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Ghazy RM, Gebreal A, Saleeb MRA, Sallam M, El-Deen AESN, Sheriff SD, Tessema EA, Ahurwendeire S, Tsoeu N, Chamambala PC, Cibangu PB, Okeh DU, Traoré AS, Eshun G, Kengo NE, Kubuka AE, Awuah LB, Salah A, Aljohani M, Fadl N. Compulsory Vaccination Coverage in 12 Sub-Saharan African Countries Two Years Following the COVID-19 Pandemic. J Community Health 2024; 49:193-206. [PMID: 37646982 DOI: 10.1007/s10900-023-01261-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 09/01/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is a global threat, challenging health services' provision and utilization. This study aimed to assess compulsory vaccination coverage in 12 Sub-Saharan African countries two years following the COVID-19 pandemic using the Health Belief Model. A cross-sectional survey was conducted from November 1 to December 15, 2022. Multivariate logistic regression was conducted to identify the determinants of vaccination coverage. Among the 5032 respondents, 73.1% reported that their children received compulsory vaccination. The lowest coverage was observed in Ghana (36.5%), while the highest was in Burkina Faso and Congo (92.0%). Factors associated with non-vaccination included older mothers (adjusted odds ratio (AOR) = 1.04, 95%CI: 1.03-1.05), lower mothers' education, older children (AOR = 0.76, 95%CI: 0.60-0.96), children with chronic illnesses (AOR = 0.55, 95%CI: 0.45-0.66), and difficult accessibility to healthcare facilities (AOR = 11.27, 95%CI: 9.48-13.44). Low perceived risk, in which non-vaccinated children were believed to be at no higher risk for infectious diseases and the disease severity would not worsen among non-vaccinated children, increased the likelihood of non-vaccination (AOR = 2.29, 95%CI: 1.75-2.99 and AOR = 2.12, 95%CI: 1.64-2.73, respectively). Perceiving vaccines as unnecessary, and needless for breastfed babies increased the probability of non-vaccination (AOR = 1.38, 95%CI: 1.10-1.73 and AOR = 1.69, 95%CI: 1.31-2.19, respectively). Higher odds of non-vaccination were found when the provision of vaccine information did not motivate parents to vaccinate their children (AOR = 4.29, 95%CI: 3.15-5.85). Conversely, believing that vaccines were safe for children decreased the odds of non-vaccination (AOR = 0.72, 95%CI: 0.58-0.88). Parental perceptions and concerns should be considered in interventions aiming to increase compulsory vaccine acceptance and coverage.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Assem Gebreal
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| | - Ahmed El-Sayed Nour El-Deen
- Department of Physiology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, PO Box 2000, Zarqa, 13110, Jordan
| | | | | | - Salvias Ahurwendeire
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | | | | | - Patrick B Cibangu
- Health Officer, Les Ailes du Coeur NGO, Congo, Democratic Republic of Congo
| | - Debra Ukamaka Okeh
- Department of Community Medicine, Federal Medical Centre Umuahia, Abia, Nigeria
| | | | - Gilbert Eshun
- Seventh-Day Adventist Hospital, Agona-Asamang, Ghana
| | - Nathan Ezie Kengo
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroun
| | - Amos Elisha Kubuka
- Saint Francis University College of health and allied Sciences, Ifakara, Morogoro, Tanzania
| | - Lydia Baffour Awuah
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Assia Salah
- Faculty of Medicine, Algiers University, Algiers, Algeria
| | - Moath Aljohani
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Noha Fadl
- Family Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt.
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