Introduction COVID-19 has become a public health concern globally with increased numbers of cases of the disease and deaths reported daily. The key strategy for the prevention of COVID-19 disease is to enhance mass COVID-19 vaccination. However, mass vaccination faces challenges of hesitation to acceptance of the vaccine in the community. The youth may not be among the vulnerable population to severe COVID-19 disease but are highly susceptible to contracting the virus and spreading it. The aim of the study was to assess COVID-19 vaccine youth behavior intentions and their determinants in Kenya. Methods The study used a mixed method design, employing a cross-sectional survey and focused group discussions across 47 counties in Urban, Peri-Urban and Rural settings of Kenya. The interviewees were youths aged 18–35, registered in online platforms/peer groups that included Shujaaz, Brck Moja, Aiffluence, Y Act and Heroes for Change. Quantitative data was collected using Google forms. A total of 665 interviews were conducted. Quantitative data was analysed using STATA version 16. In this paper we report quantitative study findings. Results The findings of the study indicated that only 42% of the youth were ready to be vaccinated, with 52% adopting a wait and see approach to what happens to those who had received the vaccine and 6% totally unwilling to be vaccinated. The determinants of these behavior intentions included: the perceived adverse effects of the vaccine on health, inadequate information about the COVID-19 vaccine, conflicting information about COVID-19 vaccine from the social media, religious implications of the vaccine, impact of education level on understanding of the vaccine, perceived risk of contracting the COVID-19 disease, efficacy of the COVID-19 vaccine, COVID-19 affecting women than men and trust in the ministry of health to lead COVID-19 interventions. Significantly it was found that hesitancy is higher among females, protestants and those with post-secondary education. Lack of information and concerns around vaccine safety and effectiveness were main cause of COVID-19 vaccine hesitancy. Social media was the major source of information contributing to hesitancy. Other contributors to hesitancy included low trust in the MoH and belief that mass vaccination is not helpful. Conclusion Vaccine hesitancy remains high among the youth but the causes of it are modifiable and health systems need to have evidence based engagements with the youth to reduce vaccine hesitancy.

Background: Coronavirus disease (COVID-19) caused socio-economic disruptions across the globe. The pandemic disrupted the health system (HS) calling for reengineering in response to high infection rates, deaths, and resultant containment measures. To deal with COVID-19 and promote resilience, community health workers (CHWs) were engaged across countries. Objective: Assess the preparedness of CHWs in supporting health system response in prevention and management of COVID-19 in Kenya, Senegal, and Uganda. Methods: A mixed methods design study involving national and subnational jurisdictions in the 3 countries. Key informant interviews were conducted with policy actors (16) and health care workers (24) while in-depth interviews involved CHWs (14) and community members (312) subjected to survey interviews. Results: Most (>50%) households survived on <USD 100/month during COVID-19 announced in March 2020 through national TV (57%), FM (42%), and radio station (27%). Community members interactions with CHWs increased during the pandemic through home visits as health educators, basic counseling providers and distributors of pandemic information tools, personal protective equipments, and social support commodities. The CHWs faced challenges during pandemic prevention and management including lack of: protective gear, salary, refresher courses, and identification tools; limited supervision and training; hostile reception during home visits; misconception and politicking about the pandemic. To effectively support prevention and manage of COVID-19, priority needs for CHWs were identified namely: provision of resources, protective gear, transport reimbursement, stipends, identification cards, and tools for recording and reporting; empowerment with adequate skills, trainings on provision of psychosocial support, first aid, and sensitization on policies. Conclusion: COVID-19 linked disruptions to optimal functioning of HS necessitated engagement of CHWs in the pandemic prevention and management. Findings underscore the important role CHWs play in supporting HS during crisis like COVID-19 to mitigate disruptions and stabilize the system for effective response. The CHWs can improve resilience of social and HS during unplanned disruptions for optimal functioning and attainment of universal health care. Policy makers should develop structured mechanisms for engaging CHWs while committing resources to address challenges that affect seamless synergy between health and CHWs Systems.

