Lower Educated People Research Articles

BELCOHORT: towards a population-based cohort for health research and policy support in Belgium

Abstract Background In the past decades much progress has been made in Belgium in the development and valorisation of population-based data collections which are directly or indirectly related to health. New surveys have been set up and the use of medico-administrative and environmental data for public health research gained momentum. However, no infrastructure is currently in place to link survey data with existing sources in a longitudinal perspective to address research questions directly relevant to health policy. BELCOHORT is a three-year pilot project aimed at developing a population based cohort enriched with these different data sources. The project is considered as a step towards a large population cohort in Belgium. Methods A first wave of participant recruitment was organized in February 2024 using the Belgian national register as a sampling frame, and 41,153 households were invited (targeted sample of 5000 individuals aged 18-69). A first baseline survey (online and paper) was organized and an annual follow-up is planned. Linkages procedures will be implemented with administrative data and geospatial data on air pollution and green space. The inclusion of data from physical examinations and biological samples will be explored. Results In the first recruitment wave the individual response rate was only 2.5%, leading to a sample of 1,947 participants. The sample showed an under-representation of women (45%), people aged 18-24 years (2%) and low educated people (21%). In total, 23% of participants opted to complete the first baseline questionnaire on paper. Stakeholder meetings have been started to implement the individual and geospatial linkages. Conclusions This project generate insights that will assist in methodological choices in the development of a large population cohort in Belgium. In the second recruitment lessons learned from the first data collection will be used to improve the response rate as well as the participation of under-represented groups. Key messages • This study provides insights on how existing population-based data collections including administrative and environmental data can be valorized in setting up a population cohort. • Recruitment strategies for a population cohort should be tested thoroughly and adapted in order to obtain a well-balanced sample composition.

How did the COVID-19 lockdown affect leisure-time exercise patterns? The case of Spain

This paper explores the effects of the lockdown measures on the population’s exercise patterns and aims to answer three questions: Were lockdown exercise patterns different from the ordinary patterns? What are the variables that explain the difference between ordinary habits and lockdown exercise frequency of participants? What are the correlates of the changes in post-lockdown exercise habits among people who exercised during lockdown? We estimated binary logits for participation and ordered logits to analyse frequency and the changes in sporting habits using the 2020 Spanish Survey of Sporting Habits. Our sample consisted of 5,154 observations, of which 3,060 people exercised at least once a month (59.4%) and 2,178 exercised during lockdown (42.3%). The results show that some determinants of the probability and frequency of exercising lost significance during lockdown. Moreover, women and higher-educated people exercised more frequently during lockdown –comparing to their ordinary habits– and women physically active during lockdown exercised less once mobility restrictions were lifted. According to our results, policy makers should focus their attention on men and lower-educated people in the event of future stay-at-home restrictions. Keywords: Exercise, participation, frequency, lockdown, COVID-19

The effect of the universal two-child policy on the gender wage gap in urban China

Abstract On 1 January 2016, China further relaxed its family planning policy and adopted the universal two-child policy, which allows any Chinese couple to have two children to address the country’s increasingly severe ageing problems and low fertility. With this shift comes a direct and profound impact on society, especially women; this paper evaluates the effect of the universal two-child policy on the gender wage gap and its mechanism. Several major conclusions emerge from this analysis. The policy significantly expands the urban gender wage gap by 12.86% in the low-policy-fertility-rate (PFR) provinces versus high-PFR provinces. Evidently, it increases the gap among younger or lower-educated people. Moreover, the severity of gender discrimination in the labour market after the implementation of the universal two-child policy is rising, and deserves further attention.

Uncovering sociodemographic disparities in temporal trends of osteoarthritis incidence and age-at-diagnosis, 2006-2019.

