Access to COVID-19 Vaccines in Wenchi Municipality, Ghana: An Analysis through the Health Belief Model
Abstract:
Equitable access
to COVID-19 vaccines remains a major public health priority worldwide. While
Ghana initiated nationwide vaccination in early 2021, coverage rates in the
Bono Region, and particularly in Wenchi Municipality, lagged behind national
targets. Accessibility challenges span across physical, logistical, and social
dimensions. This influences individuals’ ability and willingness to receive the
vaccine. A mixed-method, cross-sectional study was used to recruit 288 adults
in Wenchi Municipality via probability proportional to size sampling. Data was
collected using a structured questionnaire with both closed and open-ended
items. Quantitative data were analyzed with descriptive and inferential
statistics, while qualitative data underwent thematic analysis. The Health
Belief Model (HBM) provided the basis for the conceptual framework for
examining accessibility factors. Physical access barriers such as poor road
infrastructure, long distances to vaccination points, and reliance on walking
were identified as significant factors. Logistical challenges included
occasional vaccine stockouts, confusion about eligibility, and indirect costs
such as transport. Social access barriers included stigma (17.6% of
respondents), religious and cultural objections (3.8%), and mistrust fueled by
misinformation. Contributory factors to accessibility included encouragement
from family and friends, endorsements by community leaders, and convenient
operating hours at most sites. Access to COVID-19 vaccines in Wenchi
Municipality is constrained by a complex interplay of geographic, operational,
and socio-cultural factors. Addressing these requires a multi-pronged approach:
mobile vaccination teams, reliable supply chains, culturally attuned messaging,
and visible endorsements from trusted local figures. The HBM recommendations
framework provided offers practical, theory-based guidance for policymakers and
practitioners.
References:
[1]. World Health Organization (WHO), 2020, WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. https://www.who.int/director-general
[2]. World Health Organization (WHO), 2024, WHO Coronavirus (COVID-19) dashboard. https://covid19.who.int/
[3]. Dhama, K., Patel, S. K., Natesan, S., & Yatoo, M. I., 2020a, COVID-19 in the global context: Pandemic challenges, future outlook, and vaccine development. Human Vaccines & Immunotherapeutics, 16(12), 3062–3076. https://doi.org/10.1080/21645515.2020.1825946
[4]. Kwon, H., & Rahmati, M., 2022, Global disparities in COVID-19 vaccine access. The Lancet Global Health, 10(5), e728–e729.
[5]. Anne-Claire Dufay, & Francis Kasolo, 2021, Ghana becomes first country to receive COVID-19 vaccines from COVAX. World Health Organization Africa Newsroom. https://www.afro.who.int/news
[6]. Ghana Health Service (GHS), 2023, COVID-19 vaccination dashboard. Accra: Ghana Health Service.
[7]. Duffy, J., Crum, K., & Camp, R., 2021, Rural health accessibility and COVID-19 vaccine distribution: Challenges and solutions. American Journal of Public Health, 111(6), 1014–1021.
[8]. Santangelo, O. E., Provenzano, S., & Firenze, A., 2024, COVID-19 vaccine accessibility and equity: Global lessons. International Journal of Environmental Research and Public Health, 21(3), 224. https://doi.org/10.3390/ijerph21030224
[9]. Rotenberg, S., Dubé, E., & Vivion, M., 2021, Barriers to vaccination in rural African settings: A qualitative synthesis. Social Science & Medicine, 291, 114473. https://doi.org/10.1016/j.socscimed.2021.114473
[10]. Wenchi District Analytical Report. 2014, Population and housing census. Ghana Statistical Service.
[11]. Glanz, K., Rimer, B. K., & Viswanath, K., (Eds.), 2015, Health Behavior: Theory, Research, and Practice (5th ed.). San Francisco, CA: Jossey-Bass (Wiley).
[12]. Mbele, W., Dako-Gyeke, P., & Frans, A. N., 2024, COVID-19 vaccination uptake among healthcare workers in Ghana: A comprehensive analysis of knowledge, attitude, perceived vaccine effectiveness, and health belief model constructs. PLOS Global Public Health, 4(5). https://doi.org/10.1371/journal.pgph.0002738
[13]. Adiyoso, W., Ahsan, A., & Ahsan, M., 2023, Health Belief Model application in predicting COVID-19 vaccination uptake in Indonesia. Journal of Public Health Research, 12(2), 75–83. https://doi.org/10.4081/jphr.2023.3568
[14]. Abubakari, M., Agyei, F. B., Mensah, S. A., & Nketiah-Amponsah, E., 2023, COVID-19 vaccine hesitancy in Ghana: Examining beliefs, attitudes, and barriers. BMC Public Health, 23(1), 445. https://doi.org/10.1186/s12889-023-15240-0
[15]. World Health Organization (WHO). 2022, COVID-19 vaccine deployment in Africa: Progress and challenges. WHO Regional Office for Africa.