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Background: COVID-19 has become a public health concern globally with increased numbers of cases of the disease and deaths reported daily. The key strategy for the prevention of COVID-19 disease is to enhance mass COVID-19 vaccination. However, mass vaccination faces challenges of hesitation to acceptance of the vaccine in the community. The youths may not be among the vulnerable population to adverse effects of COVID-19 but are highly susceptible to contracting the virus. The aim of the study was to assess COVID-19 vaccine youth behavior intentions and their determinants in Kenya. Methods: The study used a mixed method study design, employing a cross-sectional survey and focused group discussions across 47 counties in Urban, Peri-Urban and Rural settings. The interviewees were youths aged 18-35, registered in online platforms that included Shujaaz, Brck Moja, Aiffluence, Y Act and Heroes for Change. Quantitative data was collected using Google docs while the Focus Group Discussions (FGDs) were done virtually. A total of 637 interviews and 4 FGDs were done. Quantitative data was analysed using STATA version 16. Qualitative data was analyzed using MAXQDA software.Results: The findings of the study indicated that only 42% of the youths were ready to be vaccinated, 52% were not ready to be vaccinated adopting wait and see approach to what happens to those who had received the vaccine, and 6% were totally not willing to be vaccinated. The determinants of behavior intention among the youths were; the perceived effects the vaccine on health, lack of adequate information about the COVID-19 vaccine, too much conflicting information about COVID-19 vaccine from the social media, religion, education level, perceived risk of contracting the COVID-19 disease, efficacy of the COVID-19 vaccine, gender, trust in the ministry of health, and the belief that the COVID-19 vaccine was harmful to the populations.Conclusion: The Vaccine hesitancy among the youths was found to be 58%. The Hesitancy is higher among females, protestants, those with post-secondary education. Lack of information and concerns around vaccine safety and effectiveness were main cause of COVID-19 vaccine hesitancy among the youths. Social media was the major source of information contributing to hesitancy. Other contributors included; low trust in the MoH, belief that mass vaccination is not helpful

Background:The purpose of the assessment was to conduct an evaluation on the status of respectful maternal care Ndola and Kitwe districts in the Copperbelt Province. Methods:The assessment used a cross-sectional study design and captured quantitative data on self-reporting of experiences of respectful maternal care during child birth among women in the reproductive age group with a child below the age of 2 years. The study was conducted in two urban districts of the Copperbelt Province of Zambia specifically in Ndola and Kitwe districts. The sample size was 471 resident women of the selected 18 high volume health facilities. Cluster sampling was used to select the sampling units referred to as catchment areas of the health facilities. A structured interview questionnaire was used to conduct household interviews. Univariate and bivariate analysis were conducted on quantitative data to provide descriptive statistics. Chi-square analysis was performed to ascertain associations. Results:The study successfully visited and interviewed 470 women in household giving a 99% response rate. Findings show that 31% were aged between 20 to 24 years, three quarters (75%) were married/living with a partner, 4 in 10 (40%) had a basic education and two-thirds (66%) were not engaged in any form of employment or economic activity. The findings show that on average, 18% of the women had experienced physical abuse by a service provider during child birth. Prominent issues that led to ill-treatment included 43% of the women not provided comfort/pain-relief. On average 41% of the women received non-consented care from the service provider. Women (74%) indicated that the service provider did not allow women to assume position of choice during birth. The findings also show that about 22% of women's right to confidentiality and privacy were not adhered to. Women (42%) also reported that there were no drapes or covering to protect their privacy and 19% indicated that there were no curtains or other visual barrier to protect woman during exams. Findings also show that on average 31% of women's right to dignified care was not adhered to. Overall in the study, 13% of the women were discriminated based on specific attributes. The findings indicate that on average 39% of the women were abandoned or denied care. Key issues include, 65% of the women reported being left without care or unattended to and 28% service provider did not respond in a timely way. Further, only 6% of the women were detained in the health facility. Conclusion:The maternal outcomes observed such as home deliveries and deliveries by skilled and unskilled birth attendants mirror the quality of care in health facilities. Indications of non-adherence to the rights of child bearing women are a barrier to achieving quality of care for child bearing women. There is need to comprehensively train service providers in respectful maternal care and devise mechanisms for implementation and supportive supervision.Perceptions and experiences of the mistreatment of women during childbirth in...