What are the key determinants to fostering equity within coronavirus disease 2019 (COVID-19) vaccination deployment initiatives in Nigeria? A scoping review

Abstract

Objective

This review aimed to identify the barriers and facilitators to equitable coronavirus disease 2019 (COVID-19) vaccine distribution in Nigeria using the consolidated framework for implementation research (CFIR).

Methods

A comprehensive search strategy was applied across five databases—Web of Science, MEDLINE, EMBASE, CAB Direct, and CINAHL. The search, conducted as part of a scoping review, yielded 2,751 citations. Seven studies met the inclusion criteria after screening. Data were extracted and analyzed using CFIR constructs to identify key barriers and facilitators to equitable vaccine distribution.

Results

Six barriers were identified: limited physical and socioeconomic access, bribery, nepotism, and insufficient availability of translated information. Facilitators included community involvement as local monitoring agents, unannounced staff inspections, healthcare worker training tailored to community needs, and localized outreach strategies such as jingles and call-in programs. CFIR constructs, including Local Conditions, Tailoring Strategies, Available Resources, and Physical Infrastructure, provided a framework for analyzing the findings.

Conclusion

This review highlights significant barriers and promising facilitators to equitable vaccine distribution in Nigeria. Targeted interventions, such as community engagement, anti-corruption measures, and culturally tailored strategies, are critical to addressing these challenges and improving access. These findings underscore the need for localized, equity-focused approaches to enhance vaccine distribution systems in Nigeria and other low-resource settings.