Hesitancy in COVID-19 Vaccine Uptake and Its Correlated Factors Using Multi-Theory Model among Adult Women: A Cross-Sectional Study in Three States of Somalia

Adam A Mohamed; Temesgen F Bocher; Mohamed A Magan; Cashington Siameja; Said A Mohamoud

doi:10.3390/vaccines11091489

Hesitancy in COVID-19 Vaccine Uptake and Its Correlated Factors Using Multi-Theory Model among Adult Women: A Cross-Sectional Study in Three States of Somalia

Vaccines (Basel). 2023 Sep 14;11(9):1489. doi: 10.3390/vaccines11091489.

Authors

Adam A Mohamed¹, Temesgen F Bocher¹, Mohamed A Magan¹, Cashington Siameja¹, Said A Mohamoud¹

Affiliation

¹ Save the Children International, Mogadishu P.O. Box 39664-00623, Somalia.

Abstract

Background: In developing countries, access to information, awareness, and availability of COVID-19 vaccines are key challenges. Somalia launched the COVID-19 vaccination in March 2021; however, the uptake of the vaccination is slow, which creates fear of further loss of life in the country unless intentional and organized campaigning and efforts are made to improve both the availability of the vaccine and its acceptance by the community. This study aimed to understand the current level of awareness, accessibility, trust, and hesitancy toward the COVID-19 vaccine among women in Somalia.

Methods: To assess COVID-19 vaccine uptake, acceptance, community awareness, and hesitancy rates in Somalia, we carried out a cross-sectional mixed methods study in three regions of Somalia that were selected randomly out of the 18 regions of Somalia. A multi-theory model (MTM) was developed to identify correlated factors associated with the hesitancy or non-hesitancy toward COVID-19 vaccination among women of all ages (18 years and above).

Results: A total of 999 eligible women (333 in each district) of 18-98 years old were interviewed in March 2022. About two-thirds (63.76%) of participants reported hesitancy about receiving the COVID-19 vaccine. The theory model initiation construct indicated that behavioral confidence in the vaccine (b = 0.476, p < 0.001), participatory dialogue (at b = 0.136, p < 0.004), and changes in the physical environment (b = 0.248, p = 0.015) were significantly associated with COVID-19 vaccine acceptance among women who were not hesitant to take the vaccine.

Conclusions: The availability of COVID-19 vaccines may not translate into their uptake. The decision to get the vaccine was determined by multiple factors, including the perceived value of the vaccination, previous experience with the vaccine, perceived risk of infection, accessibility and affordability, and trust in the vaccine itself. Public health education programming and messaging must be developed to encourage vaccine uptake among women with varying levels of vaccine hesitancy.

Keywords: COVID-19 vaccine uptake; Somalia; barriers; hesitancy; multi-theory model (MTM).

Grants and funding

This research received external funding from Save the Children Fund, commonly known as Save the Children, is an international, non-government operated organization. It was founded in the UK in 1919, with the goal of helping improve the lives of children worldwide, Save the Children member (Italy) funded this research in 2021. Save the Children (Sales) Ltd. is a registered company in England and Wales (875945).