Enablers and Barriers to Handwashing and Vaccine Uptake in Kenya, Uganda, and Tanzania in Relation to COVID-19 Prevention and Control: A Systematic Review

Background: The Coronavirus disease 2019 has brought about unprecedented challenges globally, threatening to undo the decades of progress on poverty, health systems and education. Several efforts have been put forward to edge the spread of the covid-19 disease including handwashing and mass vaccination. Despite their proven effectiveness, the uptake is low thus threatening to undermine the future successes of vaccination and handwashing campaigns. This review intends to determine the enablers and barriers to handwashing and vaccine uptake in Kenya, Uganda, and Tanzania in relation to COVID-19 prevention and control. Methods: This review was carried according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA-P) guidelines. A comprehensive literature search of studies from three databases: PubMed, Direct science and Google Scholar was conducted. Published studies within the period between December 2019 up to end of January 2023 on enablers and barriers on handwashing and vaccine uptake in Kenya, Uganda, and Tanzania in relation to COVID-19 prevention and control were assessed and selected. Results: A total of 391 research were reviewed, and 21 studies eligible for inclusion in the review. Results indicate that in the three countries: Kenya, Uganda, and Tanzania; the most cited barriers to handwashing and vaccine uptake include concerns on safety, efficacy, and quality of manufactured vaccines and handwashing practices, lack of awareness, lack of trust to the vaccines and handwashing, myths, misconceptions, and risk-perceptions. Enablers to handwashing and Covid-19 vaccine uptake identified were access to knowledge, access to hand hygiene programmes and water, involvement of community leaders to create awareness and socio-economic factors such as education level and cash incentives. Conclusion: The study has identified enablers and barriers that can influence the success of these interventions in Kenya, Uganda, and Tanzania in relation to COVID-19 prevention and control. Stakeholders should formulate strategize to address the identified barriers leveraging on enablers to motivate the individuals to accept vaccination and practice more hand hygiene through creating awareness and sensitization through community leaders, making the vaccines and clean water or soap available and accessible. Registration PROSPERO ID CRD42023396303; registered on 2nd February 2023