Vaccine-preventable-diseases are major contributors to disease burden in Sub-Saharan Africa. Ther... more Vaccine-preventable-diseases are major contributors to disease burden in Sub-Saharan Africa. There is dearth of knowledge on the drivers of childhood vaccine hesitancy in Nigeria and its impact on coverage. Although understudied, pregnant women are a particularly important vulnerable group and very relevant for childhood vaccination decisions. This study's aims are to adapt Confidence, Complacency, Constraints, Calculation, and Collective Responsibility, also known as the 5C psychological antecedence scale for the Nigerian context and to measure predictors of intention to vaccinate among pregnant women (prenatal) and subsequent vaccination behavior (postnatal). It is a longitudinal study that used multi-stage sampling procedure. One healthcare facility was selected from each district in five regional clusters, from which 255 pregnant women were randomly drawn. A standardized questionnaire was used to collect relevant data, including the 5C and some additional variables. Multiple linear regression using backward elimination analysis was performed to identify intention at prenatal and behavior at postnatal. Pregnant women's intention to vaccinate unborn children was lower if they were Muslims, had lower confidence in public health system, if husband approval was important, and if they believed in rumor. At postnatal, vaccination behavior was more likely to follow mothers' religious beliefs, when confidence in vaccine effectiveness was high and when mothers felt responsible for the collective. However, everyday stress (constraints) related to less vaccination behavior, and intention did not predict actual vaccination behavior. The 5C scale needs revision before being widely used in Nigeria. Yet, it is a better tool for measuring vaccination behavior than intention.
Background: By 11 March 2022, there were 450,229,635 Coronavirus disease (COVID-19) cases and 6,0... more Background: By 11 March 2022, there were 450,229,635 Coronavirus disease (COVID-19) cases and 6,019,085 deaths globally, with Nigeria reporting 254,637 cases and 3142 deaths. One of the essential healthcare services that has been impacted by the pandemic is childhood routine immunization. According to the 2018 National Demographic and Health Survey, only 31% of children aged 12–23 months were fully vaccinated in Nigeria, and 19% of eligible children haven’t received any vaccination in the country. A further decline in coverage due to the pandemic can significantly increase the risk of vaccine-preventable-disease outbreaks among children in Nigeria. To mitigate such an occurrence, it is imperative to urgently identify how the pandemic and the response strategies have affected vaccination services, hence, the goal of the study. Methods: The research method is qualitative, including in-depth interviews of healthcare workers and focus group discussions (FGD) with caregivers of children ...
Background: The contribution of vaccination to global public health and community wellbeing has b... more Background: The contribution of vaccination to global public health and community wellbeing has been described as one of the greatest success stories of modern medicine. However, 13.5 million children still miss at least one of their routine vaccinations, and this contributes to about 1.5 million deaths from vaccine‐preventable diseases. One of the contributing factors has been associated with vaccine hesitancy. Vaccine hesitancy is the delay or refusal of vac‐ cines despite their availability. The study explored factors from multiple perspectives that influence hesitancy among caregivers of children and adolescent girls eligible for childhood routine immunisation and the Human Papillomavirus vaccine in Malawi.
Methods: The methodology used was qualitative such as key informant interviews and focus‐group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district‐level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus‐group discus‐ sions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio‐recorded, transcribed, and analysed using a thematic content approach.
Results: Most vaccine‐hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders.
Conclusions: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID‐19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi‐component and wide‐ranging.
Climate change remains a pivotal area and a persistent challenging issue for deliberation among t... more Climate change remains a pivotal area and a persistent challenging issue for deliberation among the nations of the world. Most especially in a country like Nigeria, where fossil fuel remains a pivotal source of socio-economic development and well-being of the society. Transforming the Nigeria electricity sector into a source for reducing the country’s carbon emission remains a significant challenge to policymakers, i.e. the Government. This is attributed to the fact that the nation’s primary energy sources come from traditional biomass and fossil fuel such as coal, and natural oil and gas, which has contributed significantly to the level of carbon emissions. In this paper, we explored and identified the potentials, barriers and option for renewable energy in Nigeria. The findings of the review revealed that the Nigerian electricity sector is crucial to reducing the carbon emission generated in the country. Likewise, it is of no doubt that Nigeria is endowed with a different mix of r...
