Awareness, Acceptability, and Willingness to Pay for the R21/Matrix-M Malaria Vaccine: A Cross-Sectional Study Among Pregnant Women and Nursing Mothers Living in Enugu State, Nigeria

OBJECTIVES: This study assessed the awareness, acceptability, and willingness to pay (WTP) for the R21/Matrix-M malaria vaccine among pregnant women and nursing mothers in Enugu State, Nigeria.

METHODS: This was a prospective cross-sectional study that was carried out in three selected centres (2 in Nsukka and 1 in Enugu city) in Enugu and included pregnant and nursing mothers. The study instrument was a validated 30-item questionnaire with four domains that included sociodemographic details, awareness, acceptability, and WTP questions. The WTP was assessed using the contingent valuation method. Descriptive statistics were used to summarise the characteristics of the study variables. A logistic regression model was used to determine the predictors of WTP for the vaccine, with the significance level set at p ≤ 0.05.

RESULTS: Among the 310 participants included in this study, most were aged 22–33 years 232 (75.0%), and had at least one child aged 3 years and below 180 (58.1%). Also, the majority of the participants were not aware of the R21/Matrix-M malaria vaccine 262 (84.5%), accepted to vaccinate their child 292 (94.2%), and were willing to pay for the vaccine 262 (79.7%). The reported mean and median maximum WTP values were US$0.82 ± 1.41 (₦639.27 ± 1097) and US$0.38 (₦300), respectively. Health insurance (OR: 0.417, 95% CI: 0.19–0.92) was a predictor of WTP.

CONCLUSIONS: This study found poor awareness but a high acceptance of the vaccine; hence, more awareness must be created for wide vaccine coverage. The participants were also willing to pay for the R21/Matrix-M malaria vaccine with health insurance predicting WTP.