Vaccination communication strategies and uptake in Africa: a systematic review

Background: African countries experience high rates of infectious diseases that are mostly preventable by vaccination. Despite the risks of infections and other adverse outcomes, vaccination coverage in the African region remains significantly low. Poor vaccination knowledge is a contributory factor, and effective communication is crucial to bridging the vaccination uptake gap. This review summarises vaccination communication strategies adopted across African countries and associated changes in vaccine uptake.

Methods: A systematic search was conducted in five bibliographic databases between 2000 and 2023 and supplemented with an additional Google Scholar search. Studies with data on vaccination communication and uptake in the English language were considered. A narrative synthesis was performed, and findings were presented in text and tables.

Findings: Forty-one studies from fourteen African countries met the inclusion criteria. Several communication strategies were implemented for 13 different vaccines, mainly childhood vaccines. Mass campaigns and capacity building were the most common strategies for the public and health workers, respectively. Community-based strategies using social mobilisation effectively complemented other communication strategies. Overall, vaccination uptake increased in all countries following vaccination communication interventions. Barriers and facilitators to optimising vaccination communication at systemic and individual levels were also identified. Key barriers included lack of vaccine information, access issues, and high cost, while facilitators included improved vaccine education, reminders, trust-building initiatives, and community involvement.

Conclusions: This review highlights effective vaccination communication strategies implemented across Africa as well as systemic and individual barriers and facilitators influencing vaccination uptake. The findings can inform strategies for vaccination communication and campaign planning to improve vaccination coverage in Africa.