Culturally Relevant Covid-19 Vaccine Acceptance Strategies in Sub-Saharan Africa.

Abstract

In sub-Saharan Africa, the reasons for low rates of COVID-19 vaccination and unwillingness to accept the vaccine vary, so country-specific solutions are needed.1 Public health action that is humane, culturally relevant, and recognises the contribution of historical, structural, and other system dynamics has been called for.2 To meet these objectives, countries should frame their individual remedial strategies on the basis of approaches that WHO and the Lancet Commission on the future of health in sub-Saharan Africa advocate for generating positive health behaviours.3, 4 Central concepts of proven value that are relevant to COVID-19 vaccination uptake include innovation and task shifting away from conventionally relied upon forms of health informatics and engagement to promote health literacy and achieve health equity through action. Although vaccination rates have risen in sub-Saharan Africa, vaccine resistance is a health-related behaviour,5 and challenges to vaccine acceptance remain.1, 6 Consequently, as vaccine global supply and distribution inequities are overcome, countries must identify what individual factors different sectors of society see as compelling reasons for and against being vaccinated and find new ways to engage individuals who are undecided. As WHO and others have identified, innovative approaches need to be sought that build trust and engage at-risk populations,1, 7 remediate insensitivity and reliance on so-called top-down directives, and promote strategies that are based on culturally-sensitive dialogue and mutual respect.1, 2 Six WHO and Lancet Commission approaches encompass these criteria and are directly applicable to strategies to remediate COVID-19 vaccine resistance, as follows.