Journal of Liberty and International Affairs, 2018
Mass media have been a critical weapon of warfare since the cold war, and even more recently, the... more Mass media have been a critical weapon of warfare since the cold war, and even more recently, the powerful intrusion of the new media: transformed the landscape in terms of reach and influence. Its role can be both constructive and deconstructive. The Rwanda genocide, armed violence in Nigeria and Kenya, and the Balkan wars has questioned its roles, powers, and ethical responsibilities in violent conflict circumstances. In these cases, the mass media played a poisonous role. Although establishing a causal relationship between mass media and framing of opinion, emotion, and beliefs that steams violent conflicts in Sub-Saharan Africa is neither linear nor clear. However, this paper underscores the mass media’s compelling influence on how perception in the fragile armed conflict environment of Africa is developed. It is not only used as an effective propaganda machine for promoting regime defense, building resistant movement, but also transforming the political actor’s parochial intere...
Background: Vaccines are among the most effective and cost-efficient public health inter- vention... more Background: Vaccines are among the most effective and cost-efficient public health inter- ventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer in- cidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi.
Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors.
Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employ- ment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief.
Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
Background: Pregnant women are at high risk for severe influenza. However, maternal influenza vac... more Background: Pregnant women are at high risk for severe influenza. However, maternal influenza vaccination uptake in most World Health Organization (WHO) European Region countries remains low, despite the presence of widespread national recommendations. An influenza vaccination reduces influenza-associated morbidity and mortality in pregnancy, as well as providing newborns with protection in their first months. Potential determinants of vaccine hesitancy need to be identified to develop strategies that can increase vaccine acceptance and uptake among pregnant women. The primary objective of the systematic review is to identify the individual determinants of influenza vaccine hesitancy among pregnant women in Europe, and how to overcome the hesitancy. Methods: Databases were searched for peer-reviewed qualitative and quantitative studies published between 2009 and 2019 inclusive. Databases included PubMed via MEDLINE, Cochrane Central Register for Controlled Trials, Psy-cINFO, SAGE Journals, Taylor and Francis and Springer nature. These covered themes including psychology, medicine, and public health. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, 11 studies were eligible and analyzed for significant determinants of influenza vaccine hesitancy among pregnant women in Europe. Results: The most commonly reported factors were psychological aspects, for example concerns about safety and risks to mother and child, or general low risk perception of becoming ill from influenza. Doubts about the effectiveness of the vaccine and a lack of knowledge about this topic were further factors. There was also influence of contextual factors, such as healthcare workers not providing adequate knowledge about the influenza vaccine or the pregnant lady stating their antivaccine sentiment. Conclusion: Health promotion that specifically increases knowledge among pregnant women about influenza and vaccination is important, supporting a valid risk judgment by the pregnant lady. The development of new information strategies for dialogue between healthcare providers and pregnant women should form part of this strategy.
There is a growing debate on the linkage between social networking platforms and mental health di... more There is a growing debate on the linkage between social networking platforms and mental health disorder, such as depressive behaviour or depression. However, the relationship between Instagram use and depression or depressive behaviour has not been exhaustively examined. This review aims to examine these two variables. Only peerreviewed journal articles that are published between October 2010 and December 2018 were sought in central and journal databases. Studies were selected based on predefined criteria and assessed for risk of bias and quality of evidence using GRADE. One thousand eight hundred fifty-six studies were the outcome of the search, out of which 9 meets all eligible criteria. Of the 9 studies, three-quarter was published between 2017 and 2018, covering five continents: (North America: 3; Asia: 2; Australia: 2; South America: 1, Europe: 1). The final included studies broadly examined young Instagram users between the age of 19 and 35. The synthesis affirmed a linkage between Instagram and symptoms of depression or depressive behaviour. Variables that moderate this relationship are social comparison, self-esteem built on validation and approval of others, social media dependence, gender, negative or insufficient feedback, poor self-rated attractiveness, Instagram broadcasting and loneliness, younger users and risk of anxiety, and the number of strangers that users follow. There is a strong relationship between Instagram use and mental health disorders such as depression or depressive behaviour; however, no in-depth direct causality is proven yet. Further studies are needed to unravel the direct causality puzzles.
