The Makoko community in Nigeria is one of the most disadvantaged in the country. Located on the edge of the Lagos lagoon, it is made up of informal settlements with no access to basic amenities such as clean water and sanitation. It also has one of the lowest Covid-19 vaccination uptakes in a country — which also has one of the lowest vaccination rates in the world.
Scientific research on the ground in Makoko reveals misinformation and lack of education about the Covid-19 vaccine is the cause of vaccine hesitancy.
As part of Code for Africa’s OUTBREAK and MapMakoko projects, two researchers from Nigeria, Dr Obianuju Ozoh at the Lagos University Teaching Hospital and Dr Ayesha Akinkugbe from University of Lagos, College of Medicine conducted research on the ground in August 2021 to determine the enablers and barriers to the Covid-19 vaccine uptake in Makoko. The projects sought to increase knowledge on the extent of Covid-19 spread in order to assist in vaccination efforts in Africa.
For perspective, only 5,727, 711 people had received the first dose of the vaccine in Nigeria as of November 3, 2021, representing just 5.1% of a population of about 200 million. The low rates are attributed partly to vaccine shortages as well as logistical challenges, such as those associated with transporting the vaccine.
However, as preliminary findings from this study indicate, much of the problem lies in vaccine hesitancy, which is fuelled by misinformation around its safety and efficacy.
Makoko is one such community that has potentially fallen victim to the complex web of misinformation. Because of its unique topography and location, the community is difficult to access and has largely been left out of governmental development plans. Consequently, people have grown distrustful of the motives of a relentless stream of visitors whose impact they have hardly felt.
As such, research efforts by other civic society organisations are often seen as exploitative and an invasion of their privacy and have been met with protests and unrest. As found out, this study could not have been possible without leveraging on relationships we have built in the community over time.
So what did we do differently?
To begin with, the researchers leveraged their relationship with the Local Government Development Area officers. As a first step, they met with the community leaders who appointed coordinators to assist during data collection.
The community coordinators helped with sensitising the residents on the purpose of our visit and the potential benefits, while encouraging them to grant us access. Understanding and respecting community’s cultural, social and religious norms is imperative during engagements with gatekeepers and other community members. Honesty in the motive of the engagement is key in reducing the existing scepticism towards visitors and social programmes within the community.
Dr Ozoh explained that they were then able to recruit and interview consenting adults of 45 acceptors and 45 non-acceptors of the vaccine as required by the Barrier Analysis (BA) approach (an assessment tool used to identify determinants of a particular behaviour), and analysed the data using the standard BA analysis tool.
From the preliminary evaluation, the researchers said that many vaccination ‘acceptors’ were still hesitant to take the vaccine. According to them, mistrust, misconception and misinformation were among the influential determinants. This hesitancy was combated by providing easy-to-understand information regarding the vaccine, its benefits and side effects.
The researchers leveraged africanDRONE’s geographic data collected during the MapMakoko project, and arranged community engagement with the Yaba Local Government Development Area officers and local leaders to collect data.
‘We navigated community entry and access to the population by first engaging with the community gatekeepers at all levels, starting with the executive chair of Yaba Local Council Development Area (LCDA), the Medical Officer of Health, through to the health educators, the community leaders and the religious leaders,’ said Dr Akinkugbe.
Through the LCDA, the local health educators played a major role in meeting with the community gatekeepers who are influential in mobilisation, information dissemination, and awareness creation.
‘We at CfA strongly believe in the proactive cooperation between civic technology and data journalism initiatives such as OUTBREAK and MapMakoko and the African scientific community’, said chief data officer Jacopo Ottaviani.
‘The idea is to bring together scientists, journalists and technologists in Nigeria, with the aim of promoting scientific development while providing fact-based communication.’
As part of the OUTBREAK project, CfA’s PesaCheck initiative has fact-checked claims around Covid-19 and vaccines to debunk mis/disinformation by identifying numerous Covid-19 related claims. PesaCheck has gone ahead to create awareness and sensitisation based on factual information and was integral in our engagement in Makoko and other communities across the continent.
Tricia Govindasamy, DataLab Manager, noted that Code for Africa’s WanaData initiative will continue providing opportunities to underrepresented female experts such as Dr Akinkugbe and Dr Ozoh who are passionate about solving real world problems through research.
Understanding how pre-existing challenges in densely populated and marginalised informal settlements such as the Makoko community compound the spread of new Covid-19 variants, CfA continues to promote dissemination of verified, data-driven information across African audiences to positively impact the pandemic and vaccine management.
Code for Africa (CfA) is the continent’s largest network of civic technology and data journalism labs, with teams in 21 countries. CfA builds digital democracy solutions that give citizens unfettered access to actionable information that empowers them to make informed decisions, and that strengthens civic engagement for improved public governance and accountability. This includes building infrastructure like the continent’s largest open data portals at openAFRICA and sourceAFRICA. CfA incubates initiatives as diverse as the africanDRONE network, the PesaCheck fact-checking initiative, the sensors.AFRICA air quality sensor network and the research and analysis programme CivicSignal.
CfA also manages the African Network of Centres for Investigative Reporting (ANCIR), which gives the continent’s best muckraking newsrooms the latest possible forensic data tools, digital security and whistleblower encryption to help improve their ability to tackle crooked politicians, organised crime and predatory big business. CfA also runs one of Africa’s largest skills development initiatives for digital journalists, and seed funds cross-border collaboration.
