Awareness, perception and Willingness to Accept Malaria Vaccination for Maternal and Child Protection among Pregnant Women Attending Antenatal Care: A Cross-Sectional Study

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With the recent introduction of malaria vaccines in several African countries, community awareness and acceptance are critical for successful implementation. This study assessed awareness, perceptions, and willingness to accept the malaria vaccine among pregnant women attending antenatal care in a tertiary hospital in Nigeria. Methods A hospital-based cross-sectional study was conducted among 274 pregnant women attending antenatal clinics at a tertiary health facility. Data were collected using a structured interviewer-administered questionnaire covering sociodemographic characteristics, awareness of the malaria vaccine, perceptions about vaccination, and willingness to accept the vaccine. Descriptive statistics summarized participants’ characteristics. Associations between explanatory variables and willingness to accept the vaccine were assessed using chi-square tests and logistic regression analysis. Statistical significance was set at p < 0.05. Results The majority of participants were aged 20–34 years (75.5%), married (85.3%), and had tertiary education (55.1%). Awareness of the malaria vaccine was relatively low (48.5%). However, perceptions toward vaccination were largely positive: 86.1% believed vaccines prevent disease and 87.2% believed a malaria vaccine could protect against malaria. Overall, 81.0% of respondents were willing to receive the vaccine if available, and 79.9% were willing to vaccinate their children. Factors significantly associated with vaccine acceptance included belief in vaccine protection ( p < 0.001), healthcare provider recommendation ( p = 0.002), vaccine availability ( p = 0.002), provision of safety information ( p = 0.005), and free vaccination ( p < 0.001). In multivariable analysis, belief in vaccine protection and healthcare provider recommendation remained independent predictors of vaccine acceptance. Conclusions Despite limited awareness, pregnant women demonstrated favourable disposition and high willingness to accept the malaria vaccine. Strengthening antenatal health education and leveraging healthcare provider recommendations may improve vaccine uptake and support effective malaria vaccine implementation in high-burden settings. Malaria vaccine Vaccine acceptance Awareness Pregnant women Maternal and child protection Figures Figure 1 Introduction Malaria remains a major public health challenge in Nigeria, contributing to approximately 24.3% of global malaria cases and 30.3% of deaths, with pregnant women and children under five years old bearing the highest burden due to increased risks of severe complications such as anemia, low birth weight, and maternal mortality. 1 , 2 The recent introduction of malaria vaccines, including RTS,S/AS01 and R21/Matrix-M, marks a pivotal advancement in malaria control, with the World Health Organization (WHO) recommending their use in high-transmission settings since 2021 and 2023, respectively. 3 , 4 Nigeria commenced phased rollout of the R21/Matrix-M vaccine in November 2024, initially targeting children aged 5 months and older in high-burden states like Kebbi and Bayelsa, with plans for nationwide expansion by 2025–2026. 5 , 6 Although these vaccines are not yet routinely administered during pregnancy, pregnant women attending antenatal care clinic (ANC) play a crucial role as primary caregivers and decision-makers for child vaccination, influencing community acceptance and uptake. However, vaccine hesitancy driven by low awareness, misinformation, concerns about side effects, and cultural factors has historically undermined immunization programs in Nigeria, as evidenced by challenges during the COVID-19 and polio vaccine rollouts. 7 , 8 Recent studies highlight a pattern of limited awareness but high potential willingness among Nigerian mothers and caregivers. 9 , 10 , 11 Despite these insights, significant gaps persist. Most existing research focuses on general caregivers or mothers of under-five children, with limited data specifically on pregnant women, who are uniquely positioned at ANC clinics, a key entry point for health education and immunization promotion. 12 Additionally, studies from Southwest Nigeria are scarce, despite the region's diverse urban-rural dynamics and ongoing malaria endemicity, leaving a void in localized evidence to guide tailored interventions during the national rollout. This study addresses these gaps by assessing awareness, perceptions, and willingness to accept the malaria vaccine among pregnant women in Southwest Nigeria's ANC settings. The findings aim to inform policymakers, healthcare providers, and community stakeholders on strategies to bridge awareness deficits and leverage high latent demand for sustainable malaria control. Methods Study design This was a facility-based descriptive cross-sectional study conducted from April 2025 to July 2025. Study area The study was conducted at the antenatal care (ANC) clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH) in Sagamu, Ogun State, Southwest Nigeria. Olabisi Onabanjo University Teaching Hospital is a major tertiary referral facility serving Ogun and Lagos states), with high patient volumes for maternal and child health services, including routine ANC, immunization integration, and malaria prevention counselling. Study population The study population comprised 274 pregnant women attending routine ANC visits at OOUTH. Inclusion criteria were: women confirmed pregnant (any trimester), aged 18 years or older, and willing to provide informed consent. Exclusion criteria included: women with acute illness preventing participation, non-pregnant attendees, or those declining consent. Sampling technique and sample size determination Consecutive sampling of eligible participants was done. The sample size was determined using a standard formula for cross-sectional studies (Cochran’s Formula), considering the prevalence of malaria vaccination acceptance among women of 97.7% from a study by Alagbe et al 10 , with the assumptions of 95% confidence interval (CI) and margin of error of 2%. Considering a 15% non-response rate, the total minimum sample size calculated was 253. However, 274 pregnant women were recruited for the study. Data collection instrument A structured, interviewer-based administered questionnaire was developed, adapted from validated WHO Knowledge, Attitudes, and Practices (KAP) tools for malaria vaccines and similar studies in Nigeria. 10 , 13 , 14 (supplementary file). The tool consisted of four sections. Section A: sociodemographic and obstetric characteristics (e.g., age, education, employment, marital status, socioeconomic status using the Oyedeji classification system, 15 ethnicity, parity, trimester). Section B: Awareness of malaria vaccine (yes/no, sources via multiple choices). Section C: Perceptions (e.g., belief in vaccination as prevention, vaccine protection against malaria, and necessity for pregnancy/children. Section D: Willingness and motivators (e.g., willingness to accept for self/child, recommend to others; motivators like free access, convenient location, healthcare provider (HCP) recommendation, and safety/effectiveness information). Content validity was ensured through expert review by a public health specialist and an infectious disease expert, achieving a content validity index (CVI) of 0.85. Reliability was assessed via Cronbach's alpha (α = 0.78 for perception scale, α = 0.82 for willingness items). The questionnaire was pretested on 15 non-study ANC attendees, following which minor refinements for clarity and cultural appropriateness was made. Completion time averaged 10–15 minutes. Data collection procedure A trained research assistant administered the questionnaire during ANC waiting periods to minimize disruption after obtaining an informed consent. Questionnaires were checked for completeness on-site. Data were collected anonymously, with unique identifiers for quality control. Data Management and Analysis Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM Corp., Armonk, NY). Descriptive statistics summarized sociodemographics, awareness, perceptions, and willingness using frequencies and percentages. Bivariate associations between independent variables (sociodemographics, perceptions, motivators) and malaria vaccine acceptance (dichotomized: yes vs. no/undecided) were tested using chi-square tests. Variables with p value < 0.05 in bivariate analysis were entered into multivariable binary logistic regression to identify independent predictors, reporting adjusted odds ratios (Exp(B)) with 95% confidence intervals (CI). Level of significance was set at p < 0.05. Bar chart for sources of information was generated using Excel for visualization. Results A total of 274 pregnant women were recruited for the study. They were predominantly aged 20–34 years (75.5%), with 55.1% having tertiary education (Table 1 ). Less than half of the respondents (48.5%) were aware of the malaria vaccine, with healthcare workers being the primary source