Abstract
BACKGROUND: Despite the pivotal role of healthcare workers in vaccination programs, there is limited understanding of the factors influencing their vaccine recommendations, particularly in low-resource and rural settings. This study examines the determinants of vaccine recommendation practices among healthcare workers in Senegal. METHODS: A cross-sectional survey was conducted in 2024 among 302 healthcare workers in Senegal. A vaccine recommendation score was constructed to assess how frequently healthcare workers recommended vaccines. A typology of psychosocial determinants of healthcare workers' vaccination behaviour was developed using the short version of the Health Professionals Vaccine Confidence and Behaviours questionnaire. Multivariable log-binomial regression was used to identify factors associated with systematic vaccine recommendations. RESULTS: Vaccine recommendation practices among healthcare workers were high, with 60.6% achieving the highest score. The Professionals Vaccine Confidence and Behaviours typology classified healthcare workers into three clusters: 'Highly confident' (57.3%), 'Moderately hesitant' (14.2%), and 'Specific hesitant' (28.5%). Healthcare workers with more than 3 years of experience and those in urban areas were significantly more likely to systematically recommend vaccines. Conversely, healthcare workers displaying higher complacency, lower openness to patients, reduced commitment to vaccination, and limited self-efficacy were less consistent in their recommendations. CONCLUSION: While healthcare workers in Senegal demonstrate high vaccine confidence and vaccine recommendation practices, disparities between urban and rural settings highlight the need for targeted interventions. Efforts should focus on enhancing training, resources, and support for healthcare workers in rural areas to address barriers and strengthen vaccine promotion. Future research should explore contextual factors shaping healthcare workers' vaccination attitudes and practices to inform tailored strategies for equitable vaccination uptake.