COVID-19 vaccine hesitancy among parents in Low- and Middle-Income Countries: A meta-analysis.

Background: Vaccination is the most effective method to prevent the spread of infectious diseases. Nevertheless, vaccine hesitancy has been an issue. Parental hesitancy toward vaccines is a major part of the problem. COVID-19 vaccine acceptance is no different, it poses another challenge in facing the pandemic. In Low- and Middle-Income Countries (L&MICs) several studies measured parents' acceptance to vaccinate their children against COVID-19 and resulted in different acceptance proportions. Aims: The paper aims at obtaining a precise estimate of the overall proportion of L&MICs' parents accepting to vaccinate their children against COVID-19 and identifying the main determinant of their decisions. Methods: This meta-analysis follows the PRISMA 2020 statement on updated guidelines and the checklist for reporting systematic reviews. Studies published between December till February 2022 were assessed for inclusion. The final effect size (i.e., the proportion of parents in L&MICs accepting to vaccinate their children against COVID-19) was measured using the Arcsine proportions method. Analysis was done using R program. Results: The proportion of parents in L&MICs accepting to vaccinate their children against COVID-19 is 49%. The major reason for their acceptance is their belief that COVID-19 vaccine is fundamental to the fight against the pandemic while the most common factor for parents' hesitancy to vaccinate their children against COVID-19 is their concerns about vaccine efficacy, safety, and possible side effects. Conclusion: The proportion of parents in L&MICs accepting to vaccinate their children against COVID-19 is lower than the global level. To increase parental acceptance, responsible authorities should concentrate on increasing their population's trust in the government and in vaccine manufacturers. As well as concentrating on increasing acceptance of the vaccine idea in general.

Global health governance performance during Covid-19, what needs to be changed? a delphi survey study.

BACKGROUND: Covid-19 is not the first pandemic to challenge GHG. Preceding outbreaks and epidemics were sources of continuous debate on GHG leadership and structure resulting in its current structure. However, Covid-19 proved the presence of many deficits in the current GHG. The response to the Covid-19 pandemic is a cumulative result of all policies and actions of different governments and agencies active in global health. Assessing how Covid-19 is being handled globally provides lessons for ensuring better performance in facing upcoming outbreaks. This study has three main objectives: first, to evaluate the performance of GHG during Covid-19 in general and in relation to Covid-19 vaccine equity in particular. Second, to identify the reasons behind this performance; and third, to propose prospective changes in GHG for better performance. METHODS: A cross-sectional research design using the Delphi method was applied. A panel of experts participated in the three-round Delphi surveys. Their scores were used to perform consensus, performance and correlation analysis. RESULTS: GHG performance limited the achievement of Covid-19 vaccines' global equity. GHG performance is a product of the existing GHG system, its actors and legal framework. It is a collective result of individual GHG actors' performance. The most influential actors in decision-making regarding Covid-19 vaccine are the vaccine manufacturers and governments. While the most invoked power to influence decision are economic and political powers. Covid-19 decisions underlying value, although had human right to health at the base, overlooked the concept of health as a global public good and was skewed towards market-oriented values. GHG mal-performance along with its underlying factors calls for four main changes in GHG structure: assigning a clear steward for GHG, enhanced accountability, centralized authority, more equitable representation of actors, and better legal framework. CONCLUSION: GHG structure, actors' representation, accountability system, and underlying priorities and value require future modification for GHG to achieve better future performance and higher health equity levels.

Global Health Governance and Health Equity in the Context of COVID-19: A Scoping Review.

BACKGROUND: Health equity is an important aspect of responsible governance. COVID-19 exposed existing shortfalls of Global Health Governance (GHG). A considerable amount of related literature is produced. This scoping review aims at mapping the present knowledge and at identifying research gaps. METHODS: This scoping review is based on the Joanna Briggs Institute's guideline for standardized methods and PRISMA-ScR guidelines for reporting. Documents published from December 2019 to October 2021 were searched using PubMed, Scopus, Google Scholar, World cat, and WHO-Global Index Medicus. Two reviewers screened and reviewed eligible studies in three stages: duplicates identification and elimination, title and abstract screening, and full-text assessment. Data was charted and results were classified into conceptual categories. Analysis was done in three stages: open descriptive coding, focused thematic analysis, and frequency, commonality and significance analysis. RESULTS: forty-nine studies met the inclusion criteria. Areas of research were grouped into seven themes: "human rights and inequities", "solidarity, collaboration and partnership", "GHG structure change", "political and economic power and finance", "approaches to address inequity", "law and regulations", and "private investment and public-private partnerships (PPPs) in GHG". The highest number of papers were in the first theme, "human rights and inequities". However, the themes are interrelated. Authors who contributed to research were mostly affiliated to developed countries indicating a gap in knowledge and expertise in developing countries. CONCLUSION: Through this scoping review we found that the seven themes are interconnected. Disciplinary collaboration in research relating GHG to health inequities is solicited. Collaboration in research, information sharing, and research capacity development are in needed in developing countries.

