Community acceptability of public health measures during the COVID-19 pandemic in Malawi: A cross-sectional survey of Knowledge, Attitudes and Practices

Abstract Background Global experts estimate that in the absence of intervention, Coronavirus disease 2019 (COVID-19) will result into 40 million deaths globally and this burden is likely to be more pronounced in low-income settings. The knowledge, attitudes and practices of people during this pandemic is pivotal to uptake of recommended preventative strategies. This paper describes the Malawian knowledge, attitudes and practices related to COVID-19 and associated public health measures. Methods This was a multi-site cross-sectional survey where qualitative data was collected in nine Malawian districts over 3 weeks (5–25 October 2020), 6 months after the first confirmed COVID-19 case. A total of 521 participants (> 18 years) were enrolled to answer a questionnaire delivered through interviews. Results We found that all respondents were aware of the ongoing COVID-19 pandemic with the majority using the Radio as their main information-source. 75% of participants displayed knowledge of all key symptoms of COVID-19 (cough, fever and shortness of breath) and in addition to this knowledge, the majority of participants (97%) knew enough to take some sort of intervention (calling a COVID hotline or visiting the nearest hospital) if they developed symptoms. Participants also demonstrated a high perception of risk of COVID-19, where > 60% of participants believed to be susceptible to the coronavirus under the current preventative measures and > 50% believed they would die from infection. Communities displayed a high perceived effectiveness of all preventative measures, with “hand hygiene using soap and water” being perceived as effective by the majority of respondents. Although the majority of the participants (> 80%) were willing to self-isolate at home, various barriers to home-isolation were raised which would ultimately influence their ability to do so. Conclusion Baseline community psychosocial and behavioral information which influences the adoption of new COVID-19 public health measures in Malawi has been highlighted alongside recommendations for best practices.