To describe sociodemographic disparities in temporal trends of incidence and age distributions of first registered osteoarthritis (OA) diagnosis in southern Sweden. We identified all Skåne residents aged 35+ who had lived in the region at any point during the period 2006-2019 with no previous OA diagnosis (ICD-10 codes M15-M19) for 8 years prior to inclusion in the study (n = 849,061). We calculated person-years from inclusion until OA diagnosis, death, emigration, or 31 December 2019, whichever occurred first. Combining sex (female, male), education (low, medium, high) and nativity (Swedish, immigrant), we created a variable with 12 strata. Average annual percent changes in age-standardized incidence rates were estimated using joinpoint regression. Changes in the median age-at-diagnosis (year of diagnosis minus birth year), weighted to the mid-2005 Swedish population, were explored. Cumulative age-standardized incidence rates ranged from 116 (95% CI: 111, 121) per 10,000 person-years for immigrant males with low education to 205 (95% CI: 200, 210) for immigrant females with medium education. The estimated average annual percent changes (ranging from 3.4% to 6.1%) were generally similar, with slightly greater variations among immigrants than Swedes. The weighted median age-at-diagnosis was higher for Swedes and low educated people. Immigrant females with low education were the only stratum with a reduction (3 years) in the weighted median age-at-diagnosis over time. Sociodemographic patterns in knee OA incidence were different from patterns for hip OA. There were few sociodemographic disparities in temporal trends of OA incidence and age-at-diagnosis, suggesting persistent sociodemographic disparities in OA burden in southern Sweden.

Quality of life and psychopathology in different COVID-19 pandemic periods: A longitudinal study.

Τhe aim of this longitudinal study was to investigate the effect of the COVID-19 pandemic on the mental health and quality of life (QoL) of the general population in the region of Attica, Greece, during the third year of the pandemic (2022), and tο compare the findings with those of a survey conducted in the first year (2020). Our sample consisted of 130 participants and the study was conducted through phone interviews. The instruments used were: the World Health Organisation QoL instrument, the Depression-Anxiety-Stress Scale, the Body Vigilance Scale, the Dimensional Obsessive-Compulsive Scale, as well as socio-demographic data and questions on stressors related to COVID-19. The findings of the study were the following: (1) Regarding the comparison of the variables between the first and the third year of the pandemic in the total sample: a) In comparison to the first year, in the third year we observed a significant decrease in negative feelings caused by the pandemic; b) obsessive compulsive (OC) and hypochondriacal symptomatology were significantly reduced, and the fact that participants felt safe following vaccination had a statistically significant effect on this decrease; c) job insecurity was aggravated; d) QoL remained low and even deteriorated in the Environment domain; f) no changes were found in Depression-Stress. (2) Regarding participants who were contaminated, there was a significant increase in negative feelings during the third year of the pandemic. Moreover, QoL decreased in the Physical, Psychological health, Environment domains, as well as in OC symptomatology. (3) Depression-Stress, hypochondriacal symptomatology, and the case of contamination were the predominant factors negatively associated with the dependent variables of QoL. (4) Vaccination was found to contribute to high levels of the QoL Environment domain score. (5) Anxiety, hypochondriacal symptomatology, fear of contamination, and negative feelings seemed to predict OC symptomatology. (6) The most vulnerable groups, in terms of QoL and mental health, were men, older and lower-educated people. Overall, it was found that the negative psychosocial impact of the pandemic persisted, especially on people who had fallen ill during the third year of the pandemic. Therefore, targeted psychotherapeutic interventions should be implemented, especially for those who got infected.

Acceptance of offshore wind farm in Southwest Sardinia in Italy. Do regional energy policies matter?

