Table 1.
Studies that reported barriers to COVID-19 vaccine uptake and handwashing practice to prevent and control COVID-19.
| References | Title of paper | Country | Study design | Sample size (male) | Participants | Age [mean(sd)] | Dates of data collection | Outcome | Outcome definition | Main findings |
|---|---|---|---|---|---|---|---|---|---|---|
| Konje et al. (26) | The Coverage and Acceptance Spectrum of COVID-19 Vaccines among Healthcare Professionals in Western Tanzania: What Can We Learn from This Pandemic? | Tanzania | Cross-sectional study | 811 (423) | Healthcare professionals of different cadres from health facilities in western Tanzania | 35 (9.0) years | 13 and 26 September 2021 | Barriers to COVID-19 vaccine uptake | Perceived barriers for COVID-19 vaccine uptake and factors associated with hesitancy of COVID-19 vaccine among health professionals | The majority (62%) of participants were in the hesitancy stage due to issues related to lack of effective communication and reliable information regarding efficacy and safety. |
| Mwai et al. (27) | Assessment of water, sanitation and hygiene practices for prevention and control of COVID-19 in Kenya | Kenya | Cross-sectional survey | 612 (181) | Household heads (men and women), residing in Kilifi and Mombasa counties | 38.2 (14.8) years | 25 November and 3 December 2020, | Barriers to handwashing | Factors that hindered handwashing practices | 396 (64.7%) households reported challenges in accessing soap. Topping the list of the challenges was that there are other priorities (62.4%) and soap was too expensive (57.2%). |
| Muchiri et al. (28) | Unmet need for COVID-19 vaccination coverage in Kenya | Kenya | Mixed methods study | 622 vaccination sites | Approved COVID-19 vaccination sites comprising of dispensaries, health centres and hospitals | Not applicable | April–July 2021 | Barriers to vaccination coverage | Time taken to travel to the vaccination site as a barrier to COVID-19 vaccination | The probability of being vaccinated generally decreased with increase in mean travel times to the COVID-19 vaccination sites. Additionally, there was a negative association between the vaccination coverage and the proportion of population residing in rural areas with a 27.8% decline. |
| Kabagenyi et al. (29) | Factors Associated with COVID-19 Vaccine Hesitancy in Uganda: A Population-Based Cross-Sectional Survey | Uganda | Population-Based Cross-Sectional Survey | 1,042 (462) | Adults ages 18 and above from rural and urban settings | 40 (NA) years | June to November 2021 | Barriers to vaccine uptake | Factors reducing vaccine uptake | Participants were hesitant to receive COVID-19 vaccine due to myths and misconceptions about SARS-CoV-2 virus and the vaccine itself. For instance, 15% of the participants believed that the vaccine could cause infertility or the vaccine could infect them by spreading the virus into their bodies. |
| Ouni et al. (30) | COVID-19 vaccine hesitancy among health workers in rural Uganda: A mixed methods study | Uganda | Mixed methods study | 346 (151) | registered and practicing health workers in Dokolo district from both government and private health facilities | 31.4 (6.9) years | NA | Vaccine hesitancy | Factors associated with vaccine hesitancy | Factors associated with vaccine hesitancy included fear of side effects (Adjusted Odds Ratio [AOR]: 2.55; 95% Confidence Interval [95%CI]: 1.00, 6.49) and health workers’ lack of trust in the information provided by health authorities (AOR: 6.74; 95% CI: 2.43, 18.72). Similar factors were associated with vaccine hesitancy when we used the vaccine hesitancy score. Fear of side effects, distrust in vaccine stakeholders, and lack of trust in the vaccine were barriers to COVID-19 vaccination among health workers. |
| Ocholla et al. (31) | Association of Demographic and Occupational Factors with SARS-CoV-2 Vaccine Uptake in Kenya | Kenya | Digital cross-sectional survey | 171 (103) | Individuals across 47 counties in Kenya | 36–60 years | 2nd March and 5th March, 2021. | Hesitancy in vaccine uptake | Unwillingness to be inoculated | Out of those who were unwilling to be inoculated, the majority alleged concerns on the side effects. |
| (32) | The critical need for WASH in emergency preparedness in health settings, the case of COVID-19 pandemic in Kisumu Kenya | Kenya | Qualitative case study design | 15 (10) | County government officials and eight were NGO officials | NA | August and September 2020 | Handwashing practices | Level of preparedness of accessing handwashing | All participants indicated the healthcare system was ill-prepared for the pandemic making healthcare workers to experience severe psychosocial impacts. |
