On the school grounds in Dombe, children gather to play “mata mata,” the most common game in Onésia’s community. They mark a distance of 7 to 10 meters. At each end, two players from the same team stand, while two players from the opposing team position themselves in the middle. The players at the ends throw a ball back and forth, and the ones in the middle try to intercept it.
The goal for the middle players is to catch the ball with their hands, no matter how fast it comes. If they succeed, they score a point. If they are hit by the ball instead of catching it, they are eliminated and leave the game until all middle players are out. Once that happens, the teams switch roles: The players who were at the ends move to the middle, and the game continues.
This playful competition combines agility, focus and teamwork. It challenges children to anticipate the ball’s movement, react quickly and develop coordination skills while keeping the game fun and engaging.
For 11-year-old Onésia, playtime is now more than a game. It is also an opportunity to educate her friends about human papillomavirus (HPV) vaccination and cervical cancer prevention.
Since May, Onésia has been reaching out to other adolescents about HPV and cervical cancer in her school and community in Sussundenga District, Mozambique.
That same month, Onésia participated in a VillageReach training on HPV vaccination and cervical cancer prevention as part of the Peer-to-Peer Learning to Improve HPV Vaccine Coverage project. The training targeted key community actors as key collaborators to co-create activities to improve HPV vaccination. Participants like Onesia helped to design and prototype interventions, and played a key role in planning and carrying out the activities in their local communities. Participants received practical communication tools, including illustrated educational cards, to help participants share accurate information in simple, accessible ways.
Information Can Save Lives
Adolescents during VillageReach training on HPV
For girls like Onésia, accurate information can be lifesaving. HPV vaccination is most effective when given before exposure to the virus. Studies show that more than 98% of vaccine recipients develop an antibody response, and vaccines have shown close to 100% efficacy against vaccine type-related persistent infection and cervical precancer in clinical trials among people not previously infected with the HPV types targeted by the vaccine.
Early in 2025, Onésia was vaccinated against HPV. At the time, she did not know much about the importance of preventing cancer. But now she knows that vaccination can help protect girls from the types of HPV that cause most cervical cancers, and she is helping other girls receive that same information.
She has three younger siblings and lives with her mother. Her father passed away. Although she was initially shy, Onésia showed determination and resolve to make a difference. She gained confidence through education about HPV, especially when she began using information cards to teach her peers.
“The VillageReach training was not just a change for me, but an opportunity to save the lives of girls and other members of my community,” Onésia said.
Her story demonstrates how peer-to-peer communication can normalize conversations about health, reduce stigma and make prevention relevant and empowering. She is living proof that adolescents are not just passive recipients of health services, but active agents of change.
The Risks That Remain
Onésia now knows that HPV and cervical cancer are harsh realities in Mozambique. Cervical cancer is the leading cancer by new cases and deaths in the country, causing an estimated 5,456 new cases and 4,000 deaths in 2022. HPV often has no symptoms, which can make prevention and screening even more important. Some infections can cause genital warts, while persistent infection with high-risk HPV types can lead to cervical precancers and, if left untreated, cervical cancer.
This is a critical issue, especially in under-reached communities where access to vaccination, screening and treatment services may be limited.
Onésia not only knows the importance of getting vaccinated, but also the negative impact HPV can have. Thanks to the VillageReach training, she learned that health facilities provide the vaccine free of charge to girls, with a special focus on girls ages 9 to 14. The vaccine is safe and highly effective, especially when given before the onset of sexual activity.
“I learned in the training that women and girls who have already started sexual activity should use male or female condoms to avoid transmission. It’s also important to get regular screening exams and health tests,” she explained.
Adolescents receiving HPV information at Dombe Health Center
Her mission with other girls is to speak with them about the importance of getting vaccinated against HPV. That is why her agenda includes the Dombe Health Center, where she gives talks with the support of health professionals. At the health unit, many girls come looking for other services, making it a good place to begin important conversations about HPV.
At the community level, she approaches neighbors and nearby households. Her focus also includes boys because HPV affects everyone. While cervical cancer prevention is the central message for girls, HPV can also cause genital warts and certain cancers in men. Boys can also help carry accurate information to parents, neighbors and friends, making them important allies in prevention. Because HPV often has no symptoms, many people may not realize they have been infected or understand why prevention matters. Onésia believes that sharing information with both girls and boys can help reduce confusion, challenge rumors and make conversations about HPV more open.
“Some boys are open to receiving information about HPV because we play together. And they promise to talk with their parents and other neighbors,” she said.
Boys happy after education session on HPV
Playing and Learning
Onésia plays with other girls and boys at school and in her community. In their free time, they gather for games like mata mata and soccer. For Onésia, these moments also create space for conversation.
“Some girls already want to join the future trainings so they can be part of the fight to spread information. For now, I am encouraging my friends to be with me when I talk about HPV,” she said.
Her example shows that schools and community spaces can nurture young champions and leaders in the fight against HPV. Because adolescents often trust and listen to their peers, girls like Onésia can make health information feel familiar, credible and relevant. Through everyday interactions during games, school and visits with neighbors, peer-to-peer learning turns accurate information into conversations that adolescents are more likely to hear, repeat and act on. When awareness is raised early and delivered by trusted voices within a young person’s own social circle, the message has a greater chance of lasting and reaching more people at risk of HPV and cervical cancer.
As the saying goes, “as the twig is bent, so grows the tree.” The earlier a child is taught, the greater the chance that knowledge will take root. Onésia is an informed adolescent ready to help that knowledge grow across Dombe.