of information (Fig. 1 ). Table 1 Sociodemographic and Obstetric Characteristics of Participants (n = 274) Variable Frequency (n) Percentage (%) Age (years) < 20 3 1.1 20–34 207 75.5 35 and above 64 23.4 Level of education No formal 4 1.5 Primary 7 2.6 Secondary 112 40.9 Tertiary 151 55.1 Employment status Self-employed 189 69.0 Private employed 59 21.5 Civil servant 16 5.8 Unemployed 10 3.6 Marital status Single 13 4.7 Married 261 85.3 Socioeconomic status Upper 150 54.7 Middle 101 36.9 Lower 23 8.4 Ethnicity Yoruba 218 79.6 Igbo 36 13.1 Hausa 7 2.6 Others 13 4.7 Parity 0 87 31.8 1–2 138 50.4 3–4 45 16.4 5 and above 4 1.5 Trimester 1st 60 21.9 2nd 123 44.9 3rd 91 33.2 Despite limited awareness, perceptions toward the malaria vaccine were predominantly positive. A large proportion (86.1%) believed vaccination is an effective means of disease prevention, 87.2% believed the malaria vaccine can protect against malaria, and 77.7% considered malaria vaccination necessary during pregnancy and for children (Table 2 ). Willingness to accept the vaccine was correspondingly high: 81.0% would be willing to receive the vaccine themselves if available today, 79.9% would vaccinate their child if introduced into the National Programme on Immunization (NPI) schedule, and 78.5% would recommend it to others (Table 2 ). The key motivators for malaria vaccine acceptance included recommendation by a healthcare provider (60.2%) and information on vaccine safety and effectiveness (53.3%), Table 3 . Table 2 Perception and readiness to accept the malaria vaccine among respondents Variable Frequency, n = 274 Percentage (%) Do you believe in vaccination as a means of disease prevention? Yes 236 86.1 No 22 8.0 I don’t know 16 5.8 Do you believe the malaria vaccine can protect against malaria? Yes 239 87.2 No 21 7.7 I don’t know 14 5.1 Do you think malaria vaccination during pregnancy and for children is necessary? Yes 213 77.7 No 35 12.8 I don’t know 26 9.5 Would you recommend the malaria vaccine to others? Yes 215 78.5 No 34 12.4 I don’t know 25 9.1 If malaria vaccination were available today, would you be willing to get vaccinated? Yes 222 81.0 No 26 9.5 Undecided 26 9.5 If introduced in the NPI schedule, would you be willing to vaccinate your child? Yes 219 79.9 No 32 11.7 Undecided 23 8.4 Table 3 Motivators of vaccination acceptance among the respondence Variable Frequency, n = 274 Percentage (%) What would motivate you to accept the malaria vaccine for yourself and your child? Free vaccination Yes 130 47.4 No 144 52.6 Convenient vaccination location Yes 111 40.5 No 163 59.5 Recommendation by healthcare provider Yes 165 60.2 No 109 39.8 Information about vaccine safety and effectiveness Yes 146 53.3 No 128 46.7 Bivariate analysis revealed no significant associations between sociodemographic or obstetric characteristics (age, education, employment, marital status, parity, trimester) and vaccine acceptance (p > 0.05) (Table 4 ). However, strong positive associations were observed with perceptual and motivational factors, including belief that the vaccine protects against malaria (χ² = 49.252, p < 0.001), free vaccination (χ² = 11.230, p < 0.001), convenient location (χ² = 9.977, p = 0.002), healthcare provider recommendation (χ² = 9.726, p = 0.002), and information on safety/effectiveness (χ² = 7.915, p = 0.005) (Table 4 ). Table 4 Association between Sociodemographic and health system related factors, and malaria vaccination acceptance for mothers and their children. Malaria vaccination acceptance Variable Yes No/undecided χ 2 p value Age of mothers < 20 2 (66.7) 1 (33.3) 0.672 Y 0.715 20–34 163 (78.7) 44 (21.3) 35 and above 54 (84.4) 10 (15.6) Marital status Single 8 (61.5) 5 (38.5) 1.799 Y 0.180 Married 211 (80.8) 50 (19.2) Mothers’ level of education No formal education 4 (100) 0 (0) 0.153 Y 0.985 Primary 5 (71.4) 2 (28.6) Secondary 90 (80.4) 22 (19.6) Tertiary 120 (79.5) 31 (20.5) Mothers’ employment status Civil servants 11 (68.8) 5 (31.2) 0.879 Y 0.830 Self-employed 153 (81.0) 36 (19.0) Private employed 48 (81.4) 11 (18.6) Unemployed 7 (70.0) 3 (30.0) Parity Nulliparous 72 (82.8) 15 (17.2) 0.637 0.425 Primi/multiparous 147 (78.6) 40 (21.4) Trimester First Trimester 47 (78.3) 13 (21.7) 0.210 0.900 Second Trimester 98 (79.7) 25 (20.3) Third Trimester 74 (81.3) 17 (18.7) Believe that the malaria vaccine can protect against malaria Yes 204 (86.4) 32 (13.6) 49.252 Y < 0.001 No 5 (22.7) 17 (77.3) I don’t know 10 (62.5) 6 (37.5) Free vaccination Yes 115 (88.5) 15 (11.5) 11.230 < 0.001 No 104 (72.2) 40 (27.8) Convenient vaccination location Yes 99 (89.2) 12 (10.8) 9.977 0.002 No 120 (73.6) 43 (26.4) Recommendation by healthcare provider Yes 142 (86.1) 23 (13.9) 9.726 0.002 No 77 (70.6) 32 (29.4) Information about vaccine safety and effectiveness Yes 126 (86.3) 20 (13.7) 7.915 0.005 No 93 (72.7) 35 (27.3) χ 2 : Chi square; Y: Yates’ correction. Multivariable binary logistic regression confirmed two independent predictors of acceptance: belief in the vaccine's protective efficacy (adjusted OR = 0.303, 95% CI 0.174–0.528, p < 0.001) and healthcare provider recommendation (adjusted OR = 0.476, 95% CI 0.245–0.927, p = 0.029) (Table 5 ). Table 5 Predictors of malaria vaccination acceptance for self and child Variables B Wald p value Exp (B) 95% CI for Exp (B) Lower Upper Free vaccination − .762 3.684 0.055 0.466 0.214 1.016 Convenient vaccination location − .374 .725 0.395 0.688 0.291 1.627 Healthcare provider information − .742 4.764 0.029 0.476 0.245 0.927 Safety and effectiveness − .592 2.991 0.084 0.553 0.283 1.082 Believe that the mv can protect against malaria -1.193 17.729 0.000 0.303 0.174 0.528 Constant 6.736 38.500 0.000 841.841 B: regression coefficient, Exp (B): Exponentiated B, CI: confidence interval. Discussion The findings of this study demonstrate a notable disparity between the relatively low awareness of the malaria vaccine and the high levels of positive perceptions and willingness to accept it among pregnant women attending antenatal care clinic. Although less than half of the participants had prior knowledge of the malaria vaccine, the majority expressed readiness to receive the vaccine themselves and to allow their children to be vaccinated if it were incorporated into the National Programme on Immunization (NPI). This observation suggests the presence of a latent demand for malaria vaccination that could be effectively harnessed through improved public health communication and health system engagement. Such a pattern is consistent with emerging evidence from other parts of Nigeria where awareness of the malaria vaccine remains limited, yet willingness to accept it becomes substantial once basic information is provided. For instance, a study conducted in North-central Nigeria among mothers of under-five children reported that although awareness was only 23.7%, willingness to accept the vaccine was as high as 97.3%, with positive perceptions, particularly the belief that the vaccine provides protection against malaria, serving as a major determinant of acceptance. 10 Similarly, research conducted in Enugu State in Southeast Nigeria found a high level of initial unawareness among pregnant and nursing mothers; however, acceptability rose dramatically to 94.2% following health education, underscoring the transformative role of targeted information dissemination in improving vaccine acceptance. 11 In contrast, a national cross-sectional survey among mothers of under-five children reported relatively lower acceptance levels, largely attributed to concerns regarding vaccine safety and potential costs, highlighting the persistent influence of perceived risks and financial barriers in vaccination decision-making. 16 The channels through which participants obtained information about the malaria vaccine in the present study were predominantly healthcare providers, mass media platforms, and informal discussions within families and communities. This distribution of information sources mirrors findings from similar studies conducted in Nigeria and other malaria-endemic settings, emphasizing the importance of multiple communication channels in disseminating health information effectively. Ajayi et al 17 and Dim et al 11 reported that healthcare providers were the most trusted and frequently cited sources of malaria vaccine information in Northeast and Southeast Nigeria respectively, reinforcing the central role of frontline health workers in shaping vaccination attitudes and decisions. In addition, mass media, particularly radio, television, and social media, has increasingly emerged as an influential source of health information in urban populations, complementing the messaging delivered within clinical settings. However, the reliance on informal community discussions as a source of information may also expose populations to misinformation or incomplete knowledge regarding new vaccines. This underscores the need to strengthen structured, provider-led communication strategies within antenatal care clinics and other maternal health platforms. Notably, the low overall awareness observed in this study, despite being conducted in a tertiary healthcare facility located in an urban setting, reflects broader national trends in Nigeria where awareness levels of the malaria vaccine have ranged between 9% and 28% in recent studies. 