INTRODUCTION: There is a dearth of literature on vaccine hesitancy in Africa. In this study, we a... more INTRODUCTION: There is a dearth of literature on vaccine hesitancy in Africa. In this study, we aimed to explore the drivers of hesitancy toward recommended childhood vaccines in Kenya, Malawi, and Ethiopia. METHODS: A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O’Malley’s recommendations as modified by Levac. RESULTS: A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context. CONCLUSION: This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.
The devastating impacts that biodegradable products such as plastic bags are having on human heal... more The devastating impacts that biodegradable products such as plastic bags are having on human health, wildlife, and the environment is enormous, especially single-use once. Single-use plastics are non-biodegradable products and does not undergo biological decomposition nor degenerate. This review examines various government regulations targeted at changing behaviour against plastic bags consumption and their effectiveness. Following a rigorous search in 13 databases , including PubMed, Science Direct, Springer Nature, etc. only 17 peer-reviewed journal articles that are published between 2000 and 2019 and met the inclusion criteria were included in the study. Each study's methodological quality was assessed using the GRADE system, and data were extracted using a uniquely designed form. The results revealed that regulations based solely on the thickness of plastic bags does not reduce plastic bags consumption. However, regulations focused on banning 'single-use' plastic bag usage, imposing higher taxes and levies on consumers, significantly reduce plastic bags consumption. Overall, the latter is considered the most effective. Also, the results show that attitude, perception and behaviour change toward biodegradable products or climate-friendly behaviour can be significantly influenced by public policy or regulations. Although the behaviour seems short-lived in some countries, therefore further studies need to probe on why. Also, the absence of a national regulatory strategy in North America reduced the inclusion of studies from the region, hence need for more research focusing on sub-national regulations.
Climate change remains a pivotal area and a persistent challenging issue for deliberation among t... more Climate change remains a pivotal area and a persistent challenging issue for deliberation among the nations of the world. Most especially in a country like Nigeria, where fossil fuel remains a pivotal source of socioeconomic development and well-being of the society. Transforming the Nigeria electricity sector into a source for reducing the country's carbon emission remains a significant challenge to policymakers, i.e. the Government. This is attributed to the fact that the nation's primary energy sources come from traditional biomass and fossil fuel such as coal, and natural oil and gas, which has contributed significantly to the level of carbon emissions. In this paper, we explored and identified the potentials, barriers and option for renewable energy in Nigeria. The findings of the review revealed that the Nigerian electricity sector is crucial to reducing the carbon emission generated in the country. Likewise, it is of no doubt that Nigeria is endowed with a different mix of renewable energy sources. Hence, exploring and developing these renewable energy sources will aid the effort of the government in reducing the country's input to the global carbon emission, instrumental to the socioeconomic development of the country and improved well-being of the society at large. Also, policy recommendations to foster renewable energy development were identified.
Journal of Liberty and International Affairs, 2020
The gender-based violence in recent times has become an integral part of the ongoing Boko Haram I... more The gender-based violence in recent times has become an integral part of the ongoing Boko Haram Insurgency in NorthEast Nigeria. Since the full-scale declaration of combat between the Nigerian state and the insurgent group, the asymmetrical tactics of the group have been evolving, based on its capabilities. The recent spike in the targeted raid and attack on female schools, markets, and female institutions purposely for abduction and kidnapping of women and girls indicated this assertion. Due to the depletion of its fighters and loss of territories, there is a surge in mass deployment of 'women and young girls' as material instruments of warfare: fighters, suicide bombers, human shields, bargaining tools, sex slaves, informants, and so on. This article appraises the gender push-pull factors responsible, motivation behind the current behavior, and proffers some policy guidance.