Purpose The social acceptance of wind energy is increasingly conditioning the Italian Government and regions to authorize the construction of these plants. The proposal of offshore wind farm in the south-west of Sardinia has raised many perplexities both from the marine environmental point of view and from concern about increasing the electricity production in a region that already exports electricity to the peninsula. The purpose of this study is to evaluate what are the factors that most affect the coastal residents’ acceptability of an offshore wind farm. Design/methodology/approach The data is based on a Sardinia-wide in-person survey with about 512 participants in the period between May and June 2023. Respondents were selected randomly from five different locations in Carloforte region. Multiple regression analysis investigates the factors that influenced acceptability to construction and development of offshore wind power plant. Four independent variables were selected in the regression models such as (i) interest towards wind energy, (ii) attitude towards renewable energy production, (iii) perceived regional energy policy and (iv) attitude towards offshore wind farm. The dependent variables are the rates of coastal local residents’ acceptance of offshore wind farm for respondents in five coastal towns. Findings Fishermen and summer tourism operators’ respondents expressed significant reluctance to accept the new project because they perceive a strong risk of environmental impact on both tuna fishing and marine recreational activities in the vicinity. The distance between the turbines at sea and local residents along the coast and surrounding small islands does not have an influence to accept wind energy. The energy policy of the Region of Sardinia, which is perceived by respondents as an expansive energy policy in the production of electricity that exceeds their needs, not being accompanied by a scenario of reducing that from fossil fuels, is the variable that led about 70% of respondents to express a negative opinion towards this project. Research limitations/implications A potential problem associated with the survey is that local response produced sample selection bias. The proportion of respondents with secondary education and no school certificate is quite high. It is possible that respondents who provided valid questionnaires were more low-educated and therefore, the sample may be biased towards lower-educated people. While this does not invalidate the results of this study, it is important to note that the sample was on average less educated than the overall population in Italy. In addition, people with lower incomes were more likely to complete the questionnaires; the results are more representative of a portion of the population with incomes below the national average. Practical implications Results showed how coastal communities are in favour of wind energy within their island, but not within a marine protected area that is considered unique for its beauty and marine ecosystem. Wind energy developers should, before submitting a proposal for an offshore wind farm project, consider among other things the long approval time and understand the activities carried out by local communities and their attachment to those places. Politicians and developers should develop a coherent energy transition policy based on a long-term vision of zero emissions, because according to the findings of this study, it was the regional energy policy that is the most controversial reason for residents to reject the project. Originality/value The contribution of this study is to fill a part of the research gap linking to ongoing energy transitions. In particular, this study analysed for the first time in Italy the acceptability level of an offshore renewable energy project considering the environmental implications and risks in the fragile marine ecosystem of Carloforte waters. This study also made it possible to analyse the impact of the regional energy policy on the acceptability of residents towards the development of offshore wind farms, which is scarcely discussed in the literature.

Development and validation of a nomogram to predict medication risk based on a knowledge, attitude and practice (KAP) survey of residents in Shanxi Province, China.

Unsafe medication practices and medication errors are a major cause of harm in healthcare systems around the world. This study aimed to explore the factors that influence the risk of medication and provide medication risk evaluation model for adults in Shanxi province, China. The data was obtained from the provincial questionnaire from May to December 2022, relying on the random distribution of questionnaires and online questionnaires by four hospitals in Shanxi Province. Multiple linear regression analysis was used to explore the factors affecting the KAP score of residents. Univariate and multivariate logistic regression was used to determine the independent risk factors, and the nomogram was verified by receiver operating characteristic curve, calibration and decision curve analysis. A total of 3,388 questionnaires were collected, including 3,272 valid questionnaires. The average scores of drugs KAP were 63.2 ± 23.04, 33.05 ± 9.60, 23.67 ± 6.75 and 33.16 ± 10.87, respectively. On the evaluation criteria of the questionnaire, knowledge was scored "fair", attitude and practice were scored "good". Sex, monthly income, place of residence, insurance status, education level, and employment were regarded as independent risk factors for medication and a nomogram was established by them. Males, low-income, and low-educated people are important factors affecting the risk of medication. The application of the model can help residents understand the risk of their own medication behavior and reduce the harm of medication.

