Towards hepatitis B elimination in Ghana: Vaccination coverage and its predictors among informal sector workers in Kejetia, Kumasi, Ghana

Hepatitis B virus (HBV) infection remains a major public health concern in
Ghana, where prevalence is high despite the availability of an effective
vaccine. Informal sector workers represent a large proportion of the
national workforce but have limited access to preventive health services.
This study assessed hepatitis B vaccination coverage and its predictors
among informal sector workers in Kejetia Market, Kumasi, Ghana. A
cross-sectional survey was conducted among 809 market workers selected
using stratified random sampling across different occupational groups.
Data were collected using structured interviewer-administered
questionnaires covering sociodemographic characteristics, HBV awareness
and knowledge, and vaccination history. Vaccination uptake was categorized
as at least one dose (≥1) and full coverage (≥3 doses). Logistic
regression analyses were used to identify predictors of vaccination
uptake. Overall, only 16.9% had completed the three-dose schedule, though
31.6% of participants reported having received at least one dose of HBV
vaccine. While 88.8% of respondents had heard of HBV infection, 76.5%
reported very little or no knowledge about the disease, and 49.7% did not
know its routes of transmission. Vaccination uptake was significantly
higher among those who had received HBV-related health education (62.7%)
compared to those who had not (15.3%, p < 0.001). Multivariable
analysis identified age group, marital status, education level, residence,
and work type as independent predictors of vaccine uptake. HBV vaccination
coverage among informal sector workers in Kejetia Market is alarmingly low
despite high general awareness of the infection. Sociodemographic factors
and receipt of HBV-related health education strongly influenced uptake.
These findings underscore the urgent need for targeted health education
and subsidized vaccination programs tailored to informal sector workers in
Ghana to achieve national HBV elimination goals.