9 – 11 This finding highlights a significant gap in pre-implementation public health communication, particularly in Southwest Nigeria where malaria transmission remains stable but vaccine education efforts have not been as prominent as in northern pilot regions. The sociodemographic profile of participants in this study may have contributed to the favourable perceptions observed. A substantial proportion of respondents had tertiary education and belonged to middle or upper socioeconomic groups, characteristics that are often associated with greater access to health information and healthcare services. Nevertheless, no statistically significant associations between sociodemographic variables and willingness to accept the malaria vaccine were observed in the bivariate analysis. This finding differs from some previous studies that identified educational attainment as a key predictor of vaccine acceptance and uptake. 10 , 17 , 18 For example, studies conducted among caregivers in other Nigerian regions have shown that higher educational levels were positively associated with improved vaccine knowledge and acceptance. Similarly, research conducted in Enugu suggested that higher social class was linked to greater acceptability of the malaria vaccine, implying that socioeconomic advantages may enhance access to reliable health information and strengthen trust in health interventions.14 The absence of a significant association in our study suggests that while education and social class may shape baseline knowledge levels, perceptual factors—such as trust in vaccine effectiveness and confidence in healthcare systems—may play a more decisive role in influencing vaccine acceptance among pregnant women in clinical settings. Importantly, the key motivators for malaria vaccine acceptance identified in this study were healthcare provider recommendation and access to clear information regarding vaccine safety and effectiveness. These findings highlight the critical role of modifiable health system factors in promoting vaccine uptake. Multivariable analysis confirmed that belief in the protective efficacy of the malaria vaccine and endorsement by healthcare providers were independent predictors of willingness to accept the vaccine. This observation is consistent with established models of vaccine hesitancy, which show that individuals are more likely to accept vaccines when they perceive clear health benefits, trust healthcare professionals, and receive information through trusted interpersonal communication. 19 In many settings, healthcare providers remain the most trusted source of vaccine information and play a pivotal role in addressing concerns related to safety, efficacy, and potential adverse effects. Comparable findings were reported in a study conducted in Ibadan Nigeria, among caregivers of under-five children, where willingness to accept the malaria vaccine, reported by approximately 87% of respondents, was strongly associated with trust in healthcare providers and recommendations from health professionals. 20 Our findings extend this evidence to pregnant women, suggesting that antenatal care clinics provide a valuable opportunity for integrating malaria vaccine education, particularly as the introduction of newer vaccines such as the R21/Matrix-M expands across malaria-endemic countries. These findings carry important policy and programmatic implications for malaria control strategies in Nigeria. As the country continues the phased introduction of malaria vaccines, initially prioritizing under-five children in Kebbi and Bayelsa states, with plans for nationwide scale-up in the year 2026, there is a clear need to strengthen community engagement and public awareness campaigns. 21 Integrating structured malaria vaccine education into routine antenatal care services could serve as a strategic approach to improving maternal knowledge and fostering positive attitudes toward vaccination. Pregnant women often function as key health decision-makers within households and can therefore play an important role in advocating for childhood immunization. Strengthening provider-led counseling on vaccine safety, benefits, and availability during ANC visits may help bridge the existing awareness gap while reinforcing public confidence in malaria vaccination programmes. Overall, the findings of this study indicate that pregnant women in Sagamu, Southwest Nigeria demonstrate substantial readiness to accept malaria vaccination for themselves and their children despite limited baseline awareness. Harnessing this favourable disposition through targeted health education and trusted healthcare provider engagement may significantly enhance vaccine uptake and contribute to the successful implementation of malaria vaccination programmes in high-burden settings. Strengths and limitations of the study This study's strengths include its focus on pregnant women in an ANC setting, a novel angle in malaria vaccine literature; providing actionable insights for integration into maternal-child health programs. The adequate sample size and multivariable analysis enhance internal validity and generalizability to similar urban-referral setting in Southwest Nigeria. The single-site focus in an urban setting limits generalizability to rural or primary care settings, potentially over-representing educated, health-seeking women and underestimating barriers in underserved areas. Abbreviations ANC: Antenatal Care NPI: National Programme on Immunization AOR: Adjusted Odds Ratio CI: Confidence Interval CVI: Content Validity Index B: Regression coefficient. Exp(B): Exponentiated Beta (Odds Ratio from logistic regression) HCP: Health Care Provider KAP: Knowledge, Attitude and Practice OOUTH: Olabisi Onabanjo University Teaching Hospital SPSS: Statistical Package for the Social Sciences WHO: World Health Organization RTS,S: RTS,S/AS01 Malaria Vaccine Declarations Ethics approval and consent to participate Ethical approval was obtained from the Health Research Ethics Committee of Olabisi Onabanjo University Teaching Hospital, Sagamu, with the protocol approval number OOUTH/HREC/04/017/E269/2026AP. Informed consent was obtained from participants and participation was voluntary. Consent for publication Not applicable Availability of data and materials The datasets analysed during the current study are available from the corresponding author on reasonable request. The questionnaire used has been supplied as anadditional file. Competing interest The authors declare no competing interest Funding No funding was received for this study. Acknowledgement We are grateful to the nurses at the antenatal care clinic who assisted us with the recruitment of the pregnant women for data collection. Authors’ contributions SOA, OEJ and KO conceived the idea and design. SOA, OEJ, KO and EO were involved in the data collection process. SOA and KVO performed the data analysis and interpreted the findings. SOA drafted the manuscript. TAO and AVA shared in the study ideology and did a critical appraisal of the manuscript. All authors read and approved the final manuscript for submission. 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Factors influencing routine vaccination uptake and completion among children aged 12–23 months in Ilorin, North-Central Nigeria: A cross-sectional survey. International Journal of Medicine and Health Development. 2023; 28(4):314-320. doi: 10.4103/ijmh.IJMH_20_23 Dong B, Xu H, Qi Y and Li Y. Understanding vaccine hesitancy through the lens of trust and the 3C model: evidence from Chinese General Social Survey 2021. Front. Public Health 13:1671457. doi: 10.3389/fpubh.2025.1671457. Abdulkadir BI, Ajayi IO. Willingness to accept malaria vaccine among caregivers of under-5 children in Ibadan North Local Government Area, Nigeria. Malariaworld J. 2015 Mar 23;6:2. doi: 10.5281/zenodo.10870005. Malaria Elimination Initiative. (2020). Implementing effective community engagement for malaria control and elimination: Opportunities and challenges. San Francisco: The Global Health Group, University of California, San Francisco. