which encompasses domains such as thinking and feeling, social processes, motivation, and practical issues. Expected Results Our anticipated findings will provide insight into the contextual factors influencing HPV vaccine uptake in an often-underserved district, including nurses' knowledge and attitudes, community perceptions, logistical challenges, and policy support mechanisms. These findings will inform future implementation research activities aiming to surmount contextual barriers and enhance facilitators relevant to improving vaccine coverage in rural and resource-limited settings.

CONCLUSIONS:
Understanding outreach nurses’ perspectives will generate context-specific evidence to inform equity-centred strategies for strengthening HPV vaccine delivery and acceptance in Matatiele and other settings with similar contexts.