Drivers of hesitancy towards recommended childhood vaccines in African settings: a scoping review of literature from Kenya, Malawi and Ethiopia

There is a dearth of literature on vaccine hesitancy in Africa. In this study, we aimed to explore the drivers of hesitancy toward recommended childhood vaccines in Kenya, Malawi, and Ethiopia. A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O’Malley’s recommendations as modified by Levac. A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context. This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.