Key factors influencing intention to use Digital Health Systems among healthcare workers in Malawi

Abstract

Introduction
Digital Health systems (DHS) have the potential to strengthen healthcare delivery, yet their adoption remains limited in many low- and middle-income countries. Despite progress in digital health implementation, Malawi continues to face challenges related to effective use of DHS. This study investigates the key factors influencing healthcare workers’ intention to use DHS in Malawi.
Methods
This was a cross-sectional quantitative design that used a structured questionnaire to collect data from a sample of 615 healthcare workers across Malawi. Factor analysis and reliability testing were conducted to assess construct validity and internal consistency.
Multiple linear regression was used to identify factors influencing intention to use DHS, while generalized structural equation modelling (GSEM) examined relationships involving categorical variables.
Results
The results indicated that healthcare workers’ intention to use DHS is influenced by several factors including, perceived ease of use (β= 0.358, p <0.001), perceived usefulness (β = 0.284, p = 0.001), job relevance (β = 0.274, p = 0.001) and subjective norms (β = 0.127, p<0.001). These findings suggest that healthcare workers are more likely to use DHS when they perceive them as useful, relevant to their daily work, easy to use, and are supported by their peers. In contrast, computer anxiety indicated a significant negative effect (β = −0.061, p = 0.001), suggesting that higher levels of computer anxiety reduce the likelihood of DHS use. Demographic and contextual factors, including gender, age, and education level were not significant factors influencing DHS.
Conclusion
These findings highlight the importance of aligning digital health systems with healthcare workers’ job roles, ensuring system usability, and leveraging social influence to promote adoption. Addressing computer anxiety through targeted training and capacity building may also enhance digital confidence and sustained system use.