Implementing national COVID-19 vaccination programmes in sub-Saharan Africa- early lessons from Zimbabwe: a descriptive cross-sectional study

Introduction: Zimbabwe was one of the first countries to run a national COVID-19 vaccination programme in Africa. Lessons learnt could inform the rollout of similar programmes in sub-Saharan Africa. To describe the trends of uptake of the COVID-19 vaccines in the first three months (February - May 2021) of the Zimbabwe vaccination programme and the lessons learnt. Methods: a secondary descriptive analysis of routinely available COVID-19 vaccination data extracted from the daily situation reports published by the Ministry of Health and Child Care. Results: in the first three months of the programme, 1 020 078 doses were administered, with 675 678 being first doses and 344 400 were second doses. Using population estimates, at three months, 5.2% of the population had received at least one dose and 2.6% had received the full two doses. Uptake was initially slow, followed by a gradual, and subsequently an exponential increase. Conclusion: by the end of May 2021, Zimbabwe had rolled out one of the largest COVID-19 vaccination programme in sub-Saharan Africa. The uptake followed a pattern and trend that is consistent with vaccine hesitancy reported in the literature, driven by a combination of confidence, complacency and convenience factors. The gradual increase in uptake followed a series of national and local community engagement programmes. The roll-out of similar programmes must recognise likely patterns of uptake across the population and ensure plans are in place to address vaccine hesitancy. The available data did not allow granular analysis to understand the demographics of people who participated in the programme, which is important for surveillance, targeted action, preventing inequalities and ensuring adequate and proportionate protection of residents prioritising the most vulnerable. Further analysis of the process, outcomes and impact of the programme will be helpful in informing the rollout of similar programmes across Africa

A Primary Qualitative Study Exploring Adult BAME Individuals' Experiences Regarding Physical Activity from the North-East of England During the COVID-19 Pandemic:n/a

Researchers have found that people from BAME communities have worse health outcomes from many health interventions and face health disparities. BAME individuals experience health inequities and lower health intervention results. The experiences of adult Teesside-based BAME Individuals' regarding physical activity (PA) during the COVID-19 pandemic were mapped onto the capability, opportunity, and motivation model of behaviour (COM-B). Twelve adult BAME participants were interviewed using semi-structured interviews that lasted 40 to 60 minutes and captured participant perceptions of how their PA and perceptions related to living a healthy PA lifestyle during the pandemic between April and August 2022 via Microsoft Teams. Using thematic analysis, 10 themes were generated, but only three themes were discussed. These include knowledge and awareness of the PA lifestyle, participants' perceptions of the opportunities to improve the PA lifestyle choice of adult BAME, and the change in perceptions of PA due to COVID-19 lockdown. While literature has explored the COM-B model, there have been generalised findings that are not specific to adult BAME individuals' lived PA experiences. The COVID-19 pandemic presents an opportunity to understand the shift in adult BAME perceptions and experiences during the coronavirus pandemic, therefore calling for the urgent need to modify both models in order to combat the high mortality rates of adult BAME individuals related to sedentary lifestyle diseases. This indicates that there is a critical requirement for the COMB model in order to implement policies. Nevertheless, limited PA studies have used lifestyle behaviour models to enhance behavioural modification

Caring for older people as a social determinant of health: findings from a scoping review of observational studies

Background: Unpaid care is a critical source of support for people with health and social care needs. Unpaid carers are a group facing increasing demands and are at risk of adverse outcomes. Objectives: To assess the breadth of evidence on older carers/carers of older people in UK cohort studies. Methods: Using scoping review methods, we developed a targeted search strategy in three bibliographic databases (Medline, PsycInfo and CINAHL) for studies reporting carer characteristics and outcomes. Data were mapped using Evidence for Policy and Practice Information (EPPI) Reviewer, a web-based programme for managing and analysing data in reviews. The impacts of caring were explored and synthesised. Findings: Eighty-five studies were included. Where studies examined the impact of caring, outcomes were typically health-related; findings were inconsistent. Fewer studies reported the socioeconomic, disability-related, quality of life, or social impacts of caring. Fewer than half of studies reported subgroup analyses or care recipient information, and only five studies stratified carers’ outcomes by a measure of socioeconomic status. Limitations: Relying on data from observational studies means that key outcomes or caring pathways may be overlooked due to data collection methods. We therefore cannot infer causation/reverse causation regarding caring and carer outcomes. Implications: Our work highlights specific gaps in evidence regarding the social, economic, health and quality of life outcomes for carers. We also suggest methodological considerations to improve our understanding of care recipients, carers’ trajectories, and those at greatest risk of adverse outcomes. This information is vital to the development of research design, policies and interventions to support carers’ wellbeing

A Primary Qualitative Study Exploring Adult BAME Individuals\u27 Experiences Regarding Physical Activity from the North-East of England During the COVID-19 Pandemic

Researchers have found that people from BAME communities have worse health outcomes from many health interventions and face health disparities. BAME individuals experience health inequities and lower health intervention results. The experiences of adult Teesside-based BAME individuals\u27 regarding physical activity (PA) during the COVID-19 pandemic were mapped onto the capability, opportunity, and motivation model of behaviour (COM-B). Twelve adult BAME participants were interviewed using semi-structured interviews that lasted 40 to 60 minutes and captured participant perceptions of how their PA and perceptions related to living a healthy PA lifestyle during the pandemic between April and August 2022 via Microsoft Teams. Using thematic analysis, 10 themes were generated, but only three themes were discussed. These include knowledge and awareness of the PA lifestyle, participants\u27 perceptions of the opportunities to improve the PA lifestyle choice of adult BAME, and the change in perceptions of PA due to COVID-19 lockdown. While literature has explored the COM-B model, there have been generalised findings that are not specific to adult BAME individuals\u27 lived PA experiences. The COVID-19 pandemic presents an opportunity to understand the shift in adult BAME perceptions and experiences during the coronavirus pandemic, therefore calling for the urgent need to modify both models in order to combat the high mortality rates of adult BAME individuals related to sedentary lifestyle diseases. This indicates that there is a critical requirement for the COMB model in order to implement policies. Nevertheless, limited PA studies have used lifestyle behaviour models to enhance behavioural modification