e-Health Literacy and Female Health Workers’ Readiness in Low-Resource Crisis Settings: The Mediating Role of Self-Efficacy

Background/Objectives: Low-resource economies face acute shortages of healthcare workers and digital health skills. This digital divide impedes the successful implementation of e-health technologies and quality healthcare services by female health workers. This study examines the relationship between e-health literacy and readiness to use digital health technologies among female health workers in Malawi, with self-efficacy mediating the relationship in a low-resource healthcare context. The study aims to generate evidence to inform targeted capacity-building interventions, strengthen health workers’ digital readiness, and support more accessible, effective, and equitable healthcare delivery. Methods: A cross-sectional quantitative research design was employed, using structured questionnaires administered to 251 female health workers. Direct and mediating relationships were examined using structural equation modelling (SEM). Results: Findings showed that e-health literacy positively influenced readiness (β = 0.731, t = 4.416, p < 0.001) and self-efficacy (β = 1.061, t = 7.814, p < 0.001) among female health workers. Self-efficacy also positively affected readiness (β = 0.274, t = 2.250, p = 0.024). Mediation analysis confirmed a significant indirect effect of e-health literacy on readiness through self-efficacy (β = 0.291, 95% CI [0.162, 0.432], p < 0.001), indicating partial mediation. Conclusions: Theoretically, the study highlights the interplay among social cognitive, technology readiness, and expectancy theories in the context of a low-resource crisis; practically, it offers evidence to inform the design of digital capacity-building interventions for healthcare workers.