[16]. Naidoo, P., Mahomed, H., & Engelbrecht, M., 2023, Understanding COVID-19 risk perceptions in South Africa. African Journal of Primary Health Care & Family Medicine, 15(1), e1–e7. https://doi.org/10.4102/phcfm.v15i1.3740
[17]. Effiong, E., Adebayo, T., & Oyewole, O., 2023, Overcoming barriers to COVID-19 vaccination in Nigeria: Lessons from community-based interventions. Pan African Medical Journal, 44(112), 1–10. https://doi.org/10.11604/pamj.2023.44.112
[18]. Yenew, C., Tadesse, D., & Asfaw, E., 2023, COVID-19 vaccine uptake and accessibility in Ethiopia. Ethiopian Journal of Health Development, 37(1), 45–53.
[19]. Ghebreyesus, T. A., 2021, January 18. Opening remarks at the 148th session of the Executive Board. World Health Organization. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-148th-session-of-the-executive-board World Health Organization
[20]. World Trade Organization. 2022, July 6. TRIPS Council welcomes MC12 TRIPS waiver decision, sets out next steps. https://www.wto.org/english/news_e/news22_e/trip_08jul22_e.htm World Trade Orga
[21]. World Health Organization. 2021, mRNA Technology Transfer (mRNA TT) Programme. https://www.who.int/initiatives/mrna-technology-transfer-%28mrna-tt%29-programme World Health Organization
[22]. de Bengy Puyvallée, A., & Storeng, K. T., 2022, COVAX, vaccine donations and the politics of global vaccine equity. Globalization and Health, 18, 26. https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-022-00801-z BioMed Central
[23]. Tatar, M., et al., 2021, International COVID-19 vaccine inequality amid the pandemic. Annals of Global Health, 87(1), 1–6. https://pmc.ncbi.nlm.nih.gov/articles/PMC8252691/ PMC
[24]. World Health Organization. 2025a, May 20. World Health Assembly adopts historic Pandemic Agreement to make the world more equitable and safer from future pandemics. https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics World Health Organization
[25]. World Health Organization. 2025b, June 27. Pandemic prevention, preparedness and response accord: Q&A. https://www.who.int/news-room/questions-and-answers/item/pandemic-prevention--preparedness-and-response-accord World Health Organization
[26]. World Health Organization. 2025c, WHO Pandemic Agreement (Resolution WHA78.1). https://apps.who.int/gb/ebwha/pdf_files/WHA78/A78_R1-en.pdf World Health Organization Apps
[27]. World Health Organization. 2022, May 20, COVAX calls for urgent action to close vaccine equity gap. https://www.who.int/news/item/20-05-2022-covax-calls-for-urgent-action-to-close-vaccine-equity-gap World Health Organization
[28]. Ghana Statistical Service (GSS). 2021 population and housing census. Accra: Ghana Statistical Service.
[29]. Creswell, J. W., & Creswell, J. D., 2018, Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Sage Publications.
[30]. Ahmed, M., 2016, Determining sample size for research activities. Educational and Psychological Measurement, 30(3), 607–610.
[31]. Sebring, E., Masanja, H., & Rwehumbiza, I., 2022, Accessibility challenges to COVID-19 vaccination in sub-Saharan Africa. BMC Health Services Research, 22(1), 1120. https://doi.org/10.1186/s12913-022-08377-9
[32]. Kuatewo, S., Agyekum, E., & Opoku, E., 2025, Social media misinformation and vaccine hesitancy in rural Ghana: A mixed methods study. BMC Public Health, 25(1), 209.
[33]. Dzau, V. J., et al., 2022, Closing the global vaccine equity gap. The Lancet, 400, 2192–2194.
[34]. Alshagrawi, M., 2024, Social influence and COVID-19 vaccine uptake: A Health Belief Model perspective. Vaccine, 42(1), 118–126. https://doi.org/10.1016/j.vaccine.2023.09.042
[35]. Choi, S. H., Kim, J., Kim, J. H., & Lee, M., 2022, Factors influencing COVID-19 vaccine acceptance in Kenya: An application of the Health Belief Model. International Journal of Environmental Research and Public Health, 19(9), 5672. https://doi.org/10.3390/ijerph19095672
[36]. World Health Organization. 2025a, May 20. World Health Assembly adopts historic Pandemic Agreement to make the world more equitable and safer from future pandemics. https://www.who.int/news/item/20-05-2025-world-health-assembly-adopts-historic-pandemic-agreement-to-make-the-world-more-equitable-and-safer-from-future-pandemics World Health Organization
[37]. World Health Organization. 2024, June 1. World Health Assembly: Agreement reached on a wide-ranging package of amendments to improve the International Health Regulations (2005). https://www.who.int/news/item/01-06-2024-world-health-assembly-agreement-reached-on-wide-ranging--decisive-package-of-amendments-to-improve-the-international-health-regulations--and-sets-date-for-finalizing-negotiations-on-a-proposed-pandemic-agreement World Health Organization
[38]. Braun, V., & Clarke, V., 2006, Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.