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9204164","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":621686713,"identity":"513801e9-9d9f-45ad-8139-836a3e2d0825","order_by":0,"name":"Solomon Olubodunrin Ariyibi","email":"data:image/png;base64,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","orcid":"","institution":"Olabisi Onabanjo University","correspondingAuthor":true,"prefix":"","firstName":"Solomon","middleName":"Olubodunrin","lastName":"Ariyibi","suffix":""},{"id":621686715,"identity":"a509cf25-db0e-4747-9b35-a34a669388d5","order_by":1,"name":"Olusoji Edward Jagun","email":"","orcid":"","institution":"Olabisi Onabanjo University","correspondingAuthor":false,"prefix":"","firstName":"Olusoji","middleName":"Edward","lastName":"Jagun","suffix":""},{"id":621686716,"identity":"7c6fcdfe-b477-4d12-bb4c-3c3bfb6b0f76","order_by":2,"name":"Kehinde Moradeyo Ogunsowo","email":"","orcid":"","institution":"Olabisi Onabanjo University","correspondingAuthor":false,"prefix":"","firstName":"Kehinde","middleName":"Moradeyo","lastName":"Ogunsowo","suffix":""},{"id":621686717,"identity":"8b36365b-eb51-43ec-8bb4-49431eb4c956","order_by":3,"name":"Adekunle Durojaiye Alabi","email":"","orcid":"","institution":"Olabisi Onabanjo University","correspondingAuthor":false,"prefix":"","firstName":"Adekunle","middleName":"Durojaiye","lastName":"Alabi","suffix":""},{"id":621686718,"identity":"226b01f7-e0b2-4599-8151-62a1e49fc6fc","order_by":4,"name":"Kayode Odunuga","email":"","orcid":"","institution":"Olabisi Onabanjo University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kayode","middleName":"","lastName":"Odunuga","suffix":""},{"id":621686719,"identity":"9538eb7b-2db4-43c1-a9bf-b19a6ba7f012","order_by":5,"name":"Esther Omotosho","email":"","orcid":"","institution":"Olabisi Onabanjo University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Esther","middleName":"","lastName":"Omotosho","suffix":""},{"id":621686720,"identity":"0ae1badb-6444-442e-aa45-1bbd7b5ae725","order_by":6,"name":"Tinuade Adetutu Ogunlesi","email":"","orcid":"","institution":"Olabisi Onabanjo University","correspondingAuthor":false,"prefix":"","firstName":"Tinuade","middleName":"Adetutu","lastName":"Ogunlesi","suffix":""}],"badges":[],"createdAt":"2026-03-23 19:53:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9204164/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9204164/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106871179,"identity":"ce588ee1-c936-49ac-bf48-19d339e9349f","added_by":"auto","created_at":"2026-04-14 09:44:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":13696,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSources of information\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-9204164/v1/dcdfd1756f67e929acfadf5b.png"},{"id":106871222,"identity":"41e3f751-d402-4281-8bc4-838c8453e344","added_by":"auto","created_at":"2026-04-14 09:44:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1632390,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9204164/v1/d455aefe-508d-440b-acc2-99f3dea9618f.pdf"},{"id":106871191,"identity":"099fd718-07b1-4178-a13e-d524a90178d7","added_by":"auto","created_at":"2026-04-14 09:44:50","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":12508,"visible":true,"origin":"","legend":"","description":"","filename":"STUDYQUESTIONNAIRE.docx","url":"https://assets-eu.researchsquare.com/files/rs-9204164/v1/785467dd833fe7249ee9f8eb.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Awareness, perception and Willingness to Accept Malaria Vaccination for Maternal and Child Protection among Pregnant Women Attending Antenatal Care: A Cross-Sectional Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eMalaria remains a major public health challenge in Nigeria, contributing to approximately 24.3% of global malaria cases and 30.3% of deaths, with pregnant women and children under five years old bearing the highest burden due to increased risks of severe complications such as anemia, low birth weight, and maternal mortality.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e,\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e The recent introduction of malaria vaccines, including RTS,S/AS01 and R21/Matrix-M, marks a pivotal advancement in malaria control, with the World Health Organization (WHO) recommending their use in high-transmission settings since 2021 and 2023, respectively.\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e Nigeria commenced phased rollout of the R21/Matrix-M vaccine in November 2024, initially targeting children aged 5 months and older in high-burden states like Kebbi and Bayelsa, with plans for nationwide expansion by 2025\u0026ndash;2026.\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Although these vaccines are not yet routinely administered during pregnancy, pregnant women attending antenatal care clinic (ANC) play a crucial role as primary caregivers and decision-makers for child vaccination, influencing community acceptance and uptake.\u003c/p\u003e \u003cp\u003eHowever, vaccine hesitancy driven by low awareness, misinformation, concerns about side effects, and cultural factors has historically undermined immunization programs in Nigeria, as evidenced by challenges during the COVID-19 and polio vaccine rollouts.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e Recent studies highlight a pattern of limited awareness but high potential willingness among Nigerian mothers and caregivers.\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e Despite these insights, significant gaps persist. Most existing research focuses on general caregivers or mothers of under-five children, with limited data specifically on pregnant women, who are uniquely positioned at ANC clinics, a key entry point for health education and immunization promotion.\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e Additionally, studies from Southwest Nigeria are scarce, despite the region's diverse urban-rural dynamics and ongoing malaria endemicity, leaving a void in localized evidence to guide tailored interventions during the national rollout.\u003c/p\u003e \u003cp\u003eThis study addresses these gaps by assessing awareness, perceptions, and willingness to accept the malaria vaccine among pregnant women in Southwest Nigeria's ANC settings. The findings aim to inform policymakers, healthcare providers, and community stakeholders on strategies to bridge awareness deficits and leverage high latent demand for sustainable malaria control.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eThis was a facility-based descriptive cross-sectional study conducted from April 2025 to July 2025.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy area\u003c/h3\u003e\n\u003cp\u003e The study was conducted at the antenatal care (ANC) clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH) in Sagamu, Ogun State, Southwest Nigeria. Olabisi Onabanjo University Teaching Hospital is a major tertiary referral facility serving Ogun and Lagos states), with high patient volumes for maternal and child health services, including routine ANC, immunization integration, and malaria prevention counselling.\u003c/p\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eThe study population comprised 274 pregnant women attending routine ANC visits at OOUTH. Inclusion criteria were: women confirmed pregnant (any trimester), aged 18 years or older, and willing to provide informed consent. Exclusion criteria included: women with acute illness preventing participation, non-pregnant attendees, or those declining consent.\u003c/p\u003e\n\u003ch3\u003eSampling technique and sample size determination\u003c/h3\u003e\n\u003cp\u003eConsecutive sampling of eligible participants was done. The sample size was determined using a standard formula for cross-sectional studies (Cochran\u0026rsquo;s Formula), considering the prevalence of malaria vaccination acceptance among women of 97.7% from a study by Alagbe\u003cem\u003eet al\u003c/em\u003e\u003csup\u003e10\u003c/sup\u003e, with the assumptions of 95% confidence interval (CI) and margin of error of 2%. Considering a 15% non-response rate, the total minimum sample size calculated was 253. However, 274 pregnant women were recruited for the study.\u003c/p\u003e\n\u003ch3\u003eData collection instrument\u003c/h3\u003e\n\u003cp\u003eA structured, interviewer-based administered questionnaire was developed, adapted from validated WHO Knowledge, Attitudes, and Practices (KAP) tools for malaria vaccines and similar studies in Nigeria.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e,\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e (supplementary file). The tool consisted of four sections. Section A: sociodemographic and obstetric characteristics (e.g., age, education, employment, marital status, socioeconomic status using the Oyedeji classification system,\u003csup\u003e15\u003c/sup\u003e ethnicity, parity, trimester). Section B: Awareness of malaria vaccine (yes/no, sources via multiple choices). Section C: Perceptions (e.g., belief in vaccination as prevention, vaccine protection against malaria, and necessity for pregnancy/children. Section D: Willingness and motivators (e.g., willingness to accept for self/child, recommend to others; motivators like free access, convenient location, healthcare provider (HCP) recommendation, and safety/effectiveness information). Content validity was ensured through expert review by a public health specialist and an infectious disease expert, achieving a content validity index (CVI) of 0.85. Reliability was assessed via Cronbach's alpha (α\u0026thinsp;=\u0026thinsp;0.78 for perception scale, α\u0026thinsp;=\u0026thinsp;0.82 for willingness items). The questionnaire was pretested on 15 non-study ANC attendees, following which minor refinements for clarity and cultural appropriateness was made. Completion time averaged 10\u0026ndash;15 minutes.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData collection procedure\u003c/h2\u003e \u003cp\u003eA trained research assistant administered the questionnaire during ANC waiting periods to minimize disruption after obtaining an informed consent. Questionnaires were checked for completeness on-site. Data were collected anonymously, with unique identifiers for quality control.