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Older women traditionally influence infant health decisions in African communities, yet their contribution to reducing vaccine hesitancy is insufficiently understood. This narrative study explored perceived reasons for hesitancy and the methods used by older women in seven Ibadan slum communities using 22 focus group discussions with 175 participants, analysed via the WHO SAGE 3 Cs model and related determinants. Findings show limited vaccine knowledge and low priority, access barriers such as long clinic waits and stockouts, and confidence challenges including mistrust, healthcare attitudes, misconceptions, and prior negative experiences. Older women addressed hesitancy through community mobilization, religious leader engagement, individual-level advocacy, and supporting trust in qualified health personnel, highlighting their potential as key resources for improving vaccine uptake through formal inclusion in immunization programs.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/grandmothers-as-gatekeepers-the-role-of-older-women-in-addressing-vaccine-hesitancy-in-urban-slum-communities-in-ibadan-nigeria/445082/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/grandmothers-as-gatekeepers-the-role-of-older-women-in-addressing-vaccine-hesitancy-in-urban-slum-communities-in-ibadan-nigeria/445082.png","ImageObject",300,407,{"name":92,"@type":93},"dhado","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-05","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the purpose of this study in Ibadan urban slum communities?","Question",{"text":112,"@type":113},"To explore perceived reasons for vaccine hesitancy and the approaches older women use to address it in selected urban slum communities in Ibadan, Nigeria.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was vaccine hesitancy analysed in the study?",{"text":117,"@type":113},"Data from 22 focus group discussions with 175 older women were analysed using the WHO SAGE “3 Cs” model (complacency, convenience, confidence) and a vaccine hesitancy determinant matrix.",{"name":119,"@type":110,"acceptedAnswer":120},"What roles did older women play in addressing vaccine hesitancy?",{"text":121,"@type":113},"They used community mobilization, engaged religious leaders, advocated at the individual level, and supported trust in qualified health personnel.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},445082,1790764012,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},5909893218464,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","OPEN ACCESS  \nCitation: Balogun FM, Omobowale OC (2026)“Grandmothers as gatekeepers”: The role of older women in addressing vaccine hesitancy in urban slum communities in Ibadan, Nigeria. PLOS Glob Public Health 6(1): e0005786 .  \n[https://doi.org/10.1371/journal.pgph.0005786](https://doi.org/10.1371/journal.pgph.0005786)[ ](https://doi.org/10.1371/journal.pgph.0005786)[Editor:](Editor: Bipin Adhikari)[ Bipin Adhikari](Editor: Bipin Adhikari), University of Oxford, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND  \nReceived: July 25, 2025  \nAccepted: December 17, 2025  \nPublished: January 6, 2026  \nCopyright: © 2026 Balogun, Omobowale. This is an open access article distributed under the terms of the Creative Commons Attribution  License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.  \nData availability statement: The data set for this study can be found in Mendeley Data, V1, [https://data.mendeley.com/datasets/](https://data.mendeley.com/datasets/)[ ](https://data.mendeley.com/datasets/)[hyp5npbw9y/1](hyp5npbw9y/1.)[.](hyp5npbw9y/1.)  \nRESEARCH ARTICLE  \n“Grandmothers as gatekeepers”: The role of older women in addressing vaccine hesitancy in urban slum communities in Ibadan, Nigeria  \nFolusho Mubowale Balogun1,2*, Olubukola Christianah Omobowale2,3  \n1 Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria, 2 University College Hospital, Ibadan, Nigeria, 3 Department of Community Medicine, Faculty of Clinical Sciences, University of Ibadan, Ibadan, Nigeria  \n* [folushom@yahoo.com](folushom@yahoo.com)  \nAbstract  \nVaccine hesitancy is responsible for the resurgence of vaccine-preventable diseases in Nigeria due to suboptimal immunization as seen in urban slums. Older women are traditionally influential in infant health decision-making in African communities; however, their roles in addressing vaccine hesitancy remain underexplored. This study explored the perceived reasons for vaccine hesitancy and methods employed by older women to address vaccine hesitancy in selected urban slum communities in Ibadan, Nigeria. Narrative study design was adopted, and 22 focus group discussions were conducted with 175 older women from seven urban slum communities. Content analysis was used to analyze the data using the World Health Organization Strategic Advisory Group of Experts on Immunization (SAGE)‘3 Cs’ model of vaccine hesitancy (complacency, convenience, confidence) and vaccine hesitancy determinant matrix. Perceived causes of vaccine hesitancy included poor knowledge about the importance of vaccines, parental nonchalance, low vaccination priority (Complacency), long clinic waiting times and vaccine stockouts (Convenience), mistrust of volunteers, poor healthcare workers’ attitude, immunization misconceptions, and previous negative experiences (Confidence) . Older women addressed vaccine hesitancy through community mobilization, engagement with religious leaders, advocacy at the individual level, and by supporting trust in qualified health personnel. The older women demonstrated significant potential as key resources for addressing vaccine hesitancy. Leveraging their roles by formalizing their involvement in immunization programs could enhance the vaccination uptake in urban slum communities. Also, the existing approaches for handling vaccine hesitancy can be standardized to improve vaccination uptake.  \nPLOS Global Public Health | [https://doi.org/10.1371/journal.pgph.0005786](https://doi.org/10.1371/journal.pgph.0005786) January 6, 2026 1 / 14  \nFunding: This project was supported in whole by the Bill and Melinda Gates Foundation under the Grand Challenge Explorations [OPP1190834 to FMB] . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.  \nCompeting interests: The authors have declared that no competing interests exist.  \nIntroduction  \nVa","cbCaioEWT3L4A9a0","https://ap.wps.com/l/cbCaioEWT3L4A9a0","pdf",341970,14,"English","# Abstract\n# Introduction","[{\"question\":\"What was the purpose of this study in Ibadan urban slum communities?\",\"answer\":\"To explore perceived reasons for vaccine hesitancy and the approaches older women use to address it in selected urban slum communities in Ibadan, Nigeria.\"},{\"question\":\"How was vaccine hesitancy analysed in the study?\",\"answer\":\"Data from 22 focus group discussions with 175 older women were analysed using the WHO SAGE “3 Cs” model (complacency, convenience, confidence) and a vaccine hesitancy determinant matrix.\"},{\"question\":\"What roles did older women play in addressing vaccine hesitancy?\",\"answer\":\"They used community mobilization, engaged religious leaders, advocated at the individual level, and supported trust in qualified health personnel.\"}]","Grandmothers as Gatekeepers - The Role of Older Women in Addressing Vaccine Hesitancy in Urban Slum Communities in Ibadan, Nigeria | PDF",1790710246,35]