JMIR Publications

ABSTRACT

Background:

Digital surveillance systems are increasingly recognised as essential tools for enhancing early outbreak detection, reporting, and response, especially in low-resource settings. The COVID-19 pandemic unveiled the critical role of digital health surveillance systems in timely detection, monitoring, and response to public health threats. However, successful implementation depends on public knowledge, acceptance, and willingness to participate. Limited evidence exists on how the public perceive and interact with digital surveillance in Malawi.

Objective:

The aim of the study was to assess the knowledge, attitudes, and practices of adult Malawians towards digital surveillance during pandemics and epidemics.

Methods:

A cross-sectional quantitative study design was employed. Data was collected in the ten selected districts (Chitipa, Mzimba South, Kasungu, Lilongwe, Salima, Balaka, Thyolo, Phalombe, Blantyre, and Chikwawa) of Malawi which had high and low Cholera and COVID-19 disease burden. The survey recruited 1,174 participants who were 18 years and above at the time of data collection. Descriptive statistics were employed using R statistical software. Ethical approval was obtained from the National Health Sciences Research Committee prior to data collection.

Results:

A total of 1174 participants were surveyed, 65% were females, and the median age was 36.9 years (SD = 14.26). Only 59% demonstrated awareness of digital surveillance systems, though 51% had smart phones and 41% used mobile phones. A positive attitude was observed in 89% of respondents, with most believing digital reporting could improve outbreak control. 80% were confident with privacy and data security. Practices related to digital reporting were low, with only 18% having ever reported health symptoms through any digital platform.

Conclusions:

Enhancing digital health surveillance literacy, promoting inclusivity and ensuring accountability will improve readiness for future pandemics through digital surveillance systems. Hence the need for nationwide community sensitization programs to raise awareness about the benefits of digital health surveillance.