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Management and Analysis\u003c/h3\u003e\n\u003cp\u003eData were entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 26.0 (IBM Corp., Armonk, NY). Descriptive statistics summarized sociodemographics, awareness, perceptions, and willingness using frequencies and percentages. Bivariate associations between independent variables (sociodemographics, perceptions, motivators) and malaria vaccine acceptance (dichotomized: yes vs. no/undecided) were tested using chi-square tests. Variables with p value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 in bivariate analysis were entered into multivariable binary logistic regression to identify independent predictors, reporting adjusted odds ratios (Exp(B)) with 95% confidence intervals (CI). Level of significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05. Bar chart for sources of information was generated using Excel for visualization.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 274 pregnant women were recruited for the study. They were predominantly aged 20\u0026ndash;34 years (75.5%), with 55.1% having tertiary education (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Less than half of the respondents (48.5%) were aware of the malaria vaccine, with healthcare workers being the primary source of information (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic and Obstetric Characteristics of Participants (n\u0026thinsp;=\u0026thinsp;274)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo formal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e189\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e261\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e85.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocioeconomic status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e150\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e54.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiddle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e101\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYoruba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgbo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHausa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTrimester\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1st\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2nd\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e44.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3rd\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eDespite limited awareness, perceptions toward the malaria vaccine were predominantly positive. A large proportion (86.1%) believed vaccination is an effective means of disease prevention, 87.2% believed the malaria vaccine can protect against malaria, and 77.7% considered malaria vaccination necessary during pregnancy and for children (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Willingness to accept the vaccine was correspondingly high: 81.0% would be willing to receive the vaccine themselves if available today, 79.9% would vaccinate their child if introduced into the National Programme on Immunization (NPI) schedule, and 78.5% would recommend it to others (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The key motivators for malaria vaccine acceptance included recommendation by a healthcare provider (60.2%) and information on vaccine safety and effectiveness (53.3%), Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePerception and readiness to accept the malaria vaccine among respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;274\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you believe in vaccination as a means of disease prevention?\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e236\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e86.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you believe the malaria vaccine can protect against malaria?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e239\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e87.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDo you think malaria vaccination during pregnancy and for children is necessary?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWould you recommend the malaria vaccine to others?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e215\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIf malaria vaccination were available today, would you be willing to get vaccinated?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e222\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndecided\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIf introduced in the NPI schedule, would you be willing to vaccinate your child?\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUndecided\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMotivators of vaccination acceptance among the respondence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency,\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;274\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat would motivate you to accept the malaria vaccine for yourself and your child?\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFree vaccination\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e144\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConvenient vaccination location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e59.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRecommendation by healthcare provider\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInformation about vaccine safety and effectiveness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e53.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e128\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eBivariate analysis revealed no significant associations between sociodemographic or obstetric characteristics (age, education, employment, marital status, parity, trimester) and vaccine acceptance (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). However, strong positive associations were observed with perceptual and motivational factors, including belief that the vaccine protects against malaria (χ\u0026sup2; = 49.252, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), free vaccination (χ\u0026sup2; = 11.230, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), convenient location (χ\u0026sup2; = 9.977, p\u0026thinsp;=\u0026thinsp;0.002), healthcare provider recommendation (χ\u0026sup2; = 9.726, p\u0026thinsp;=\u0026thinsp;0.002), and information on safety/effectiveness (χ\u0026sup2; = 7.915, p\u0026thinsp;=\u0026thinsp;0.005) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between Sociodemographic and health system related factors, and malaria vaccination acceptance for mothers and their children.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003eMalaria vaccination acceptance\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo/undecided\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eχ\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge of mothers\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.672\u003csup\u003eY\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.715\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163 (78.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44 (21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (84.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (61.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (38.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.799\u003csup\u003eY\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.180\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e211 (80.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMothers\u0026rsquo; level of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.153\u003csup\u003eY\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (28.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (80.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (79.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (20.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMothers\u0026rsquo; employment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCivil servants\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11 (68.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (31.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.879\u003csup\u003eY\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.830\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e153 (81.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (19.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrivate employed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (81.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (18.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (70.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (30.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eParity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNulliparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e72 (82.