Journal of Liberty and International Affairs, 2020
Drug trafficking has become the new threat to the economic and political stability of the West Af... more Drug trafficking has become the new threat to the economic and political stability of the West Africa sub-region; by virtue of its new toga as the new transit hub for drug trafficking. 80% and 13% of seizures in cocaine transhipment annually of 60-250 tons to Europe and globally respectively, passes the West African maritime borderlands/coast. The informal economy based on drugs has replaces over $400 million contribution to the region's GDP from fishing. The impacts of drug trafficking had had a long negative toll on the institutions of the states and state-building infrastructure in the region. Besides, intra-states conflicts, drug money and activities had exacerbated state failure in the region; notably in Guinea-Bissau, Mali, Guinea, etc. The West African Coast Initiative is making crawling impacts. Although, still in its pilot phase, it had enhanced coordination of intelligence in the region on drug trafficking and organized crime. However, it is still short of fundamentally addressing obvious policy gap, due to its lack of clear focus; plus, being only operational in just five West African states. This paper identified absence of comprehensive maritime coordination policy against drug trafficking in West Africa as the bane of the surge. Therefore, a tripartite approach, based on state, regional and global levels policy restructuring in the region is required.
Journal of Liberty and International Affairs, 2019
Mass media have been a critical weapon of warfare since the cold war, and even more recently, the... more Mass media have been a critical weapon of warfare since the cold war, and even more recently, the powerful intrusion of the new media: transformed the landscape in terms of reach and influence. Its role can be both constructive and deconstructive. The Rwanda genocide, armed violence in Nigeria and Kenya, and Balkan wars has questioned its roles, powers and ethical responsibilities in violent conflict circumstances. In these cases the mass media played a poisonous role. Although establishing a causal relationship between mass media and framing of opinion, emotion and beliefs that steams violent conflicts in Sub-Saharan Africa is neither linear nor clear. However, this paper underscores mass media’s compelling influence on how perception in fragile armed conflict environment of Africa is developed. It is not only used as an effective propaganda machine for promoting regime defense, building resistant movement, but also transforming the political actor’s parochial interest into people’s interest.
Transnational organised crime (TOC) has dominated the fragility debate in West Africa since the 1... more Transnational organised crime (TOC) has dominated the fragility debate in West Africa since the 1990s in view of emerging linkages to crisis and instability in the sub-region. It was initially regarded as a consequence of the failed structural economic programmes, resulting in a surge of illicit smuggling of licit goods such as cigarettes, petrol and consumer goods. However, it took a transnational dimension following the Economic Community of West African States (ECOWAS) protocol on free movement within the sub-region. Evidence has shown a rise in incidences of violence, insecurity, weakened state institutions and state failure, as well as equal rise in activities of organised criminal networks. The direct causal relationship is not clear-cut (as in Mali, Guinea-Bissau, Liberia, Sierra Leone, etc.); however, organised crime and its elements fuels the internal stress factors that result not only in the production and reproduction of state failure, but regional instability. Many civil conflicts are outcomes or prolonged due to access to criminal gains; be it blood diamonds, oil or cocaine. The book aims to dichotomise relations between transnational organised crime and political instability in West Africa. Does fragility in West Africa exacerbate transnational organised crime or vice versa and what is the way forward?
Vaccine-preventable-diseases are major contributors to disease burden in Sub-Saharan Africa. Ther... more Vaccine-preventable-diseases are major contributors to disease burden in Sub-Saharan Africa. There is dearth of knowledge on the drivers of childhood vaccine hesitancy in Nigeria and its impact on coverage. Although understudied, pregnant women are a particularly important vulnerable group and very relevant for childhood vaccination decisions. This study's aims are to adapt Confidence, Complacency, Constraints, Calculation, and Collective Responsibility, also known as the 5C psychological antecedence scale for the Nigerian context and to measure predictors of intention to vaccinate among pregnant women (prenatal) and subsequent vaccination behavior (postnatal). It is a longitudinal study that used multi-stage sampling procedure. One healthcare facility was selected from each district in five regional clusters, from which 255 pregnant women were randomly drawn. A standardized questionnaire was used to collect relevant data, including the 5C and some additional variables. Multiple linear regression using backward elimination analysis was performed to identify intention at prenatal and behavior at postnatal. Pregnant women's intention to vaccinate unborn children was lower if they were Muslims, had lower confidence in public health system, if husband approval was important, and if they believed in rumor. At postnatal, vaccination behavior was more likely to follow mothers' religious beliefs, when confidence in vaccine effectiveness was high and when mothers felt responsible for the collective. However, everyday stress (constraints) related to less vaccination behavior, and intention did not predict actual vaccination behavior. The 5C scale needs revision before being widely used in Nigeria. Yet, it is a better tool for measuring vaccination behavior than intention.