The Psychological and Social Impacts of Curfew during the COVID-19 Outbreak in Kuwait: A Cross-Sectional Study

The Coronavirus (COVID-19) pandemic in Kuwait led to a nationwide curfew between 22 March and August 2020. The purpose of this study was to evaluate the impact of the COVID-19 curfew during the pandemic on Kuwaiti citizens and residents. A cross-sectional survey was used to collect data from Kuwaiti residents over the age of 21 through an online questionnaire shared via social media, including WhatsApp and Facebook. Data collection occurred between 18 June and 15 July 2020. Data from 679 respondents (57.9% females and 42.1% males;67.7% Kuwaiti nationals and 32.3% non-Kuwaiti nationals) were analyzed. Symptoms of depression were reported among 59.8% of females and 51.0% of males, and extremely severe depression among 20.4% of females and 13.6% of males. Approximately 42.0% of females and 37.8% of males were under psychological distress, with 15.1% of females and 9.1% of males experiencing severe or extremely severe psychological distress. Over a third of females (34.9%) reported experiencing tensions or violent behaviors from family members, and 22.1% reported verbal or physical abuse. Among males, 26.4% reported experiencing tensions or violent behaviors, and 12.2% reported verbal or physical abuse. Extremely severe depression was associated with being female (2.00 times), aged 21–29 (4.56 times), experiencing tensions or violent behaviors from family members (4.56 times), being physically inactive (1.64 times), smoking cigarettes (3.02 times), and having poor or very poor quality of sleep (1.75 times). Severe or extremely severe psychological distress was associated with being female (3.09 times), aged 21–49 (3.68 times), having ill-health conditions or diseases (1.83 times), experiencing tension or violent behaviors from family members (3.56 times), smoking cigarettes (3.06 times), and having poor or very poor quality of sleep (2.20 times). Findings indicate that people living in Kuwait experienced negative psychological impacts, such as depression and psychological distress, attributable to the pandemic-related restrictions. Unpartnered females aged 21–49 are more mentally vulnerable than partnered males over the age of 50. Findings support an urgent need for targeted interventions to improve health behaviors and social support, including coping mechanisms specific to COVID-19 related stress, family counseling systems, and the provision of accessible and acceptable services using telehealth.

Effects of COVID-19 Lockdown on Physical Activity and Dietary Behaviors in Kuwait: A Cross-Sectional Study.

The Coronavirus disease (COVID-19) pandemic has brought about drastic measures that have significantly altered the norms of daily living. These measures have affected human behaviors in disparate ways. This study seeks to understand the impact of the pandemic on physical activity and dietary behavior among adults living in Kuwait. A cross-sectional survey was conducted between 18 June and 15 July 2020, using a questionnaire disseminated through social media, including WhatsApp and Facebook. The target population was individuals aged 21 years or older living in the State of Kuwait. The study included 679 respondents; 57.9% were females, and 67.7% were Kuwaiti nationals. Both genders reported an increased consumption of vegetables, fruits, and carbohydrates, and a decreased consumption of fish and sugary drinks. Compared to males, females reported eating more during the outbreak than their pre-pandemic eating behaviors (32.3% vs. 35.9%, p < 0.05). Approximately one-third of respondents (33.1%) reported performing less than 30 min of physical activity or exercise in a week, and 36.4% of respondents rated their quality of sleep as 'poor' or 'very poor'. The rate of smoking cigarettes among males was significantly higher than in females (40.6% vs. 5.3%, p < 0.001). Physical activity was positively correlated with vegetable consumption and quality of sleep. Quality of sleep was negatively correlated with the consumption of sweets and snacks, just as the consumption of vegetables was negatively correlated with the consumption of sugary drinks. The overall negative impact of the COVID-19 pandemic in Kuwait necessitates the development of health promotion interventions to support positive physical activity and dietary behaviors using alternative coping strategies among the residents of Kuwait.