We have explored the KAP of Nigerians on pandemic and determined that the current state of pandemic preparedness among Nigerian general public requires urgent attention in terms of focused interventions and bolstering public health resilience. Though respondents demonstrated good knowledge of pandemic preparedness, cause-specific awareness about historical and potential causes of future pandemics, such as the Spanish flu, Zika disease, AMR, and highly pathogenic avian influenza, remains relatively low. While 63.6% of respondents expressed satisfactory attitudes toward pandemic preparedness, a significant portion had not participated in community initiatives, half of them had not educated themselves about pandemic preparedness, and many lacked trust in the government's prioritization, felt insufficiently informed, and lacked confidence in the country's economic recovery from future pandemics. Less than half of the respondents had a positive perception of Nigeria's ability to control future pandemics, although they expressed positive views on personal preventive measures and pandemic control policies, with few believing in Nigeria's preparedness for future pandemics. To the best of our knowledge, this study is the first to survey the knowledge gaps, attitudes, and perceptions of Nigerians regarding preparedness for future pandemics.
A noteworthy finding from our study is the prevalence of inadequate knowledge regarding pandemics and preparedness measures among respondents. Despite the high awareness of pandemics in general, particularly in the recognition of recent outbreaks such as COVID-19, the understanding of historical pandemics such as the Spanish flu and emerging threats such as AMR remains alarmingly low. The inadequate knowledge of cause-specific pathogens makes the Nigerian community vulnerable to outbreaks even though awareness and knowledge is there. This deficiency in historical and prospective knowledge underscores the need for targeted educational campaigns aimed at enhancing public awareness and understanding of pandemic dynamics. Though, recent studies have indicated that citizens of various countries have good knowledge of recent pandemics such as COVID-19 [14, 18, 34], emphasis should be placed on the need for Nigerian citizens to be enlightened about past pandemics to create a sense of adequate preparation for future pandemics. A sufficient understanding of pandemics and general health information serves to dispel misconceptions surrounding pandemic situations, heighten awareness of susceptibility to infection risk and bolster self-efficacy in self-protection measures [35–37]. In particular, awareness about AMR and the highly pathogenic avian influenza pandemics is increasing as they present constant re-emergence threats to the world, including Nigeria.
Our observation that most participants exhibited strong awareness of preparedness strategies for future pandemics, including social distancing, personal hygiene, regulated international travel and trade, lockdown policies, and vaccination is expected. This finding is similar to earlier reports in which citizens demonstrated the required level of awareness and preparedness for pandemics [38]. However, more efforts should be made to educate Nigerian citizens on national bodies such as the Presidential Task Force entrusted with the duties to curtail pandemics.
Although most of the respondents (63.6%) in our survey displayed satisfactory attitudes toward pandemic preparedness, a significant portion did not engage in related community initiatives. Not participating in community initiative makes the society leaves the responsibility of pandemic control to health authorities alone, but whole-of-society approach at disease management will engender One Health disease intelligence better. Community initiatives are crucial for pandemic control, fostering collective responses to curb the spread of infectious diseases as they empower communities to promote public health guidelines, provide essential resources, organize vaccination drives, and support vulnerable populations. Strong community infrastructure is a necessary element that has been insufficiently addressed in effective pandemic prevention, preparedness, and response frameworks [39]. Poor community engagement initiatives have led to disastrous events during the Ebola virus disease epidemic in West Africa from 2014–2016 [40]. However, with the COVID-19 pandemic, community engagement was well-utilized during the pandemic resulting in positive outcomes in some LMICs [40, 41]. Through grassroots efforts, communities can disseminate accurate information, combat misinformation, and encourage adherence to preventive measures such as social distancing and hygiene practices. These initiatives promote solidarity, mutual aid, and resilience, ensuring that no one is left behind.
Moreover, our findings revealed a pervasive sense of skepticism and apprehension among respondents regarding the adequacy of preparedness efforts, with a substantial proportion (667/1276) expressing doubts about the government's commitment to prioritizing pandemic preparedness and response. This finding is similar to an earlier report from South American countries [42]. This reflects broader concerns about institutional capacity and efficacy. The lack of confidence in the country's ability to swiftly recover from the economic fallout of future pandemics underscores the interconnectedness of public health and socio-economic resilience. Lack of confidence in the government’s ability to contain disease outbreaks create trust gap, hence self-help and hiding information from government about early outbreaks will become rampant. Addressing these perception challenges demands proactive engagement and advocacy with stakeholders to foster trust, transparency, and accountability in pandemic response strategies [43, 44].
Tertiary education has emerged as a key predictor of better knowledge, attitudes, and perceptions, emphasizing the pivotal role of education in shaping public health literacy and awareness. Similarly, younger respondents exhibit greater levels of knowledge and more positive perceptions than older respondents, suggesting the need for targeted interventions tailored to different demographic segments. Furthermore, variations in perception across different states highlight the importance of contextualizing interventions to address regional disparities and sociocultural nuances in Nigeria. Efforts to strengthen pandemic preparedness should prioritize comprehensive education initiatives targeting diverse demographic groups. However, higher tertiary level education dominating the study may not truly reflect the whole population structure of the country, hence, may not give overall comprehensive outlook of how the whole of society may behave. Possibly a similar study in the more rural areas may have different outcomes, as general health perception may vary by residence [45].
The study is subject to certain limitations, including the cross-sectional design and the reliance on self-reported data, which may be subject to recall bias and social desirability effects. However, we ensured that our methodology was well-structured and included a validated instrument ensuring reliability and depth in understanding Nigerians' knowledge, attitudes, and perceptions regarding pandemic preparedness. The main strength of the research lies in its comprehensive assessment, facilitated by a large and diverse sample size of 1276 respondents across Nigeria. Additionally, adherence to ethical guidelines, contextual relevance, and the identification of significant knowledge gaps further enhance the study's robustness and its potential to inform targeted interventions and policy recommendations for enhancing public health resilience in Nigeria. Future research should adopt longitudinal approaches and incorporate qualitative methods to gain deeper insights into the socio-cultural factors shaping public perceptions of pandemic preparedness. Exploring the role of social media and traditional communication channels in influencing public attitudes can offer valuable insights into effective risk communication strategies.