Prostate cancer mortality temporal trend in Brazil

Prostate cancer (CaP) is the second most common malignant tumor among men in Brazil and represents a significant factor in mortality when diagnosed late. Studies on mortality are relevant sources for understanding the epidemiological profile and measuring the importance of PCa as a public health problem. The objective was to describe the distribution and temporal trends of the mortality rate in different age groups (30 to 80 years or more) in Brazil between the years 2011 - 2020. The research has a quantitative and analytical character, through the collection of mortality data in the Mortality Information System (SIM) of the Ministry of Health (SIM/MS/DATASUS). The mortality rate due to malignant prostate neoplasia was calculated annually, considering age range, and then arranged in simple dispersion data. According to the analyses, it was observed that the incidence of prostate cancer was 95.17% in individuals over 60 years of age, highlighting the age group of 80 years or more in which it was 44%. Furthermore, the mortality rate prevailed in white ethnic groups, with low education and married people. Among the years analyzed, the period with the peak in mortality was in 2017, representing 29.25%. Furthermore, a linear decline in PCa mortality rates was evidenced in all age groups between 2011 and 2020. However, there was a higher prevalence of deaths from the sixth decade of life onwards, with emphasis on the population over 80 years. And, it was possible to observe a lower number of deaths among individuals aged 30 to 59 years.

O.4.5-3 Trend in sedentary behaviour in the Netherlands

Abstract Purpose Prolonged sedentary behaviour has been associated with a higher risk of cardio-vascular diseases and premature death. The general recommendation is to interrupt long periods of sitting. The aim of this study was to investigate trends in sedentary behaviour among (subgroups of) the Dutch population. Methods Data from the Additional module Physical activity and Accidents of the Dutch Lifestyle Monitor was used, which includes a representative sample of the Dutch population aged 4 years and older. Sedentary time was measured in the years 2015, 2017, 2019 and 2021, using an adjusted version of the Marshall questionnaire. Sitting domains were: 1) traveling, 2) at work, 3) at school or studying 4) watching television, 5) using a computer/smartphone at home, and 6) otherwise. Trends in sedentary time on an average day of the week, in total and per domain, were analysed for the total Dutch population and stratified by different background characteristics using univariate and multivariate linear regression analysis. Results A positive (i.e. increasing) trend over time was seen in the number of hours spent sitting, i.e. from 8.7 hours in 2015 to 9.1 hours in 2021 (p = 0.003). In the following groups this trend was more increasing compared to other groups of the particular background characteristic: women, older age groups (65- to 79-year-olds and people over 80), lower educated people, people with an household income in the 2nd quintile, partners in a couple with or without children living at home, paid workers working ≥32 hours per week, people in good health, overweight and obese persons, people who did not meet the Physical Activity Guidelines, and people who did not exercise weekly. These trends were mostly seen in the domains: at school or studying, watching television, and other leisure time activities. Conclusions Our study showed an increasing trend between 2015 and 2021 in sedentary behaviour in several groups of the Dutch population of 4 years and older. These results provide possible starting points for future policy, but can also be used as a benchmark for other studies of sedentary behaviour among different target groups.

When Women’s Work Disappears: Marriage and Fertility Decisions in Peru

Abstract This paper studies the gendered labor market and demographic effects of trade liberalization in Peru. To identify these effects, we use variation in the exposure of local labor markets to import competition from China based on their baseline industrial composition. On average, the increase in Chinese imports during 1998–2008 led to a persistent decline in the employment share of low-educated female workers but had smaller and transitory effects on the employment of low-educated men. In contrast to the predictions of Becker’s model of household specialization, we find that the increase in import competition during this period increased the share of single low-educated people and decreased their marriage rates. There is little evidence that import competition affected fertility decisions. The results highlight the role of gains from joint consumption in marriage formation.

The Effect of Family Economy on Education Opportunities (Analysis of the Impact of Parents' Irregular Income on Millennial Children's Educational Opportunities in the DKI Jakarta Area)

We certainly often hear that poverty and education are two things that are closely interrelated, the terms poor because uneducated and uneducated because poor have always been endless discourses. Every parent certainly wants the future fate of their children to be much better than himself, so children's education is part of the parents' pledge regardless of their educational background. It is in this context that the interests of parents often clash with policies even though policies are made with the aim of helping children get a good education. This study intends to elaborate on the issue of educational opportunities for children of families with irregular income in Jakarta who tend to be vulnerable and must get priority from the government.
 This research uses a type of qualitative descriptive research with a case study approach that occurs throughout the DKI Jakarta Province with a focus on parents of school-age children (12 - 18 years) with a background of irregular income (PTT).
 The results showed that family economic factors often become an obstacle to children's education, although it also cannot automatically be mentioned that family economic factors correlate significantly with their children's educational opportunities, uncertain economic conditions of parents also often prevent their children from getting the opportunity to receive education well, especially for low-educated people who are often passive So that the government's efforts to help children's education costs through a series of stimulation programs are often not on target and sometimes trapped in administrative rules that actually eliminate their rights. In terms of opportunities, children of highly educated parents are more likely than children of low-educated parents even though their economies are the same.

