In The Gambia, the EPI programme operates 486 monthly vaccination service delivery points combining fixed sites and outreaches, with school-based campaigns and quarterly PIRI activities as the primary service delivery modes. Following a NITAG recommendation, the country switched to a single-dose HPV schedule in January 2025, resulting in a national coverage increase from 12% to 43% in the first eight months of the year. A national HPV e-tracker — piloted in seven health facilities in 2022–23 and rolled out nationally in 2024 — supports individual-level data availability and performance monitoring, though DHIS2 capacity gaps and rural connectivity constraints remain ongoing challenges. Key barriers include inadequate resources, difficulties reaching out-of-school girls, and intermittent vaccine stockouts, while strengths include a functional TWG, integration with RMNCAH services and PIRI platforms, and active stakeholder engagement with school authorities and caregivers.