| Rego et al. (33) | COVID-19 vaccination refusal trends in Kenya over 2021 | Kenya | Longitudinal rapid response phone surveys | 11,569 (5,432) | Household cohort survey representative of the Kenyan population including refugees | 40 (14) years | February and October 2021 | Vaccination refusal | Factors associated with vaccination refusal | Vaccination refusal was associated with having education beyond the primary level and believing in misinformation |
| Orangi et al. (34) | Assessing the Level and Determinants of COVID-19 Vaccine Confidence in Kenya | Kenya | Cross-sectional study | 4,136 (1355) | Participants were sampled from households in four existing Population Council prospective cohort studies across four counties: Kilifi, Kisumu, Nairobi and Wajir. | 40.8 (12.6) years | February 2021 | Determinants of vaccine hesitancy | Factors promoting unwillingness to receive COVID-19 vaccine. | Factors associated with vaccine hesitancy included: Rural regions, perceived difficulty in adhering to government regulations on COVID-19 prevention, no perceived COVID-19 infection risk, concerns regarding vaccine safety and effectiveness, and religious and cultural reasons. |
| Bono et al. (35) | Factors Affecting COVID-19 Vaccine Acceptance: An International Survey among Lowand Middle-Income Countries | Uganda | Descriptive cross-sectional study | 107 (55) | Individuals 18 years and older who provided informed consent to participate in this study. | 33.79 (8.84)years | 10 December 2020 to 9 February 2021 | Vaccine refusal | Factors associated with vaccine refusal | The main reasons underpinning vaccine refusal were fear of side effects (41.2%) and lack of confidence in vaccine effectiveness (15.1%). |
| Kanyanda et al. (36) | Acceptance of COVID-19 vaccines in sub-Saharan Africa: evidence from six national phone surveys | Uganda | Longitudinal high-frequency phone surveys | 2,129 | Respondents of national high-frequency phone surveys, aged 15 years and older, drawn from a nationally representative sample of households | ≥ 15 years | December 2020 | Vaccine hesitancy | Factors causing vaccine reluctance | Safety concerns about the vaccine in general and its side effects specifically emerge as the primary reservations toward a COVID-19 vaccine across countries. |
| Kanyike et al. (37) | Acceptance of the coronavirus disease2019 vaccine among medical students in Uganda | Uganda | Online, descriptive, cross-sectional study using a quantitative approach | 600 (377) | Medical students pursuing undergraduate degree programs of choice. |
≥ 18 years | Monday 15 March and Sunday 21 March 2021 | Factors preventing vaccine uptake | Barriers to vaccine uptake | The most cited reasons for not taking up the vaccine were concerns about safety and having heard or read negative information about the vaccine. |
| Wafula et al. (38) | Intention to vaccinate against COVID-19 and adherence to non-pharmaceutical interventions against COVID-19 prior to the second wave of the pandemic in Uganda: a cross-sectional study | Uganda | Nationwide cross-sectional survey | 1,053 (651) | Adults 18 years and older with access to cell phones and who had been residents in the study district for at least 6 months. | 34 (18–80) years | March 2021 | Reason for reluctance to get vaccinated | Barriers to vaccine uptake | Concerns for side effects were negatively associated with vaccination intent |
| Osur et al. (39) | Determinants of COVID-19 vaccine behavior intentions among the youth in Kenya: a cross-sectional study | Kenya | Mixed-method study using a cross-sectional survey and focused group discussion approaches. | 665 (401) | Youths aged 18–35, registered in online platforms/peer groups that included Shujaaz, Brck Moja, Aifuence, Y Act and Heroes for Change. | 18–35 years | Not available | Vaccine hesitancy | Reasonsa for vaccine hesitancy | Lack of information and concerns around vaccine safety and effectiveness were main cause of COVID-19 vaccine hesitancy |
| Shah et al. (40) | Perceptions and Knowledge toward COVID-19 Vaccine Hesitancy among a Subpopulation of Adults in Kenya: An English Survey at Six Healthcare Facilities | Kenya | Cross-sectional survey | 3,996 (1789) | The general adult public (patients and relatives) visiting the inpatient and outpatient clinics from six different healthcare facilities | 33 (26.5–43.0) years | November 2021 and January 2022 | Vaccine hesitancy perceptions | Barriers to vaccine hesitance | Some participants reported being hesitant to take the vaccine due to side effects associated with the vaccine. |
COVID-19, coronavirus disease 19; LMICs, Low—and Middle-Income Countries; WASH, water, sanitation, and hygiene; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2.