Intersectional approach of everyday geography

Hour-by-hour variations in spatial distribution of gender, age and social class within cities remain poorly explored and combined in the segregation literature mainly centred on home places from a single social dimension. Taking advantage of 49 mobility surveys compiled together (385,000 respondents and 1,711,000 trips) and covering 60% of France’s population, we consider variations in hourly populations of 2572 districts after disaggregating population across gender, age and education level. We first isolate five district hourly profiles (two ‘daytime attractive’, two ‘nighttime attractive’ and one more ‘stable’) with very unequal distributions according to urban gradient but also to social groups. We then explore the intersectional forms of these everyday geographies. Taking as reference the dominant groups (men, middle-age and high educated people) known as concentrating hegemonic power and capital, we analyze specifically whether district hourly profiles of dominant groups diverge from those of the others groups. It is especially in the areas exhibiting strong increase or strong decrease of ambient population during the day that district hourly profiles not only combine the largest dissimilarities all together across gender, age and education level but are also widely more synchronous between dominant groups than between non-dominant groups (women, elderly and low-educated people). These intersectional patterns shed new light on areas where peers are synchronously located over the 24-hour period and thus potentially in better position to interact and to defend their common interests.

Change of human flourishing during the COVID-19 pandemic in Japan: Results from population-based U-CORONA study

Longitudinal change in flourishing during the pandemic of COVID-19 would provide new insight to reveal determinants of well-being. We aimed to describe changes in flourishing during the COVID-19 pandemic in Japan and to examine the association of sex, age, education, and income with changes in flourishing. Utsunomiya COVID-19 seROprevalence Neighborhood Association (U-CORONA) study conducted in October 2020 and November 2021 was used (n = 419 in 2020 and n = 478 in 2021, and n = 327 for both waves). Flourishing was assessed using a 12-item multidimensional flourishing scale including six domains. Change of flourishing was categorized into decreased, unchanged, and increased. Multinomial logistic regression was applied to longitudinal data to estimate the relative risk ratio of increase and decrease in flourishing scores. Cross-sectional analysis showed that the mean score of flourishing was approximately seven in both waves, with no sex differences, but older adults had higher scores than young-aged adults. We found that men were twice as likely to lose their flourishing scores as women and lower levels of education were associated with 2–3 times declining flourishing scores than higher levels of education. Age and income were not significantly associated with the change of flourishing. During the COVID-19 pandemic, flourishing declined, and men and lower-educated people were more vulnerable. In prolonged difficult situations, support for men and less educated people may contribute to the prevention of declining well-being in Japan.

Senior Citizen’s Understanding Regarding the Quality of Life and Policy of Bangladesh

Older people are encouraged to participate more in the economic, social, and governmental sectors as part of progressive aging policies worldwide. Very little is known about applying engagement techniques or carrying out strategies in Bangladesh that are important for involving seniors in social engagement. Therefore, this qualitative research was conducted in Dhaka, Bangladesh, among 385 people aged sixty or above to assess their understanding of the quality of life and the gap in government policy. Results showed that between 60 and 65 were more mobile, creative, engaged in productive activity, and had significantly higher decision-making power (p<0.000). Aging greatly enhances dependency (p<0.000). Lower-educated people were significantly dependent on their families (p<0.000). Moreover, elderly income and the cost of treatment were significantly correlated to abuse (p<0.001). Furthermore, 10% of participants reported negative relationships with family members (p<0.031). However, most (61.6%) were unaware of the 2013 Parent's Care Act. Though most participants (73.2%) knew of the government-funded Old Age Allowance, 92.5% received no non-governmental assistance. The research concluded that education and economic condition have a long-term relationship with reducing dependency. In recommendation, Government can increase the retirement age from 59 to 65 years which may increase self of security, respect, and self-esteem and reduce harassment. Parent's Care Act 2013 should implement. Government should include Community Health and Social Service centers for the quality of life of the elderly.