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (17.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.425\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimi/multiparous\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e147 (78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTrimester\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFirst Trimester\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 (78.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (21.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.210\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.900\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecond Trimester\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e98 (79.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThird Trimester\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74 (81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBelieve that the malaria vaccine can protect against malaria\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e204 (86.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.252\u003csup\u003eY\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (22.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI don\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (62.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFree vaccination\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115 (88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.230\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e104 (72.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 (27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConvenient vaccination location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e99 (89.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.977\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (73.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (26.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRecommendation by healthcare provider\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e142 (86.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (13.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.726\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e77 (70.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (29.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eInformation about vaccine safety and effectiveness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e126 (86.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e93 (72.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (27.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eχ\u003c/b\u003e \u003csup\u003e \u003cb\u003e2\u003c/b\u003e \u003c/sup\u003e: \u003cb\u003eChi square; Y: Yates\u0026rsquo; correction.\u003c/b\u003e\u003c/p\u003e \u003cp\u003eMultivariable binary logistic regression confirmed two independent predictors of acceptance: belief in the vaccine's protective efficacy (adjusted OR\u0026thinsp;=\u0026thinsp;0.303, 95% CI 0.174\u0026ndash;0.528, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and healthcare provider recommendation (adjusted OR\u0026thinsp;=\u0026thinsp;0.476, 95% CI 0.245\u0026ndash;0.927, p\u0026thinsp;=\u0026thinsp;0.029) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePredictors of malaria vaccination acceptance for self and child\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWald\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eExp (B)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e95% CI for Exp (B)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFree vaccination\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.762\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.684\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConvenient vaccination location\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.374\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.725\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.395\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.688\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.627\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealthcare provider information\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.742\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.764\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.029\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.476\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.927\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSafety and effectiveness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.592\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.991\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.553\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.082\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBelieve that the mv can protect against malaria\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.193\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.729\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.303\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e0.174\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.528\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.736\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38.500\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e841.841\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eB: regression coefficient, Exp (B): Exponentiated B, CI: confidence interval.\u003c/b\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings of this study demonstrate a notable disparity between the relatively low awareness of the malaria vaccine and the high levels of positive perceptions and willingness to accept it among pregnant women attending antenatal care clinic. Although less than half of the participants had prior knowledge of the malaria vaccine, the majority expressed readiness to receive the vaccine themselves and to allow their children to be vaccinated if it were incorporated into the National Programme on Immunization (NPI). This observation suggests the presence of a latent demand for malaria vaccination that could be effectively harnessed through improved public health communication and health system engagement. Such a pattern is consistent with emerging evidence from other parts of Nigeria where awareness of the malaria vaccine remains limited, yet willingness to accept it becomes substantial once basic information is provided. For instance, a study conducted in North-central Nigeria among mothers of under-five children reported that although awareness was only 23.7%, willingness to accept the vaccine was as high as 97.3%, with positive perceptions, particularly the belief that the vaccine provides protection against malaria, serving as a major determinant of acceptance.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e Similarly, research conducted in Enugu State in Southeast Nigeria found a high level of initial unawareness among pregnant and nursing mothers; however, acceptability rose dramatically to 94.2% following health education, underscoring the transformative role of targeted information dissemination in improving vaccine acceptance.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e In contrast, a national cross-sectional survey among mothers of under-five children reported relatively lower acceptance levels, largely attributed to concerns regarding vaccine safety and potential costs, highlighting the persistent influence of perceived risks and financial barriers in vaccination decision-making.\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eThe channels through which participants obtained information about the malaria vaccine in the present study were predominantly healthcare providers, mass media platforms, and informal discussions within families and communities. This distribution of information sources mirrors findings from similar studies conducted in Nigeria and other malaria-endemic settings, emphasizing the importance of multiple communication channels in disseminating health information effectively. Ajayi \u003cem\u003eet al\u003c/em\u003e\u003csup\u003e17\u003c/sup\u003e and Dim \u003cem\u003eet al\u003c/em\u003e\u003csup\u003e11\u003c/sup\u003e reported that healthcare providers were the most trusted and frequently cited sources of malaria vaccine information in Northeast and Southeast Nigeria respectively, reinforcing the central role of frontline health workers in shaping vaccination attitudes and decisions. In addition, mass media, particularly radio, television, and social media, has increasingly emerged as an influential source of health information in urban populations, complementing the messaging delivered within clinical settings. However, the reliance on informal community discussions as a source of information may also expose populations to misinformation or incomplete knowledge regarding new vaccines. This underscores the need to strengthen structured, provider-led communication strategies within antenatal care clinics and other maternal health platforms. Notably, the low overall awareness observed in this study, despite being conducted in a tertiary healthcare facility located in an urban setting, reflects broader national trends in Nigeria where awareness levels of the malaria vaccine have ranged between 9% and 28% in recent studies.