Evidence map›Paper›PMID 42785944›Full record

ArticleBMJ open2026

Availability and accessibility of SARS-CoV-2 vaccines among rural populations in sub-Saharan Africa: a systematic review and meta-analysis protocol.

Elia Nyangi, Yoktani Bukagu, Mpanga Paul, Norberth Massawe, Rebecca Mkumbwa, Elinesi Mwasanga, Thadeus Ruwaichi, Neema Mawi, Siri Abihudi, Pankras Luoga

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Elia NyangiDepartment of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of Elia.nyangi@muhas.ac.tz.ORCID http://orcid.org/0000-0002-7951-9248
Yoktani BukaguDevelopment Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.
Mpanga PaulDepartment of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Norberth MassaweDevelopment Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.
Rebecca MkumbwaDepartment of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Elinesi MwasangaDepartment of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Thadeus RuwaichiDepartment of Development Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Neema MawiDepartment of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Siri AbihudiInstitute of Traditional Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of.
Pankras LuogaDevelopment Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Dar es Salaam, Tanzania, United Republic of.ORCID http://orcid.org/0000-0002-0483-1720

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe COVID-19 pandemic has posed unprecedented global public health challenges since its emergence in late 2019. Vaccination remains the most effective intervention for preventing severe disease and reducing transmission. However, disparities in vaccine distribution and access have been widely reported, particularly in low-income and middle-income countries and rural communities. Rural populations in sub-Saharan Africa (SSA) often face structural barriers, including weak health systems, limited infrastructure and an inadequate healthcare workforce, which may affect the availability and accessibility of COVID-19 vaccines. As COVID-19 vaccination transitions from emergency campaign delivery to integration within routine national immunisation programmes, coverage across the WHO African Region remains substantially below global targets and the residual unvaccinated population is disproportionately rural. Despite growing literature on COVID-19 vaccination, there remains limited synthesised evidence examining vaccine availability and accessibility among rural populations in SSA. This systematic review and meta-analysis aims to synthesise existing evidence regarding the availability and accessibility of SARS-CoV-2 vaccines among rural populations in SSA. METHODS AND ANALYSIS: A systematic search will be conducted across 13 electronic databases, including PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL, PsycINFO, Global Health (CABI), the Cochrane Library, African Journals Online (AJOL), African Index Medicus, the WHO Global Index Medicus, ProQuest Dissertations and Theses Global, and Google Scholar. Searches will cover the period from 1 October 2025, corresponding to the first regulatory authorisations of COVID-19 vaccines, to 30 October 2027. A structured SARS-CoV-2 grey literature search of international agency repositories, preprint servers, thesis repositories, trial registries and ministry of health sources will also be undertaken. Two independent reviewers will screen titles, abstracts and full texts, appraise methodological quality using the Joanna Briggs Institute critical appraisal tools, the Critical Appraisal Skills Programme checklist and the AACODS checklist as appropriate to source type and extract data in duplicate. Quantitative findings will be pooled using a DerSimonian and Laird random-effects model in Stata V.18, with heterogeneity assessed using Cochran's Q test and the I² statistic. Qualitative findings will be synthesised using the thematic synthesis approach of Thomas and Harden, with coding managed in NVivo V.15. The two strands will be integrated using a convergent segregated mixed-methods design. ETHICS AND DISSEMINATION: Ethical approval is not required as the review will use publicly available data from published studies. The findings will be disseminated through peer-reviewed publications and scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42023466198.

Indexed as

COVID-19COVID-19 VaccinesHealth Services AccessibilityRural PopulationAfrica South of the SaharaHumansImmunization ProgramsMeta-Analysis as TopicResearch DesignSub-Saharan African PeopleSystematic Reviews as TopicCOVID-19 VaccinesAfrica South of the SaharaCOVID-19SARS-CoV-2 InfectionVaccination

Identifiers

PMID42785944
PMCPMC13630019

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.