Justice Matters. News Framing Effects on Opinions about Pension Reform

Abstract As aging populations put pressure on pension systems worldwide, pension reforms have dominated the (political) agenda in many countries for years. The media are essential information providers on such hotly debated issues. By selecting and highlighting certain aspects of an issue and glossing over others, also known as framing, news media can propagate a particular interpretation of the issue to the public. This study therefore approaches pension reform from the perspective of the media by examining how news frames of pension reform (i.e., responsibility frame and justice frame) influence how citizens perceive and respond to pension reform. Findings of an online survey-embedded experiment (N = 762) show that citizens who encountered a news frame that emphasized individual or collective responsibility for pensions showed a stronger preference for this type of responsibility; however, this effect was only positive if news media also framed individual or collective responsibility for pensions as just. In fact, exposure to an unjust frame leads to more negative attitudes toward the specific form of responsibility. Regarding individual differences, lower-educated people are more strongly impacted by the responsibility frame than higher-educated people. The strength of framing effects did not differ among citizens of different ages or levels of solidarity, nor between citizens who received the frames via their primary mode of news use and the ones exposed to a less preferred mode of news use. This study shows the importance of news framing in shaping citizens’ attitudes toward pension reforms, suggesting that media coverage matters in the public debate on pensions.

Situational analysis of syphilis cases taking place between 2015 and 2021 in the state of Rio Grande do Norte - Brazil

Introduction: Syphilis is a sexually transmitted infection that represents a severe public health problem worldwide and in Brazil it has not been different. The national compulsory notifications regarding syphilis cases are significantly increasing, and therefore, this fact alone justifies the study of such a relevant subject. Objective: This work presents a situational analysis of syphilis cases in the state of Rio Grande do Norte, Brazil, between 2015 and 2021, aiming primarily at assisting public healthcare authorities in decision-making processes to cope with the disease. Concomitantly, this research aims to build knowledge as well as to provide awareness to the population. Methods: This study analyzed data from compulsory notifications reports from 2015 to 2021, available in the database of the Brazilian Unified Health System’s Informatics Department, in the Brazilian Information System of Notifiable Diseases and in the Brazilian Health Surveillance Secretariat. Results: In the state, 70% of patients with syphilis are aged 15 to 39 years. The rate of patients affected with acquired syphilis that have low education is 48%, and for pregnant women, this value rises to 77%. The declared mixed-race patients represent 48% of notifications for acquired syphilis, and for mixed-race pregnant women, this value increases to 60%. In congenital syphilis, 98% of compulsory notifications occurred for children aged up to 7 days of birth. Conclusion: Syphilis in Rio Grande do Norte is a public health problem that mainly affects the vulnerable population, predominantly the groups at risk with low education, mixed race, and young-adult people, being of paramount importance to combat the disease through population awareness, as well as through constant and adequate compulsory notification.

Does the COVID-pandemic affect the educational and financial inequality in weekly sport participation in the Netherlands?

ABSTRACT This paper explores the impact of the COVID-pandemic on educational and financial inequality in level of weekly sport participation in the Netherlands. Restrictions due to the COVID-pandemic resulted in several barriers for people to continue sport participation. Lower educated people and individuals with financial problems are expected to have relatively few resources to adapt to the COVID restrictions, and therefore, more likely will decrease their level of weekly sport participation. Using high-quality data from the Dutch Longitudinal Internet Studies for the Social Sciences (LISS) panel, we are able to compare individual sport behaviour before and during the COVID-pandemic. Our findings suggest that the level of weekly sport participation of lower educated people and individuals with financial problems decreased more strongly during the COVID-pandemic. This implies that indeed the COVID-pandemic resulted in increasing educational and financial inequality in sport participation. With these results, our study contributes to a body of knowledge on the broader societal impact of COVID on issues of social exclusion. It may also inform policymakers to critically assess and intensify sport promotion policies directed at vulnerable groups in society.