\u003csup\u003e\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e This finding highlights a significant gap in pre-implementation public health communication, particularly in Southwest Nigeria where malaria transmission remains stable but vaccine education efforts have not been as prominent as in northern pilot regions.\u003c/p\u003e \u003cp\u003eThe sociodemographic profile of participants in this study may have contributed to the favourable perceptions observed. A substantial proportion of respondents had tertiary education and belonged to middle or upper socioeconomic groups, characteristics that are often associated with greater access to health information and healthcare services. Nevertheless, no statistically significant associations between sociodemographic variables and willingness to accept the malaria vaccine were observed in the bivariate analysis. This finding differs from some previous studies that identified educational attainment as a key predictor of vaccine acceptance and uptake.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e For example, studies conducted among caregivers in other Nigerian regions have shown that higher educational levels were positively associated with improved vaccine knowledge and acceptance. Similarly, research conducted in Enugu suggested that higher social class was linked to greater acceptability of the malaria vaccine, implying that socioeconomic advantages may enhance access to reliable health information and strengthen trust in health interventions.14 The absence of a significant association in our study suggests that while education and social class may shape baseline knowledge levels, perceptual factors\u0026mdash;such as trust in vaccine effectiveness and confidence in healthcare systems\u0026mdash;may play a more decisive role in influencing vaccine acceptance among pregnant women in clinical settings.\u003c/p\u003e \u003cp\u003eImportantly, the key motivators for malaria vaccine acceptance identified in this study were healthcare provider recommendation and access to clear information regarding vaccine safety and effectiveness. These findings highlight the critical role of modifiable health system factors in promoting vaccine uptake. Multivariable analysis confirmed that belief in the protective efficacy of the malaria vaccine and endorsement by healthcare providers were independent predictors of willingness to accept the vaccine. This observation is consistent with established models of vaccine hesitancy, which show that individuals are more likely to accept vaccines when they perceive clear health benefits, trust healthcare professionals, and receive information through trusted interpersonal communication.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e In many settings, healthcare providers remain the most trusted source of vaccine information and play a pivotal role in addressing concerns related to safety, efficacy, and potential adverse effects. Comparable findings were reported in a study conducted in Ibadan Nigeria, among caregivers of under-five children, where willingness to accept the malaria vaccine, reported by approximately 87% of respondents, was strongly associated with trust in healthcare providers and recommendations from health professionals.\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e Our findings extend this evidence to pregnant women, suggesting that antenatal care clinics provide a valuable opportunity for integrating malaria vaccine education, particularly as the introduction of newer vaccines such as the R21/Matrix-M expands across malaria-endemic countries.\u003c/p\u003e \u003cp\u003eThese findings carry important policy and programmatic implications for malaria control strategies in Nigeria. As the country continues the phased introduction of malaria vaccines, initially prioritizing under-five children in Kebbi and Bayelsa states, with plans for nationwide scale-up in the year 2026, there is a clear need to strengthen community engagement and public awareness campaigns.\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e Integrating structured malaria vaccine education into routine antenatal care services could serve as a strategic approach to improving maternal knowledge and fostering positive attitudes toward vaccination. Pregnant women often function as key health decision-makers within households and can therefore play an important role in advocating for childhood immunization. Strengthening provider-led counseling on vaccine safety, benefits, and availability during ANC visits may help bridge the existing awareness gap while reinforcing public confidence in malaria vaccination programmes. Overall, the findings of this study indicate that pregnant women in Sagamu, Southwest Nigeria demonstrate substantial readiness to accept malaria vaccination for themselves and their children despite limited baseline awareness. Harnessing this favourable disposition through targeted health education and trusted healthcare provider engagement may significantly enhance vaccine uptake and contribute to the successful implementation of malaria vaccination programmes in high-burden settings.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations of the study\u003c/h2\u003e \u003cp\u003eThis study's strengths include its focus on pregnant women in an ANC setting, a novel angle in malaria vaccine literature; providing actionable insights for integration into maternal-child health programs. The adequate sample size and multivariable analysis enhance internal validity and generalizability to similar urban-referral setting in Southwest Nigeria. The single-site focus in an urban setting limits generalizability to rural or primary care settings, potentially over-representing educated, health-seeking women and underestimating barriers in underserved areas.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eANC: Antenatal Care\u003c/p\u003e\n\u003cp\u003eNPI: National Programme on Immunization\u003c/p\u003e\n\u003cp\u003eAOR: Adjusted Odds Ratio\u003c/p\u003e\n\u003cp\u003eCI: Confidence Interval\u003c/p\u003e\n\u003cp\u003eCVI: Content Validity Index\u003c/p\u003e\n\u003cp\u003eB: Regression coefficient.\u003c/p\u003e\n\u003cp\u003eExp(B): \u0026nbsp; Exponentiated Beta (Odds Ratio from logistic regression)\u003c/p\u003e\n\u003cp\u003eHCP: Health Care Provider\u003c/p\u003e\n\u003cp\u003eKAP: Knowledge, Attitude and Practice\u003c/p\u003e\n\u003cp\u003eOOUTH: Olabisi Onabanjo University Teaching Hospital\u003c/p\u003e\n\u003cp\u003eSPSS: Statistical Package for the Social Sciences\u003c/p\u003e\n\u003cp\u003eWHO: World Health Organization\u003c/p\u003e\n\u003cp\u003eRTS,S: RTS,S/AS01 Malaria Vaccine\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthical approval was obtained from the Health Research Ethics Committee of Olabisi Onabanjo University Teaching Hospital, Sagamu, with the protocol approval number OOUTH/HREC/04/017/E269/2026AP. Informed consent was obtained from participants and participation was voluntary.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets analysed during the current study are available from the corresponding author on reasonable request. The questionnaire used has been supplied as anadditional file.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interest\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe are grateful to the nurses at the antenatal care clinic who assisted us with the recruitment of the pregnant women for data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSOA, OEJ and KO conceived the idea and design. SOA, OEJ, KO and EO were involved in the data collection process. SOA and KVO performed the data analysis and interpreted the findings. SOA drafted the manuscript. TAO and AVA shared in the study ideology and did a critical appraisal of the manuscript. All authors read and approved the final manuscript for submission.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eCorrespondence to Solomon O. Ariyibi.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization. World malaria report 2025. Geneva: WHO; 2025. Available from: https://www.who.int/publications/i/item/9789240117822\u003c/li\u003e\n\u003cli\u003eSevere Malaria Observatory. Malaria in Nigeria: Statistics \u0026amp; Facts. 2025. Available from: https://www.severemalaria.org/countries/nigeria\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Malaria vaccines (RTS,S and R21). Geneva: WHO; 2023. Updated 2025.\u003c/li\u003e\n\u003cli\u003eWHO Regional Office for Africa. Nigeria Introduces the R21 Vaccine in a Pivotal Move for Malaria Control. 2024. Available from:https://www.afro.who.int/countries/nigeria/news/nigeria-introduces-r21-vaccine-pivotal-move-malaria-control\u003c/li\u003e\n\u003cli\u003eGavi, the Vaccine Alliance. Nigeria\u0026apos;s first malaria vaccine roll-out. 2025. Available from: https://www.gavi.org/vaccineswork/nigerias-first-malaria-vaccine-roll-out-is-greeted-by-an-expectant-population\u003c/li\u003e\n\u003cli\u003eAtere, AO, Mustapha FB, Mustapha MJ. Logistics of the malaria vaccine roll-out in Nigeria. The Lancet. 