In Malawi and Mozambique — two countries with among the highest cervical cancer incidence rates globally (67.9 and 47.8 per 100,000 women respectively) — a multi-stakeholder human-centered design process engaged adolescents aged 9–14, caregivers, teachers, health workers, and community and religious leaders across 35 workshops in four districts to co-create integrated HPV vaccination delivery solutions. Community-generated solutions prioritised integrating HPV vaccination into school health and nutrition programming alongside adolescent-friendly services including HIV testing and counselling, family planning, and STI education, with additional community-level integration to reach out-of-school girls. Stakeholders emphasised the need for trusted messengers — particularly teachers and caregivers — and for intentional demand generation strategies including community dialogues and peer-led approaches. The HCD process catalysed immediate community-led implementation before any external logistical support was provided, demonstrating a high level of local ownership; Phase 2 implementation and Phase 3 impact evaluation are ongoing.