Partial de-annuitization of public pensions vs. retirement age differentiation: Which is best to account for longevity differences?

AbstractExtensive research by demographers and economists has shown that longevity differs across socio-economic status (SES), with low-educated or low-income people living, on average, shorter lives than their better-endowed and wealthier peers. Therefore, a pension system with a unique retirement age is a priori problematic. The usual policy recommendation to address this problem is to differentiate the retirement age by SES. This paper explores the relative merits of partial de-annuitization of public pensions as a way of addressing the (imperfectly assessed) inequality of longevity.

AN ANALYSIS OF SOCIO-DEMOGRAPHIC AND CULTURAL FACTORS ON COVID-19 MEASURES IN THE REGION VICTIM OF OUTREACH OF EBOLA DISEASE: EVIDENCE FROM NORTH KIVU PROVINCE OF THE DEMOCRATIC REPUBLIC OF THE CONGO.

Public health measures have been identified as a preventive strategy for influenza pandemics. However, there is no insight related to the role that play socio-demographic, cultural, geographical distance, psychological, behavioural factors towards the low COVID-19 measures. In order to fill this gap in the existing literature review, the present article has used a random sample of 2123 people living in North Kivu, logistic and multiple linear regression to investigate, analyze and assess the effects of socio-demographic, socio-cultural, geographical distance, psychological, behavioural factors that are driving the COVID-19 vaccine in the Province of Nord Kivu, that was victim of the outreach of Ebola and pandemic of COVID-19. The results revealed that there was a low adherence of COVID-19 measures, female had 39% (95% CI (0.47;0.79]) decrease to adhere to COVID-19 measures compared to male. Those with age group above 15-24 had higher odds (AOR=3, 95% CI (1.31;5.59]) to adhere to COVID-19 measures than those with age group of 15-24. People with high education had higher odds (AOR=2, 95% CI (0.95;5.53]) to adhere to COVID-19 measures than those with no education. The odds of COVID-19 measures of rural residence occurring decreased by 98% (95% CI (0.06;0.061]) compared to urban residence. Catholic church believers were majority to adhere to COVID-19 measures compared to other churches, geographical distance, psychological, behavioural affect adherence to COVID-19 measures at 30.5%. The results from this study inform policymakers and health system to engage with sensitization, communication and training as strategies for increasing the adherence to COVID-19 measures among females, young and low educated people and both leaders of churches and communities.

D DO SOCIO-DEMOGRAPHIC AND SOCIO-CULTURAL FACTORS IMPACT ON COVID-19 VACCINATION UPTAKE IN NORTH KIVU PROVINCE?

The Sustainable Development Goals three (SDG3) highlighted that immunization impacts directly on health and it does contribute to 14 out of the 17 Sustainable Development Goals (SDGs), such as ending poverty, reducing hunger, and reducing inequalities especially in low and middle-income countries. However, there is no insight related to the role that play by socio-demographic, cultural, geographical distance, psychological, behavioural factors towards the low COVID-19 vaccination uptake. In order to fill this gap in the existing literature review, this paper has used random sample of 2123 people living in North Kivu, logistic and multiple linear regression to investigate, analyze and assess the effects of socio-demographic, geographical distance, psychological, behavioural factors that are driving the COVID-19 vaccine in the Province of Nord Kivu, which province was victim of outreach Ebola and pandemic of COVID-19. The results revealed that males were likely to adhere to COVID-19 vaccine than females, old people were 4 times to adhere to COVID-19 vaccine compared to young people and the high educated people were 3 times to adhere to COVID-19 vaccine than people with low education, catholic church believers were majority to adhere to COVID-19 vaccine compared to others churches, geographical distance, psychological, behavioural affect adherence to COVID-19 at 30.5%. The results from this study inform policymakers and health system to engage with sensitization, communication and training as strategies for increasing the adhere to COVID-19 vaccine among females, young and low educated people and leaders of churches and communities.