Background: By 11 March 2022, there were 450,229,635 Coronavirus disease (COVID-19) cases and 6,0... more Background: By 11 March 2022, there were 450,229,635 Coronavirus disease (COVID-19) cases and 6,019,085 deaths globally, with Nigeria reporting 254,637 cases and 3142 deaths. One of the essential healthcare services that has been impacted by the pandemic is childhood routine immunization. According to the 2018 National Demographic and Health Survey, only 31% of children aged 12–23 months were fully vaccinated in Nigeria, and 19% of eligible children haven’t received any vaccination in the country. A further decline in coverage due to the pandemic can significantly increase the risk of vaccine-preventable-disease outbreaks among children in Nigeria. To mitigate such an occurrence, it is imperative to urgently identify how the pandemic and the response strategies have affected vaccination services, hence, the goal of the study. Methods: The research method is qualitative, including in-depth interviews of healthcare workers and focus group discussions (FGD) with caregivers of children ...
Background: The contribution of vaccination to global public health and community wellbeing has b... more Background: The contribution of vaccination to global public health and community wellbeing has been described as one of the greatest success stories of modern medicine. However, 13.5 million children still miss at least one of their routine vaccinations, and this contributes to about 1.5 million deaths from vaccine‐preventable diseases. One of the contributing factors has been associated with vaccine hesitancy. Vaccine hesitancy is the delay or refusal of vac‐ cines despite their availability. The study explored factors from multiple perspectives that influence hesitancy among caregivers of children and adolescent girls eligible for childhood routine immunisation and the Human Papillomavirus vaccine in Malawi.
Methods: The methodology used was qualitative such as key informant interviews and focus‐group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district‐level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus‐group discus‐ sions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio‐recorded, transcribed, and analysed using a thematic content approach.
Results: Most vaccine‐hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders.
Conclusions: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID‐19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi‐component and wide‐ranging.
Climate change remains a pivotal area and a persistent challenging issue for deliberation among t... more Climate change remains a pivotal area and a persistent challenging issue for deliberation among the nations of the world. Most especially in a country like Nigeria, where fossil fuel remains a pivotal source of socio-economic development and well-being of the society. Transforming the Nigeria electricity sector into a source for reducing the country’s carbon emission remains a significant challenge to policymakers, i.e. the Government. This is attributed to the fact that the nation’s primary energy sources come from traditional biomass and fossil fuel such as coal, and natural oil and gas, which has contributed significantly to the level of carbon emissions. In this paper, we explored and identified the potentials, barriers and option for renewable energy in Nigeria. The findings of the review revealed that the Nigerian electricity sector is crucial to reducing the carbon emission generated in the country. Likewise, it is of no doubt that Nigeria is endowed with a different mix of r...
Journal of Liberty and International Affairs, 2018
Mass media have been a critical weapon of warfare since the cold war, and even more recently, the... more Mass media have been a critical weapon of warfare since the cold war, and even more recently, the powerful intrusion of the new media: transformed the landscape in terms of reach and influence. Its role can be both constructive and deconstructive. The Rwanda genocide, armed violence in Nigeria and Kenya, and the Balkan wars has questioned its roles, powers, and ethical responsibilities in violent conflict circumstances. In these cases, the mass media played a poisonous role. Although establishing a causal relationship between mass media and framing of opinion, emotion, and beliefs that steams violent conflicts in Sub-Saharan Africa is neither linear nor clear. However, this paper underscores the mass media’s compelling influence on how perception in the fragile armed conflict environment of Africa is developed. It is not only used as an effective propaganda machine for promoting regime defense, building resistant movement, but also transforming the political actor’s parochial intere...
Background: Vaccines are among the most effective and cost-efficient public health inter- vention... more Background: Vaccines are among the most effective and cost-efficient public health inter- ventions for promoting child health. However, uptake is considerably affected by vaccine hesitancy. An example is Malawi, with a decline in second vaccine doses and the highest cervical cancer in- cidence and mortality rate in Sub-Saharan Africa. Understanding vaccine hesitancy is especially important when new vaccines are introduced. This study explores factors contributing to vaccine hesitancy for routine childhood immunization and the human papillomavirus vaccine in Malawi.
Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors.
Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employ- ment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief.
Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
Background: Pregnant women are at high risk for severe influenza. However, maternal influenza vac... more Background: Pregnant women are at high risk for severe influenza. However, maternal influenza vaccination uptake in most World Health Organization (WHO) European Region countries remains low, despite the presence of widespread national recommendations. An influenza vaccination reduces influenza-associated morbidity and mortality in pregnancy, as well as providing newborns with protection in their first months. Potential determinants of vaccine hesitancy need to be identified to develop strategies that can increase vaccine acceptance and uptake among pregnant women. The primary objective of the systematic review is to identify the individual determinants of influenza vaccine hesitancy among pregnant women in Europe, and how to overcome the hesitancy. Methods: Databases were searched for peer-reviewed qualitative and quantitative studies published between 2009 and 2019 inclusive. Databases included PubMed via MEDLINE, Cochrane Central Register for Controlled Trials, Psy-cINFO, SAGE Journals, Taylor and Francis and Springer nature. These covered themes including psychology, medicine, and public health. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, 11 studies were eligible and analyzed for significant determinants of influenza vaccine hesitancy among pregnant women in Europe. Results: The most commonly reported factors were psychological aspects, for example concerns about safety and risks to mother and child, or general low risk perception of becoming ill from influenza. Doubts about the effectiveness of the vaccine and a lack of knowledge about this topic were further factors. There was also influence of contextual factors, such as healthcare workers not providing adequate knowledge about the influenza vaccine or the pregnant lady stating their antivaccine sentiment. Conclusion: Health promotion that specifically increases knowledge among pregnant women about influenza and vaccination is important, supporting a valid risk judgment by the pregnant lady. The development of new information strategies for dialogue between healthcare providers and pregnant women should form part of this strategy.
There is a growing debate on the linkage between social networking platforms and mental health di... more There is a growing debate on the linkage between social networking platforms and mental health disorder, such as depressive behaviour or depression. However, the relationship between Instagram use and depression or depressive behaviour has not been exhaustively examined. This review aims to examine these two variables. Only peerreviewed journal articles that are published between October 2010 and December 2018 were sought in central and journal databases. Studies were selected based on predefined criteria and assessed for risk of bias and quality of evidence using GRADE. One thousand eight hundred fifty-six studies were the outcome of the search, out of which 9 meets all eligible criteria. Of the 9 studies, three-quarter was published between 2017 and 2018, covering five continents: (North America: 3; Asia: 2; Australia: 2; South America: 1, Europe: 1). The final included studies broadly examined young Instagram users between the age of 19 and 35. The synthesis affirmed a linkage between Instagram and symptoms of depression or depressive behaviour. Variables that moderate this relationship are social comparison, self-esteem built on validation and approval of others, social media dependence, gender, negative or insufficient feedback, poor self-rated attractiveness, Instagram broadcasting and loneliness, younger users and risk of anxiety, and the number of strangers that users follow. There is a strong relationship between Instagram use and mental health disorders such as depression or depressive behaviour; however, no in-depth direct causality is proven yet. Further studies are needed to unravel the direct causality puzzles.
INTRODUCTION: There is a dearth of literature on vaccine hesitancy in Africa. In this study, we a... more INTRODUCTION: There is a dearth of literature on vaccine hesitancy in Africa. In this study, we aimed to explore the drivers of hesitancy toward recommended childhood vaccines in Kenya, Malawi, and Ethiopia. METHODS: A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O’Malley’s recommendations as modified by Levac. RESULTS: A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context. CONCLUSION: This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.
