COVID-19 Vaccination intentions and related factors in South Africa: results from a large-scale public survey

Introduction/ Background: Despite COVID-19 vaccines being ubiquitous in South Africa, 30% of the population are vaccinated. Understanding socio-behavioural determinants of vaccination intention can inform interventions to improve vaccination uptake. We assessed the intentions and attitudes regarding the COVID-19 vaccinations and the socio-behavioural factors associated with intention to vaccinate among South African adults. Methods: Data was analysed from a large-scale public survey conducted in South Africa from 25 June-15 September 2021. The survey was administered online using a data-free platform and telephonically. Invitations to participate were widely distributed on social media platforms. Vaccination intention was based on the question “When available, would you take the COVID 19 vaccine?” Data were benchmarked using the general population demographics. Bivariate analyses examined the association between vaccination intentions and explanatory variables that included attitudinal, behavioural, and sociodemographic variables. Results: 73.8% reported they would definitely/probably take the vaccine, 16.4% were uncertain and 9.9% reported they probably or definitely would not (N=14,419). 63.4% thought vaccines are useful to protect communities from disease;over 60% were concerned about vaccination-related side-effects;72.9% heard conflicting information about COVID-19 vaccinations and 18.7% felt their religion/culture would discourage them or their families from being vaccinated. Vaccination intentions were significantly lower for 18-29-year-olds, women;those concerned about side-effects;who felt their religion/culture discouraged them, who thought there was inadequate safety information about the vaccines, and who questioned their effectiveness due to fast development. Impact: The study identifies subgroups of individuals for whom targeted public health interventions and health communication should be prioritised and tailored in order to improve intentions to vaccinate. Behavioural interventions can be tailored to address the identified determinants of vaccination intentions. Conclusion: Young age, gender;concerns about side-effects, safety information and effectiveness due to the rapid development of the COVID-19 vaccines, and cultural or religious concerns were determinants of the intentions to receive a vaccine among South African adults.

Factors influencing healthcare workers' perception of South African health system capability for managing COVID-19 pandemic

Background: During the emergence of the COVID-19 pandemic in South Africa in March 2020, there was an urgent mobilization of healthcare workers (HCWs) who had to adapt quickly to a challenging health system. Therefore, this paper examines factors associated with HCWs' perceptions of the South African health system's capability for managing COVID-19 during the early stages of the pandemic.

Spatial analysis of perceived health system capability and actual health system capacity for covid-19 in south africa

Introduction: People’s confidence in the health system's capability in managing the COVID-19 pandemic can determine public support, risk perceptions, and compliance to the required behaviors during the pandemic. Therefore, this paper investigated people’s perception of health system capability to manage the COVID-19 pandemic in different spatial areas across the country using data from an online survey. Methods: Multivariate logistic regression models were used to examine factors associated with people’s perception of the health system capability to manage the COVID-19 pandemic at the national and provincial levels. Spatial comparative analysis was conducted to contrast spatial density indicators of the number of hospitals, hospital beds, and ICU beds per given population across various provinces. Results: Findings showed that South Africans had low confidence in the health system capability, with only two in five (40.7%) reporting that they thought that the country’s health system was able to manage the COVID-19 pandemic. Sex and knowledge on COVID-19 were significantly associated with the people’s perception of the health system capability to manage the pandemic at the national level and in four of the nine provinces. Conclusion: Overall, the findings of this study clearly highlight challenges facing the country’s health system, both perceived or real, that needed to be addressed as part of the preparation for the COVID-19 pandemic. Timeous implementation of a countrywide National Health Insurance (NHI) system is now more critical than ever in improving healthcare outcomes of the South African population beyond the existence of the COVID-19 epidemic.

Compliance with lockdown regulations during the covid-19 pandemic in south africa: Findings from an online survey

Background: Background: SARS-CoV-2 has resulted in the COVID-19 pandemic. Based on a nationally representative online survey conducted several weeks on the pandemic, this paper explores how South Africans responded to the compliance regulations laid down by the national government and factors associated with individuals’ confidence in their community adhering to lockdown regulations. Methods: The study was conducted using a closed-ended questionnaire on a data-free online platform. Additionally, a telephonic survey was included to accommodate individuals who do not have access to smart-phones. The study population consisted of respondents who were 18 years and older and living in South Africa (n=19 933). Data were benchmarked to the 2019 midyear population estimates. Descriptive statistics and bivariate logistic regression are presented. Results: Over a quarter (26.1%) of respondents reported that they had not left home, indicating compliance with the COVID-19 control regulations, and 55.3% who did leave their homes did so to purchase essential items. A small proportion (1.2%) reported that they had visited friends. People, classified as coloured, those who were more literate (those with secondary, matric and tertiary education status), those residing in disadvantaged areas (informal settlements, townships, rural areas and farms), and those who perceived their risk of contracting COVID-19 as moderate and high, reported not being confident of their community adhering to lockdown. Conclusion: Communication strategies must be employed to ensure that important information regarding the pandemic be conveyed in the most important languages and be dispatched via various communication channels to reach as many people as possible.

South Africans' understanding of and response to the COVID-19 outbreak: An online survey.

BACKGROUND: The COVID-19 outbreak is in an accelerating phase, and South Africa (SA) has had the highest number of documented cases during the early phase of the pandemic in sub-Saharan Africa. OBJECTIVES: To assess South Africans' understanding of and response to COVID-19 during the first week of the country's lockdown period. METHODS: An online survey was conducted in SA from 27 March to 2 April 2020. The survey was distributed widely among several websites and social media networks, including on a data-free platform. Descriptive statistics of knowledge, risk perception, access to and trust in information sources, and public and media opinions were calculated. Estimates were benchmarked to the 2019 national adult population estimates. RESULTS: Of the 55 823 participants, the majority (83.4%) correctly identified the main symptoms of COVID-19. Over 90% had correct knowledge of the incubation period, with lower rates for 18 - 29-year-olds. Knowledge of symptoms and the incubation period varied significantly by population group (p<0.001), dwelling type (p<0.001) and sex (p<0.001). A quarter (24.9%) perceived themselves as at high risk of contracting COVID-19. Risk perception varied by age, population group, employment status and dwelling type (p<0.001). The most prevalent COVID-19 information sources were government sources (72.9%), news websites/apps (56.3%), satellite television (51.6%) and local television (51.4%). CONCLUSIONS: Understanding knowledge, attitudes and behaviours of people facing the COVID-19 pandemic is crucial for guiding strategic policy. These findings provide public understanding of COVID-19 as the phases of the country-level epidemic progress, and also directly inform communication needs and gaps.