This minireview provides a summary of the main findings, features, as well as limitations and gaps in the current epidemiologic research on COVID-19 vaccine hesitancy (VH) in Pakistani population. For this purpose, data on VH studies were extracted from January 2020 to October 2021, using a systematic review and meta-analysis approach. Literature review and other narrative studies were excluded. There exists a significant heterogeneity in the reported vaccine hesitancy in the population (pooled estimates from random-effects meta-analysis: 35% (95% CI, 28–43%). However, none of the co-variables included in the studies explained the observed variance/heterogeneity in the moderator analysis models. In this minireview and critical appraisal of current VH research, we conclude that an in-depth analysis of COVID-19 vaccine hesitancy in a representative sample of Pakistani population is crucial to measure the magnitude of VH as well to explore and identify the determinants of VH in Pakistani population. This is an important step toward informing intervention and policy design and to address this issue at its root cause. To this end, focused, methodologically robust and hypothesis-driven VH research is needed using a wide range of co-variables to support a detailed coverage of the individual and environmental level VH attributes.
Background
Cross-cultural competence is widely regarded to play an important role in being able to deliver appropriate and effective health care to patients with different backgrounds, race, gender orientation and cultural beliefs. This study aims to assess how medical students feel about their comfort, knowledge, and skill level in handling a diverse patient population using a validated questionnaire.
Methods
This study was carried out over a period of three weeks from July 5th to July 26th of 2021, in the Aga Khan University Hospital, Karachi, Pakistan. All medical students who fulfilled the eligibility criteria and gave informed consent were included in the study. A modified version of the Harvard cross-cultural care survey was used to assess the medical students’ comfort, knowledge and skill level in a variety of circumstances related to patients with different backgrounds and cultures. Descriptive statistical analysis of the questionnaire items was carried out. We reported frequencies and percentages for gender and year of study. For the questionnaire items, we reported mean, assuming that our Likert scale had equivariant intervals. Furthermore, multivariate analysis between demographics and themes was carried out. A p-value of < 0.05 was taken as statistically significant.
Results
It was found that students of year 5 considered themselves more knowledgeable, comfortable and skilled in dealing with patients of different backgrounds, religions and beliefs compared to students of year 1 and had a higher average score in all of these categories which was statistically significant. Additionally, students who believed it is extremely important to practice medicine with a diverse patient population also had the highest averages in perceived knowledge, comfort and skills in dealing with patients of different sociocultural backgrounds compared to students who believed it wasn’t important at all.
Conclusion
This is a first of its kind study in a private medical university in Pakistan and highlights the students’ self-assessment of their competence when caring for patients from different backgrounds. This study can be used as a reference study in the region to carry out further studies and to assess and improve the gaps in medical training being provided.
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