The devastating impacts that biodegradable products such as plastic bags are having on human heal... more The devastating impacts that biodegradable products such as plastic bags are having on human health, wildlife, and the environment is enormous, especially single-use once. Single-use plastics are non-biodegradable products and does not undergo biological decomposition nor degenerate. This review examines various government regulations targeted at changing behaviour against plastic bags consumption and their effectiveness. Following a rigorous search in 13 databases , including PubMed, Science Direct, Springer Nature, etc. only 17 peer-reviewed journal articles that are published between 2000 and 2019 and met the inclusion criteria were included in the study. Each study's methodological quality was assessed using the GRADE system, and data were extracted using a uniquely designed form. The results revealed that regulations based solely on the thickness of plastic bags does not reduce plastic bags consumption. However, regulations focused on banning 'single-use' plastic bag usage, imposing higher taxes and levies on consumers, significantly reduce plastic bags consumption. Overall, the latter is considered the most effective. Also, the results show that attitude, perception and behaviour change toward biodegradable products or climate-friendly behaviour can be significantly influenced by public policy or regulations. Although the behaviour seems short-lived in some countries, therefore further studies need to probe on why. Also, the absence of a national regulatory strategy in North America reduced the inclusion of studies from the region, hence need for more research focusing on sub-national regulations.
Climate change remains a pivotal area and a persistent challenging issue for deliberation among t... more Climate change remains a pivotal area and a persistent challenging issue for deliberation among the nations of the world. Most especially in a country like Nigeria, where fossil fuel remains a pivotal source of socioeconomic development and well-being of the society. Transforming the Nigeria electricity sector into a source for reducing the country's carbon emission remains a significant challenge to policymakers, i.e. the Government. This is attributed to the fact that the nation's primary energy sources come from traditional biomass and fossil fuel such as coal, and natural oil and gas, which has contributed significantly to the level of carbon emissions. In this paper, we explored and identified the potentials, barriers and option for renewable energy in Nigeria. The findings of the review revealed that the Nigerian electricity sector is crucial to reducing the carbon emission generated in the country. Likewise, it is of no doubt that Nigeria is endowed with a different mix of renewable energy sources. Hence, exploring and developing these renewable energy sources will aid the effort of the government in reducing the country's input to the global carbon emission, instrumental to the socioeconomic development of the country and improved well-being of the society at large. Also, policy recommendations to foster renewable energy development were identified.
Journal of Liberty and International Affairs, 2020
The gender-based violence in recent times has become an integral part of the ongoing Boko Haram I... more The gender-based violence in recent times has become an integral part of the ongoing Boko Haram Insurgency in NorthEast Nigeria. Since the full-scale declaration of combat between the Nigerian state and the insurgent group, the asymmetrical tactics of the group have been evolving, based on its capabilities. The recent spike in the targeted raid and attack on female schools, markets, and female institutions purposely for abduction and kidnapping of women and girls indicated this assertion. Due to the depletion of its fighters and loss of territories, there is a surge in mass deployment of 'women and young girls' as material instruments of warfare: fighters, suicide bombers, human shields, bargaining tools, sex slaves, informants, and so on. This article appraises the gender push-pull factors responsible, motivation behind the current behavior, and proffers some policy guidance.
Journal of Liberty and International Affairs, 2020
Drug trafficking has become the new threat to the economic and political stability of the West Af... more Drug trafficking has become the new threat to the economic and political stability of the West Africa sub-region; by virtue of its new toga as the new transit hub for drug trafficking. 80% and 13% of seizures in cocaine transhipment annually of 60-250 tons to Europe and globally respectively, passes the West African maritime borderlands/coast. The informal economy based on drugs has replaces over $400 million contribution to the region's GDP from fishing. The impacts of drug trafficking had had a long negative toll on the institutions of the states and state-building infrastructure in the region. Besides, intra-states conflicts, drug money and activities had exacerbated state failure in the region; notably in Guinea-Bissau, Mali, Guinea, etc. The West African Coast Initiative is making crawling impacts. Although, still in its pilot phase, it had enhanced coordination of intelligence in the region on drug trafficking and organized crime. However, it is still short of fundamentally addressing obvious policy gap, due to its lack of clear focus; plus, being only operational in just five West African states. This paper identified absence of comprehensive maritime coordination policy against drug trafficking in West Africa as the bane of the surge. Therefore, a tripartite approach, based on state, regional and global levels policy restructuring in the region is required.
