Community acceptability of public health measures during the coronavirus pandemic in Malawi: a cross-sectional survey of knowledge, attitudes, and practices

BACKGROUND: The knowledge, attitudes, and practices (KAP) of people during the coronavirus pandemic are pivotal to the uptake of recommended preventative strategies. OBJECTIVE: This paper describes the Malawian KAP related to coronavirus and associated public health measures. METHODS: This was a multi-site cross-sectional survey where data was collected through personal one-on-one interviews in nine Malawian districts over 3 weeks (5-25 October 2020). 521 participants (>18 years) were enrolled to answer a questionnaire. RESULTS: We found that all respondents were aware of the ongoing coronavirus pandemic with the majority using the Radio. 75% of participants displayed knowledge of all key symptoms of coronavirus disease (cough, fever, and shortness of breath) and additionally, the majority of participants (97%) knew enough to take some sort of intervention (calling a hotline or visiting the nearest hospital) if they developed symptoms. Participants also demonstrated a high perception of the risk of coronavirus, where >60% believed to be susceptible to the coronavirus under the current preventative measures, and >50% believed they would die from the 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. CONCLUSIONS: Baseline community psychosocial and behavioral information which influence the adoption of public health measures in Malawi has been highlighted alongside recommendations for best practices.