{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:49:10Z","timestamp":1785415750623,"version":"3.56.0"},"reference-count":31,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Healthcare workers (HCWs) are crucial for coronavirus disease 2019 (COVID-19) vaccination programmes, but their perceptions of the vaccine, particularly in low-income countries, are underexplored. This study investigated HCWs perceptions of the COVID-19 vaccination in Rwanda.\n\nAim: This study aimed to understand HCWs\u2019 perceptions of the COVID-19 vaccine in Rwanda.\n\nSetting: A convergent mixed-methods study was conducted in 45 purposively selected health facilities in Rwanda.\n\nMethods: A sample of 230 HCWs was purposively calculated to include 45 health facilities from both rural and urban districts across Rwanda to participate in this study. Healthcare workers were selected conveniently ensuring representation of the different cadres. Furthermore, one participant per facility underwent an in-depth interview. Data were analysed using STATA 17 (quantitative) and Dedoose (qualitative) software. Descriptive analysis was applied and findings presented frequencies and graphical representations. Inductive thematic analysis was performed to identify key themes in the qualitative data.\n\nResults: Most participants were female, 183 (89%), and median age was 39 years. Most were nurses and\/or midwives, 98 (42.6%) and all were fully vaccinated. A total of 59 (25.7%) HCWs had little or no confidence in answering patients\u2019 questions about COVID-19 and the vaccine. Despite this, 91.3% would recommend Ministry or World Health Organization (WHO)-approved vaccines and had a positive overall perception about COVID-19 vaccine.\n\nConclusion: The positive perception of the COVID-19 vaccine among Rwandan HCWs aligns with the country\u2019s successful vaccination programme. This potentially reflects effective national strategies. Further research into Rwanda\u2019s COVID-19 response is however, warranted.\n\nContribution: This study reveals discrepancies in HCWs vaccine confidence in Rwanda, highlighting the need for targeted educational interventions to strengthen national COVID-19 response efforts.<\/jats:p>","DOI":"10.4102\/jphia.v16i1.668","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T07:31:52Z","timestamp":1744356712000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Perceptions about COVID-19 vaccine among healthcare workers in Rwanda: A mixed-methods study"],"prefix":"10.4102","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6231-7893","authenticated-orcid":false,"given":"Erigene","family":"Rutayisire","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00286hs46","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1762-4867","authenticated-orcid":false,"given":"Fran\u00e7ois X.","family":"Ndayambaje","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00286hs46","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1702-0713","authenticated-orcid":false,"given":"Sembuche","family":"Senga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9849-5088","authenticated-orcid":false,"given":"Raji","family":"Tajudeen","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8502-0128","authenticated-orcid":false,"given":"Darius","family":"Uzabakiriho","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03jggqf79","id-type":"ROR","asserted-by":"publisher"}],"name":"Rwanda Biomedical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1667-3046","authenticated-orcid":false,"given":"Solange","family":"Nikwigize","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03jggqf79","id-type":"ROR","asserted-by":"publisher"}],"name":"Rwanda Biomedical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5006-9271","authenticated-orcid":false,"given":"Marie F.","family":"Muremba","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03jggqf79","id-type":"ROR","asserted-by":"publisher"}],"name":"Rwanda Biomedical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-8877","authenticated-orcid":false,"given":"Eric","family":"Remera","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03jggqf79","id-type":"ROR","asserted-by":"publisher"}],"name":"Rwanda