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Impact of Hepatitis B Education on Hepatitis B Vaccination Uptake among Healthcare Workers in Nigeria

Abstract

Hepatitis B virus (HBV) infection is an important global and occupational public health concern, particularly among healthcare workers who may be exposed to infected blood and other potentially infectious body fluids during clinical practice. Healthcare workers may face occupational risks through needlestick injuries, sharps injuries, exposure to blood or body fluids, and other healthcare procedures. Hepatitis B vaccination is an important preventive measure for reducing the risk of HBV infection among healthcare workers. Hepatitis B education provides healthcare workers with information about HBV transmission, occupational risk factors, signs and symptoms, complications, vaccination benefits, recommended vaccination schedules, post-exposure measures, and infection prevention practices. In Nigeria, incomplete vaccination, inadequate knowledge, concerns about vaccine safety, cost and availability, limited occupational health services, and poor follow-up may contribute to suboptimal hepatitis B vaccination uptake among healthcare workers. Effective hepatitis B education may improve healthcare workers' knowledge, risk perception, confidence in vaccination, and willingness to initiate and complete the recommended vaccination schedule. Against this background, this study investigates the impact of hepatitis B education on hepatitis B vaccination uptake among healthcare workers in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding healthcare workers' decisions to receive hepatitis B vaccination. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping preventive health behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from hepatitis B education may influence vaccination practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how hepatitis B education may influence vaccination uptake among healthcare workers in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from healthcare workers in selected public and private healthcare facilities in Nigeria using a structured self-administered or interviewer-administered questionnaire and, where feasible, vaccination record verification. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, departments, and eligible healthcare workers. Where feasible, selected healthcare facilities or participants will be assigned to intervention and comparison groups. Healthcare workers in the intervention group will receive structured hepatitis B education covering HBV transmission, occupational exposure risks, signs and symptoms, complications, hepatitis B vaccination, recommended vaccination schedules, vaccine safety and effectiveness, post-exposure management, and standard infection prevention practices. Vaccination uptake will be assessed using indicators such as vaccination initiation, number of doses received, completion of the recommended vaccination schedule, and timely receipt of subsequent doses where applicable. Where feasible, self-reported vaccination status will be verified using vaccination cards, occupational health records, or facility immunization records. Descriptive statistics will be used to summarize healthcare workers' sociodemographic and occupational characteristics, hepatitis B knowledge, exposure to hepatitis B education, and vaccination uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple logistic regression analysis, will be employed to determine the impact of hepatitis B education on vaccination uptake. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and the robustness of the findings. The study anticipates that hepatitis B education will have a significant positive impact on hepatitis B vaccination uptake among healthcare workers in Nigeria. Healthcare workers exposed to structured hepatitis B education are expected to demonstrate improved knowledge of HBV transmission and occupational risks and greater willingness to initiate and complete hepatitis B vaccination. Education may increase perceived susceptibility, clarify the benefits and safety of vaccination, reduce misconceptions, and encourage timely completion of the vaccination schedule. However, education alone may not guarantee vaccination uptake because healthcare workers may continue to face barriers such as vaccine cost, limited vaccine availability, workload, difficulty accessing occupational health services, inadequate institutional support, and poor follow-up systems. Consequently, hepatitis B education is expected to be most effective when combined with accessible and affordable vaccination services, workplace vaccination programmes, adequate vaccine supply, occupational health policies, and effective monitoring of vaccination status. This study is expected to contribute to the literature on hepatitis B prevention, occupational health, healthcare worker safety, immunization, infectious disease prevention, health education, and public health in Nigeria by providing empirical evidence on the impact of hepatitis B education on vaccination uptake among healthcare workers. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention (NCDC), National Primary Health Care Development Agency (NPHCDA), state ministries of health, hospitals, primary healthcare facilities, occupational health departments, healthcare worker professional associations, public health practitioners, and policymakers regarding strategies for improving HBV prevention among healthcare workers. The study will also provide evidence-based recommendations for strengthening hepatitis B education, establishing routine workplace vaccination programmes, improving access to affordable hepatitis B vaccines, maintaining accurate vaccination records, strengthening occupational health services, and promoting complete vaccination among healthcare workers across Nigeria.

Keywords: Hepatitis B education, hepatitis B vaccination uptake, healthcare workers, hepatitis B virus, occupational health, vaccination, infectious disease prevention, health education, immunization, healthcare worker safety, public health, Nigeria.