Understanding Covid-19 Vaccine Hesitancy in Africa: A Systematic Review of Sociocultural Beliefs, Trust in Health Systems, and Misinformation Dynamic

COVID-19 vaccine hesitancy became a major challenge affecting vaccination efforts acrossAfrican countries during the COVID-19 pandemic.This systematic review examined sociocultural beliefs, trust in health systems, and misinformation dynamics influencing vaccine hesitancy across Africa.The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Electronic databases including PubMed, Scopus, Web of Science, Google Scholar, African Journals Online (AJOL), and ScienceDirect were searched for studies published between 2020 and 2026.Additional reports were obtained from the World Health Organization (WHO), United Nations Children's Fund (UNICEF), and Africa Centres for Disease Control and Prevention (Africa CDC).Studies addressing COVID-19 vaccine hesitancy among African populations were included.A total of 286 records were identified, with 38 studies meeting the inclusion criteria after screening and eligibility assessment.The review revealed that vaccine hesitancy across Africa was driven by multiple interconnected factors including misinformation spread through social media, mistrust in governments and healthcare systems, sociocultural and religious beliefs, fear of vaccine side effects, and concerns regarding vaccine safety.Misconceptions related to infertility, hidden political agendas, and harmful effects of vaccines were frequently reported.Healthcare worker hesitancy, poor public health communication, and socioeconomic inequalities further contributed to low vaccine confidence in several African settings.The review concludes that improving vaccine uptake in Africa requires culturally sensitive communication strategies, strengthened institutional trust, effective misinformation control, and stronger community engagement to improve confidence in future vaccination programs.