Biomedical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2771-0444","authenticated-orcid":false,"given":"Tonny","family":"Muwonge","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dmz0111","id-type":"ROR","asserted-by":"publisher"}],"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2741-0563","authenticated-orcid":false,"given":"Leah","family":"Mbabazi","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dmz0111","id-type":"ROR","asserted-by":"publisher"}],"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7287-8563","authenticated-orcid":false,"given":"Rodgers R.","family":"Ayebare","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dmz0111","id-type":"ROR","asserted-by":"publisher"}],"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4047-6620","authenticated-orcid":false,"given":"Francis","family":"Kakooza","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03dmz0111","id-type":"ROR","asserted-by":"publisher"}],"name":"Makerere University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1896-1208","authenticated-orcid":false,"given":"Tamrat","family":"Shaweno","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5406-4171","authenticated-orcid":false,"given":"Nebiyu","family":"Dereje","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01d9dbd65","id-type":"ROR","asserted-by":"publisher"}],"name":"Africa Centres for Disease Control and Prevention"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1045-4930","authenticated-orcid":false,"given":"Elizabeth","family":"Gonese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8740-4072","authenticated-orcid":false,"given":"Mosoka P.","family":"Fallah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9516-9508","authenticated-orcid":false,"given":"Ayman","family":"Ahmed","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/02jbayz55","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Khartoum"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6075-5603","authenticated-orcid":false,"given":"Jean Claude S.","family":"Ngabonziza","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00286hs46","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Rwanda"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"ref0","unstructured":"Mathieu E, Ritchie H, Rod\u00e9s-Guirao L, et al. Coronavirus pandemic (COVID-19). Our world in data [homepage on the Internet]. 2020 [cited 2024 Mar 14]. Available from: https:\/\/ourworldindata.org\/coronavirus"},{"key":"ref1","unstructured":"WHO. COVID-19 Rwanda situation. WHO COVID-19 dashboard [homepage on the Internet]. [cited 2024 Mar 14]. Available from: https:\/\/data.who.int\/dashboards\/covid19\/cases?m49=646&n=c"},{"key":"ref2","unstructured":"Nsanzabaganwa C, Bigirimana N, Hitimana N, et al. Rwanda COVID-19 vaccination program implementation [homepage on the Internet]. Kigali; 2021 [cited 2024 Mar 14]. Available from: https:\/\/rbc.gov.rw\/publichealthbulletin\/img\/RPHB%20Vol.%203,%20issue%201.%20pp7-9.pdf"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Hoernke K, Djellouli N, Andrews L, et al. Frontline healthcare workers\u2019 experiences with personal protective equipment during the COVID-19 pandemic in the UK: A rapid qualitative appraisal. BMJ Open. 2021;11:e046199. https:\/\/doi.org\/10.1136\/bmjopen-2020-046199","DOI":"10.1136\/bmjopen-2020-046199"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Moyo I, Mavhandu-Mudzusi AH, Haruzivishe C. Frontline healthcare workers\u2019 experiences of providing care during the COVID-19 pandemic at a COVID-19 centre in Bulawayo, Zimbabwe: A phenomenological study. Curationis. 2022;45(1):e1\u2013e11. https:\/\/doi.org\/10.4102\/curationis.v45i1.2292","DOI":"10.4102\/curationis.v45i1.2292"},{"key":"ref5","unstructured":"Nguyen LH, Drew DA, Graham MS, et al. Risk of COVID-19 among front-line health-care workers and the general community: A prospective cohort study. Lancet Public Health [serial online]. 2020 [cited 2024 Mar 14];5:e475\u2013e483. Available from: http:\/\/www.thelancet.com\/article\/S246826672030164X\/fulltext"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Niyigena A, Nyirahabimana N, Cubaka V, et al. Knowledge and practices surrounding outbreaks and COVID-19 among community health workers in rural Rwanda: A cross-sectional mixed-methods study. Pan Afr Med J. 2023;45:35. https:\/\/doi.org\/10.11604\/pamj.2023.45.35.37020","DOI":"10.11604\/pamj.2023.45.35.37020"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Alhassan RK, Owusu-Agyei S, Ansah EK, Gyapong M. COVID-19 vaccine uptake among health care workers in Ghana: A case for targeted vaccine deployment campaigns in the global south. Hum Resour Health. 