Perceptions about COVID-19 vaccine among healthcare workers in Rwanda: A mixed-methods study

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. Aim: This study aimed to understand HCWs' perceptions of the COVID-19 vaccine in Rwanda. Setting: A convergent mixed-methods study was conducted in 45 purposively selected health facilities in Rwanda. Methods: 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. Results: 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' 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. Conclusion: The positive perception of the COVID-19 vaccine among Rwandan HCWs aligns with the country's successful vaccination programme. This potentially reflects effective national strategies. Further research into Rwanda's COVID-19 response is however, warranted. Contribution: This study reveals discrepancies in HCWs vaccine confidence in Rwanda, highlighting the need for targeted educational interventions to strengthen national COVID-19 response efforts.