{
  "abstract": "Introduction The COVID-19 pandemic has highlighted significant disparities in vaccine uptake across sub-Saharan Africa, yet research exploring the regional and country-specific factors influencing these rates remains limited. Understanding these factors is crucial for developing targeted regional and global public health interventions to improve vaccination uptake and strengthen pandemic preparedness. This study aims to fill a critical knowledge gap by assessing the factors influencing vaccination rates across sub-Saharan Africa at the operational, systemic and socio-political levels.Methods and analysis The study will employ a comparative case study design across 12 African countries to examine context-specific factors influencing pandemic vaccine preparedness. The 12 selected countries (Angola, Botswana, Burundi, Cameroon, Côte d'Ivoire, Malawi, Namibia, Nigeria, Rwanda, Senegal, South Africa and Uganda) will be categorised by vaccination rate (high, moderate or low). The study will integrate quantitative and qualitative data to provide comprehensive insights. Quantitative data, including COVID-19, macroeconomic, health system and governance indicators, will be sourced from reputable online portals, such as the WHO, the World Bank and Our World in Data. Qualitative data will be collected through key informant interviews with experts across participating African countries, except Angola. Due to delays in obtaining ethics approval in Angola, no primary data collection including key informant interviews will be conducted in Angola unless ethics approval is obtained. Angola will therefore be included through a secondary data approach, drawing on publicly available reports, published literature and relevant case studies. All qualitative data will be analysed using thematic analysis, and quantitative data will be analysed using descriptive methods.Ethics and dissemination Ethics approval was obtained from Western University’s Health Sciences Research Ethics Board (126398) and relevant bodies in the 11 participating countries. Findings will be shared through reports to public health authorities, policy briefs and presentations at academic conferences and peer-reviewed publications.",
  "authors": [
    {
      "affiliations": [
        "University of Western Ontario Faculty of Health Sciences, London, Ontario, Canada",
        "University of Toronto Scarborough, Toronto, Ontario, Canada",
        "African Center for Innovation and Leadership Development, Abuja, Nigeria"
      ],
      "name": "Obidimma Ezezika"
    },
    {
      "affiliations": [
        "Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia"
      ],
      "name": "Bakary Sonko"
    },
    {
      "affiliations": [
        "University of Western Ontario Faculty of Health Sciences, London, Ontario, Canada",
        "African Center for Innovation and Leadership Development, Abuja, Nigeria"
      ],
      "name": "Omolola Olorunbiyi"
    },
    {
      "affiliations": [
        "Vaccines for Africa Initiative, School of Public Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa"
      ],
      "name": "Edina Amponsah-Dacosta"
    },
    {
      "affiliations": [
        "Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong, Hong Kong"
      ],
      "name": "Edward Kwabena Ameyaw"
    },
    {
      "affiliations": [
        "Department of Medical Microbiology and Parasitology, Kisii University, Kisii, Kenya"
      ],
      "name": "Eric Omori Omwenga"
    },
    {
      "affiliations": [
        "Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada",
        "Department of Biostatistics, University of the Witwatersrand Johannesburg, Johannesburg, South Africa"
      ],
      "name": "Ngianga-Bakwin Kandala"
    },
    {
      "affiliations": [
        "Department of Biochemistry, Faculty of Science, University of Yaounde 1, Yaounde, Cameroon"
      ],
      "name": "Marceline Djuidje-Ngounoue"
    },
    {
      "affiliations": [
        "Department of Environmental Management and Toxicology, Federal University Otuoke, Otuoke, Bayelsa, Nigeria"
      ],
      "name": "Morufu Raimi"
    },
    {
      "affiliations": [
        "Department of Animal & Environmental Biology, Osun State University, Osogbo, Osun, Nigeria"
      ],
      "name": "Olabanji Surakat"
    },
    {
      "affiliations": [
        "Department of Human Nutrition and Dietetics Sciences, University of Ibadan, Ibadan, Oyo, Nigeria"
      ],
      "name": "Oluwaseun Ariyo"
    },
    {
      "affiliations": [
        "East Africa Centre for Vaccines and Immunization (ECAVI), Kampala, Uganda",
        "Department of Paediatrics & Child Health, Moi University, Eldoret, Kenya",
        "Department of Paediatrics & Child Health, Makerere University, Kampala, Uganda",
        "Department of Public Health Pharmacy and Management, Sefako Makgatho Health Sciences University, Pretoria, South Africa"
      ],
      "name": "Ombeva Oliver Malande"
    },
    {
      "affiliations": [
        "Medical Parasitology and Entomology, Kisii University, Kisii, Kenya"
      ],
      "name": "Samuel Mong’are"
    },
    {
      "affiliations": [
        "Algoma University, Sault Ste. Marie, Ontario, Canada"
      ],
      "name": "Suleyman M Demi"
    },
    {
      "affiliations": [
        "National Reference Laboratory, Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria"
      ],
      "name": "Nnaemeka Ndodo"
    },
    {
      "affiliations": [
        "University of Toronto Scarborough, Toronto, Ontario, Canada"
      ],
      "name": "Selina Quibrantar"
    },
    {
      "affiliations": [
        "University of Toronto Scarborough, Toronto, Ontario, Canada"
      ],
      "name": "Fatima Kishif"
    },
    {
      "affiliations": [
        "Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia"
      ],
      "name": "Musa Abdullahi"
    },
    {
      "affiliations": [
        "Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia"
      ],
      "name": "Joseph Edor"
    },
    {
      "affiliations": [
        "Department of Medical Microbiology, Parasitology and Immunology, Federal University Otuoke, Otuoke, Bayelsa, Nigeria"
      ],
      "name": "Chris Elemuwa"
    },
    {
      "affiliations": [
        "Female Genital Schistosomiasis Society of Nigeria (FGSSON), Abuja, Nigeria"
      ],
      "name": "Nebe Obiageli"
    },
    {
      "affiliations": [
        "Public Health, Bowen University College of Health Sciences, Iwo, Nigeria"
      ],
      "name": "Akintayo O Ogunwale"
    },
    {
      "affiliations": [
        "East Africa Centre for Vaccines and Immunization, Kampala, Uganda"
      ],
      "name": "Rachel Afaayo Nakatugga"
    },
    {
      "affiliations": [
        "Ethiopia Ministry of Health, Addis Ababa, Ethiopia"
      ],
      "name": "Mesert Zelalem"
    },
    {
      "affiliations": [
        "Department of Geography and Environment, Western University, London, Ontario, Canada"
      ],
      "name": "Isaac N Luginaah"
    }
  ],
  "title": "Pairwise and three-country comparisons of high and low COVID-19 vaccination rates in 12 African countries: a mixed-method study protocol",
  "uid": "6220f31b-545f-533d-8f4d-652feb503094"
}