2025;405(10492):1815. doi:10.1016/S0140-6736(25)00716-0\u003c/li\u003e\n\u003cli\u003eSadiq M, Croucher S, Dutta D. COVID-19 Vaccine Hesitancy: A Content Analysis of Nigerian YouTube Videos. Vaccines (Basel). 2023 Jun 2;11(6):1057. doi: 10.3390/vaccines11061057.\u003c/li\u003e\n\u003cli\u003eEze OV, Meyer JC, Campbell SM. Poliomyelitis in Nigeria: Impact of Vaccination Services and Polio Intervention and Eradication Efforts. Vaccines (Basel). 2025 Feb 25;13(3):232. doi: 10.3390/vaccines13030232. \u003c/li\u003e\n\u003cli\u003eYusuf, H., Suleiman, A., Shehu, S., Yahaya, U., Usman, S., \u0026amp; Indabo, U. (2025). Knowledge, acceptance and willingness to pay for malaria vaccine among residents of a semi-urban community in Kaduna State, North-western Nigeria. \u003cem\u003eNigerian Medical Journal\u003c/em\u003e, \u003cem\u003e66\u003c/em\u003e(1), 266. https://doi.org/10.71480/nmj.v66i1.701\u003c/li\u003e\n\u003cli\u003eAlagbe OO, Iliya RS, Rotimi B, Solomon A. Awareness, perceptions and willingness to accept malaria vaccine for children under age 5 among mothers in Northcentral Nigeria: a cross-sectional study. BMJ Open. 2025 Mar 25;15(3):e091739. doi: 10.1136/bmjopen-2024-091739. \u003c/li\u003e\n\u003cli\u003eDim OF, Chima UE, Iloabuchi FC, Anene-Okeke CG, Nwachuya CA, Onyehalu JC, Umeh AU, Agbo CA, Agbo JE, Isah A. Awareness, acceptability, and willingness to pay for the R21/Matrix-M malaria vaccine: a cross-sectional study among pregnant women and nursing mothers in Enugu State, Nigeria. BMC Public Health. 2025 Nov 18;25(1):4011. doi: 10.1186/s12889-025-25405-1. \u003c/li\u003e\n\u003cli\u003eIrodi CC, Ugeh V, Archibong NB, Irodi CN, Oderinde M, Chukwuka LO. Attitude and perception of pregnant mothers towards antenatal health education in Egbeta Primary Health Care, Ovia North-East, Edo State. International Journal Dental and Medical Sciences Research. 2023:5(1), 533-542. doi:10.35629/5252-0501533542.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Malaria Vaccine Implementation Programme (MVIP): Lessons Learned and Recommendations. Geneva: WHO; 2024. Available from: https://www.who.int/initiatives/malaria-vaccine-implementation-programme.\u003c/li\u003e\n\u003cli\u003eChinawa AT, Ossai EN, Onukwuli VO, Nduagubam OC, Uwaezuoke NA, Okafor CN, et al. Willingness to accept malaria vaccines amongst women presenting at outpatient and immunization clinics in Enugu state, Southeast Nigeria. Malar J. 2024 Apr 25;23(1):117. doi: 10.1186/s12936-024-04914-1. \u003c/li\u003e\n\u003cli\u003eOyedeji GA. Socio-economic and cultural background of hospitalised children in Ilesha. Nig J Paediatr 1985;12: 111-117.\u003c/li\u003e\n\u003cli\u003eAdigwe OP, Onavbavba G. Acceptance and affordability of malaria vaccines: issues relating to hesitancy and willingness to pay amongst Nigerian parents of under-five children. Malar J. 2025 Feb 7;24(1):36. doi: 10.1186/s12936-025-05268-y. \u003c/li\u003e\n\u003cli\u003eAjayi MY, Emeto DC. Awareness and acceptability of malaria vaccine among caregivers of under-5 children in Northern Nigeria. Malar J. 2023 Oct 31;22(1):329. doi: 10.1186/s12936-023-04768-z. \u003c/li\u003e\n\u003cli\u003eAriyibi SO, Ojuawo AI, Ibraheem RM, Afolayan FM, Ariyibi RO, Akanbi PO. Factors influencing routine vaccination uptake and completion among children aged 12\u0026ndash;23 months in Ilorin, North-Central Nigeria: A cross-sectional survey. International Journal of Medicine and Health Development. 2023; 28(4):314-320. doi: 10.4103/ijmh.IJMH_20_23\u003c/li\u003e\n\u003cli\u003eDong B, Xu H, Qi Y and Li Y. Understanding vaccine hesitancy through the lens of trust and the 3C model: evidence from Chinese General Social Survey 2021. Front. Public Health 13:1671457. doi: 10.3389/fpubh.2025.1671457.\u003c/li\u003e\n\u003cli\u003eAbdulkadir BI, Ajayi IO. Willingness to accept malaria vaccine among caregivers of under-5 children in Ibadan North Local Government Area, Nigeria. Malariaworld J. 2015 Mar 23;6:2. doi: 10.5281/zenodo.10870005. \u003c/li\u003e\n\u003cli\u003eMalaria Elimination Initiative. (2020). Implementing effective community engagement for malaria control and elimination: Opportunities and challenges. San Francisco: The Global Health Group, University of California, San Francisco.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Malaria vaccine, Vaccine acceptance, Awareness, Pregnant women, Maternal and child protection","lastPublishedDoi":"10.21203/rs.3.rs-9204164/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9204164/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eNigeria contributes substantially to the global burden of malaria, with pregnant women and young children among the most vulnerable groups. With the recent introduction of malaria vaccines in several African countries, community awareness and acceptance are critical for successful implementation. This study assessed awareness, perceptions, and willingness to accept the malaria vaccine among pregnant women attending antenatal care in a tertiary hospital in Nigeria.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA hospital-based cross-sectional study was conducted among 274 pregnant women attending antenatal clinics at a tertiary health facility. Data were collected using a structured interviewer-administered questionnaire covering sociodemographic characteristics, awareness of the malaria vaccine, perceptions about vaccination, and willingness to accept the vaccine. Descriptive statistics summarized participants\u0026rsquo; characteristics. Associations between explanatory variables and willingness to accept the vaccine were assessed using chi-square tests and logistic regression analysis. Statistical significance was set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe majority of participants were aged 20\u0026ndash;34 years (75.5%), married (85.3%), and had tertiary education (55.1%). Awareness of the malaria vaccine was relatively low (48.5%). However, perceptions toward vaccination were largely positive: 86.1% believed vaccines prevent disease and 87.2% believed a malaria vaccine could protect against malaria. Overall, 81.0% of respondents were willing to receive the vaccine if available, and 79.9% were willing to vaccinate their children. Factors significantly associated with vaccine acceptance included belief in vaccine protection (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), healthcare provider recommendation (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002), vaccine availability (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.002), provision of safety information (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.005), and free vaccination (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In multivariable analysis, belief in vaccine protection and healthcare provider recommendation remained independent predictors of vaccine acceptance.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eDespite limited awareness, pregnant women demonstrated favourable disposition and high willingness to accept the malaria vaccine. Strengthening antenatal health education and leveraging healthcare provider recommendations may improve vaccine uptake and support effective malaria vaccine implementation in high-burden settings.\u003c/p\u003e","manuscriptTitle":"Awareness, perception and Willingness to Accept Malaria Vaccination for Maternal and Child Protection among Pregnant Women Attending Antenatal Care: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-14 09:44:22","doi":"10.21203/rs.3.rs-9204164/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-13T11:26:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"209023885729074879378535758147583252539","date":"2026-04-12T12:44:08+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"123135038093918862635211992485757226600","date":"2026-04-09T12:12:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"316942442320961826238407545561506586170","date":"2026-04-09T10:53:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"306666595982387464181660261010099039706","date":"2026-04-08T14:46:30+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"46456209033577023274771130162823646601","date":"2026-04-08T09:00:33+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"254582787701845939958640324643789785032","date":"2026-04-07T08:17:55+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-07T07:21:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-03-25T12:34:43+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-03-25T04:04:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-03-25T04:04:22+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2026-03-23T19:40:49+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c94b16e7-0c58-4b47-98af-36054e9ebaee","owner":[],"postedDate":"April 14th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-07T20:38:13+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-14 09:44:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9204164","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9204164","identity":"rs-9204164","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}