2021;19:1\u201312. https:\/\/doi.org\/10.1186\/s12960-021-00657-1","DOI":"10.1186\/s12960-021-00657-1"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Biswas N, Mustapha T, Khubchandani J, Price JH. The nature and extent of COVID-19 vaccination hesitancy in healthcare workers. J Community Health. 2021;46:1244\u20131251. https:\/\/doi.org\/10.1007\/s10900-021-00984-3","DOI":"10.1007\/s10900-021-00984-3"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Adane M, Ademas A, Kloos H. Knowledge, attitudes, and perceptions of COVID-19 vaccine and refusal to receive COVID-19 vaccine among healthcare workers in northeastern Ethiopia. BMC Public Health. 2022;22:1\u201314. https:\/\/doi.org\/10.1186\/s12889-021-12362-8","DOI":"10.1186\/s12889-021-12362-8"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Lim EH, Fong NP, Pang J. Factors of COVID-19 vaccine perception among transport drivers in singapore: A cross-sectional pilot study. Am J Trop Med Hyg. 2023;108:588. https:\/\/doi.org\/10.4269\/ajtmh.22-0510","DOI":"10.4269\/ajtmh.22-0510"},{"key":"ref11","unstructured":"National Institute of Statistics of Rwanda. Main indicators: 5th Rwanda Population and Housing Census (PHC) [homepage on the Internet]. Kigali: National Institute of Statistics Rwanda; 2023 [cited 2024 Mar 14]. Available from: https:\/\/www.statistics.gov.rw\/publication\/main_indicators_2022"},{"key":"ref12","unstructured":"Ministry of Health Rwanda. Health sector annual performance report 2020\u20132021 [homepage on the Internet]. Kigali; 2022 [cited 2024 Mar 14]. Available from: https:\/\/www.moh.gov.rw\/index.php?eID=dumpFile&t=f&f=36820&token=2e1aac6615a585b990697f58e2915ee3ee2c6f9a"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Patel MK, Bergeri I, Bresee JS, et al. Evaluation of post-introduction COVID-19 vaccine effectiveness: Summary of interim guidance of the World Health Organization. Vaccine. 2021;39:4013. https:\/\/doi.org\/10.1016\/j.vaccine.2021.05.099","DOI":"10.1016\/j.vaccine.2021.05.099"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Brewer NT, Chapman GB, Rothman AJ, Leask J, Kempe A. Increasing vaccination: Putting psychological science into action. Psychol Sci Public Interest. 2017;18:149\u2013207. https:\/\/doi.org\/10.1177\/1529100618760521","DOI":"10.1177\/1529100618760521"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Mohammed R, Nguse TM, Habte BM, Fentie AM, Gebretekle GB. COVID-19 vaccine hesitancy among Ethiopian healthcare workers. PLoS One. 2021;16(12):e0261125. https:\/\/doi.org\/10.1371\/journal.pone.0261125","DOI":"10.1371\/journal.pone.0261125"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Amuzie CI, Odini F, Kalu KU, et al. Covid-19 vaccine hesitancy among healthcare workers and its socio-demographic determinants in abia state, southeastern nigeria: A cross-sectional study. Pan Afr Med J. 2021;40:10. https:\/\/doi.org\/10.11604\/pamj.2021.40.10.29816","DOI":"10.11604\/pamj.2021.40.10.29816"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Li H, Chen B, Chen Z, et al. Trust in COVID-19 information from different media types and its association with preventive measures adoption in the U.S. J Health Commun. 2023;28:633\u2013647. https:\/\/doi.org\/10.1080\/10810730.2023.2245373","DOI":"10.1080\/10810730.2023.2245373"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Maykrantz SA, Gong T, Petrolino AV, Nobiling BD, Houghton JD. How trust in information sources influences preventative measures compliance during the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18(11):5867. https:\/\/doi.org\/10.3390\/ijerph18115867","DOI":"10.3390\/ijerph18115867"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Holzmann-Littig C, Braunisch MC, Kranke P, et al. Covid-19 vaccination acceptance and hesitancy among healthcare workers in Germany. Vaccines (Basel). 2021;9(7):777. https:\/\/doi.org\/10.3390\/vaccines9070777","DOI":"10.3390\/vaccines9070777"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Jain J, Saurabh S, Kumar P, et al. COVID-19 vaccine hesitancy among medical students in India. Epidemiol Infect. 