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<p>Health care workers are at elevated risk for COVID-19 and are prioritized for vaccination. Despite this, vaccine uptake remains suboptimal in many low-income settings. This study aimed to evaluate the behavioural and social drivers of COVID-19 vaccine uptake among health care workers in Ethiopia. A facility-based cross-sectional survey was conducted among healthcare workers in selected government health facilities in Ethiopia from December 2023 to February 2024. Health facilities were selected using stratified multistage sampling based on facility type (hospitals and health centres), with proportional allocation across strata. Within each selected facility, healthcare workers were selected using simple random sampling from updated staff lists. Data was collected using the World Health Organization’s Behavioural and Social Drivers-based questionnaire. Data were analysed using the Statistical Package for Social Sciences (v.23.0) and AMOS (v.23.0). Logistic regression was used to identify factors associated with outcomes. Statistical significance was set at <i>p</i> &lt; 0.05. All participants completed the questionnaire (100% response rate). Among 420 health care workers, 63.6% received at least one dose of the COVID-19 vaccine. Vaccination was significantly associated with age (COR = 1.14; 95% CI: 1.09–1.19) and prior COVID-19 infection (COR = 6.67; 95% CI: 4.29–10.39). Behavioural drivers, including perceived vaccine importance (OR: 8.46; 95% CI: 5.26–13.60), safety (COR = 7.05; 95% CI: 4.48–11.09), and trust in providers (COR = 2.28; 95% CI: 1.49–3.48), were strongly associated with higher vaccination rates. Structural equation modelling showed ‘Practical issues’ (β = 0.459) and ‘Motivation’ (β = 0.402) directly influenced vaccine uptake, while ‘Thinking and feeling’ and ‘Social processes’ had significant indirect effects. Health care workers expressed mixed views on COVID-19 vaccination. Approximately 70% perceived COVID-19 vaccination as important for protecting themselves and others, despite concerns about side effects (32%). About two-thirds of health care workers had received at least one dose of a COVID-19 vaccine. Vaccine uptake was influenced by behavioural, social, and practical factors. While confidence in vaccine importance and effectiveness was generally high, concerns about safety and access persisted. Interventions should focus on strengthening trust, addressing safety concerns, and improving service delivery.</p>

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Behavioural and social drivers of COVID-19 vaccination among front-line health care workers in South-west Ethiopia: a cross-sectional study

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  • 出版模式：

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  • 发表日期：

    2026年8月1日

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  • Zeleke Mekonnen,
  • Tsegaye Melaku,
  • Jane Brandt Sørensen,
  • Tania Aase Draebel,
  • Dan Wolf Meyrowitsch,
  • Reginald A. Kavishe,
  • Esayas Kebede Gudina

摘要

Health care workers are at elevated risk for COVID-19 and are prioritized for vaccination. Despite this, vaccine uptake remains suboptimal in many low-income settings. This study aimed to evaluate the behavioural and social drivers of COVID-19 vaccine uptake among health care workers in Ethiopia. A facility-based cross-sectional survey was conducted among healthcare workers in selected government health facilities in Ethiopia from December 2023 to February 2024. Health facilities were selected using stratified multistage sampling based on facility type (hospitals and health centres), with proportional allocation across strata. Within each selected facility, healthcare workers were selected using simple random sampling from updated staff lists. Data was collected using the World Health Organization’s Behavioural and Social Drivers-based questionnaire. Data were analysed using the Statistical Package for Social Sciences (v.23.0) and AMOS (v.23.0). Logistic regression was used to identify factors associated with outcomes. Statistical significance was set at p < 0.05. All participants completed the questionnaire (100% response rate). Among 420 health care workers, 63.6% received at least one dose of the COVID-19 vaccine. Vaccination was significantly associated with age (COR = 1.14; 95% CI: 1.09–1.19) and prior COVID-19 infection (COR = 6.67; 95% CI: 4.29–10.39). Behavioural drivers, including perceived vaccine importance (OR: 8.46; 95% CI: 5.26–13.60), safety (COR = 7.05; 95% CI: 4.48–11.09), and trust in providers (COR = 2.28; 95% CI: 1.49–3.48), were strongly associated with higher vaccination rates. Structural equation modelling showed ‘Practical issues’ (β = 0.459) and ‘Motivation’ (β = 0.402) directly influenced vaccine uptake, while ‘Thinking and feeling’ and ‘Social processes’ had significant indirect effects. Health care workers expressed mixed views on COVID-19 vaccination. Approximately 70% perceived COVID-19 vaccination as important for protecting themselves and others, despite concerns about side effects (32%). About two-thirds of health care workers had received at least one dose of a COVID-19 vaccine. Vaccine uptake was influenced by behavioural, social, and practical factors. While confidence in vaccine importance and effectiveness was generally high, concerns about safety and access persisted. Interventions should focus on strengthening trust, addressing safety concerns, and improving service delivery.