Journal of Liberty and International Affairs, 2019
Mass media have been a critical weapon of warfare since the cold war, and even more recently, the... more Mass media have been a critical weapon of warfare since the cold war, and even more recently, the powerful intrusion of the new media: transformed the landscape in terms of reach and influence. Its role can be both constructive and deconstructive. The Rwanda genocide, armed violence in Nigeria and Kenya, and Balkan wars has questioned its roles, powers and ethical responsibilities in violent conflict circumstances. In these cases the mass media played a poisonous role. Although establishing a causal relationship between mass media and framing of opinion, emotion and beliefs that steams violent conflicts in Sub-Saharan Africa is neither linear nor clear. However, this paper underscores mass media’s compelling influence on how perception in fragile armed conflict environment of Africa is developed. It is not only used as an effective propaganda machine for promoting regime defense, building resistant movement, but also transforming the political actor’s parochial interest into people’s interest.
Transnational organised crime (TOC) has dominated the fragility debate in West Africa since the 1... more Transnational organised crime (TOC) has dominated the fragility debate in West Africa since the 1990s in view of emerging linkages to crisis and instability in the sub-region. It was initially regarded as a consequence of the failed structural economic programmes, resulting in a surge of illicit smuggling of licit goods such as cigarettes, petrol and consumer goods. However, it took a transnational dimension following the Economic Community of West African States (ECOWAS) protocol on free movement within the sub-region. Evidence has shown a rise in incidences of violence, insecurity, weakened state institutions and state failure, as well as equal rise in activities of organised criminal networks. The direct causal relationship is not clear-cut (as in Mali, Guinea-Bissau, Liberia, Sierra Leone, etc.); however, organised crime and its elements fuels the internal stress factors that result not only in the production and reproduction of state failure, but regional instability. Many civil conflicts are outcomes or prolonged due to access to criminal gains; be it blood diamonds, oil or cocaine. The book aims to dichotomise relations between transnational organised crime and political instability in West Africa. Does fragility in West Africa exacerbate transnational organised crime or vice versa and what is the way forward?
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Methods: The methodology used was qualitative such as key informant interviews and focus‐group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district‐level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus‐group discus‐ sions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio‐recorded, transcribed, and analysed using a thematic content approach.
Results: Most vaccine‐hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders.
Conclusions: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID‐19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi‐component and wide‐ranging.
Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors.
Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employ- ment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief.
Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
METHODS: A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O’Malley’s recommendations as modified by Levac.
RESULTS: A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context.
CONCLUSION: This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.
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Methods: The methodology used was qualitative such as key informant interviews and focus‐group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district‐level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus‐group discus‐ sions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio‐recorded, transcribed, and analysed using a thematic content approach.
Results: Most vaccine‐hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders.
Conclusions: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID‐19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi‐component and wide‐ranging.
Methods: The study used a cross-sectional survey design targeting caregivers of children under five years old and adolescent girls. The sample population was derived using three inclusion criteria: one district with low vaccine uptake (Dowa), one district with high vaccine uptake (Salima), and one district where human papillomavirus vaccine was piloted earlier (Zomba). A convenience sample of one primary and one secondary health facility was selected within each district, and participants were systematically included (n = 600). The measures were based on 5C scale for measuring vaccine hesitancy. Multiple regression analyses were performed to explore vaccination intention predictors.
Results: Confidence in vaccine safety was the strongest predictor of routine childhood immunization, followed by constraints due to everyday stress. Caregivers had lower confidence in vaccine safety and efficacy when they believed rumors and misinformation and were unemployed. Confidence was higher for those who had more trust in healthcare workers. Age, gender, religion, education, employ- ment, belief in rumors, and trust in healthcare workers were considered predictors of vaccination intention. A husband’s positive attitude (approval) increased childhood vaccination intention. For human papillomavirus, vaccination intentions were higher for those with lower education, more trust in healthcare workers, lower complacency, and a lower tendency toward calculating the benefits and risks of vaccination. Knowledge of human papillomavirus did not increase vaccination intention, but the need to attain a husband’s approval did. Being a young adult and unemployed increased belief in rumors, while trust in healthcare workers reduced the belief.
Conclusions: This study provides good insights into the drivers of vaccine hesitancy across different contexts in Malawi. However, further studies are necessary to understand low risk perception among elderly people and the declining trend in second vaccine doses.
METHODS: A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O’Malley’s recommendations as modified by Levac.
RESULTS: A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context.
CONCLUSION: This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.