2021;149:e132. https:\/\/doi.org\/10.1017\/S0950268821001205","DOI":"10.1017\/S0950268821001205"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Khubchandani J, Bustos E, Chowdhury S, Biswas N, Keller T. COVID-19 vaccine refusal among nurses worldwide: Review of trends and predictors. Vaccines (Basel). 2022;10(2):230. https:\/\/doi.org\/10.3390\/vaccines10020230","DOI":"10.3390\/vaccines10020230"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Bon HB, Brouwers SA, Mote J, et al. Measuring behavioral and social drivers of COVID-19 vaccination in health workers in Eastern and Southern Africa. BMC Proc. 2023;17(Suppl 7):14. https:\/\/doi.org\/10.1186\/s12919-023-00262-1","DOI":"10.1186\/s12919-023-00262-1"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Iyer HS, Chukwuma A, Mugunga JC, et al. A comparison of health achievements in Rwanda and Burundi. Health Hum Rights. 2018;20:199.","DOI":"10.1596\/35577"},{"key":"ref24","unstructured":"Leslie FM, Ravishankar N, Squires J, Williamson TR, Brinkerhoff D. Rwanda health governance assessment [homepage on the Internet]. 2010 [cited 2024 Mar 14]. Available from: https:\/\/www.hfgproject.org\/wp-content\/uploads\/2015\/02\/Rwanda-Health-Governance-Assessment.pdf"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Mohammed AS, Asumah MN, Padhi BK, et al. Predictors of SARS-CoV-2 vaccine uptake among health professionals: A cross-sectional study in Ghana. Vaccines (Basel). 2023;11(1):190. https:\/\/doi.org\/10.3390\/vaccines11010190","DOI":"10.3390\/vaccines11010190"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Lubad MA, Abu-Helalah MA, Alahmad IF, et al. Willingness of healthcare workers to recommend or receive a third COVID-19 vaccine dose: A cross-sectional study from Jordan. Infect Dis Rep. 2023;15:210\u2013221. https:\/\/doi.org\/10.3390\/idr15020022","DOI":"10.3390\/idr15020022"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Abdulle HM, Masika MM, Oyugi JO. COVID-19: Knowledge, perception of risk, preparedness and vaccine acceptability among healthcare workers in Kenya. Pan Afr Med J. 2022;41:239. https:\/\/doi.org\/10.11604\/pamj.2022.41.239.33985","DOI":"10.11604\/pamj.2022.41.239.33985"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Arrais M, DIas W, Gama JMR, Brito M. Physicians\u2019 perceptions of their knowledge and the preparedness of health facilities in Angola to diagnose and manage COVID-19. Int Health. 2022;14:103\u2013110. https:\/\/doi.org\/10.1093\/inthealth\/ihab017","DOI":"10.1093\/inthealth\/ihab017"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Kadoya Y, Zen K, Wakana N, et al. Knowledge, perception, and level of confidence regarding COVID-19 care among healthcare workers involved in cardiovascular medicine: A web-based cross-sectional survey in Japan. J Cardiol. 2021;77:239. https:\/\/doi.org\/10.1016\/j.jjcc.2020.07.029","DOI":"10.1016\/j.jjcc.2020.07.029"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Elgibaly O, Daef E, Elghazally SA, et al. Knowledge, perception, and confidence of healthcare workers about COVID-19 preventive measures during the first wave of the pandemic: A cross-sectional study from Egypt. Germs. 2021;11(2):179\u2013188. https:\/\/doi.org\/10.18683\/germs.2021.1255","DOI":"10.18683\/germs.2021.1255"}],"container-title":["Journal of Public Health in Africa"],"original-title":[],"link":[{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/668\/html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/668\/epub","content-type":"application\/epub+zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/668\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/668\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/668\/1709","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T11:34:53Z","timestamp":1779104093000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/668"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,8]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/jphia.v16i1.668","relation":{},"ISSN":["2038-9922","2038-9930"],"issn-type":[{"value":"2038-9922","type":"print"},{"value":"2038-9930","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,8]]},"article-number":"a668"}}