Knowledge, perceived benefits, perceived concerns, and predisposition to use telehealth services in Mogadishu, Somalia: A cross-sectional survey

Abstract

Introduction: Telehealth offers a promising route to expand access to care in low-resource settings such as Somalia, but community readiness remains poorly characterized. This study assessed knowledge, perceived benefits and concerns, and predisposition to use telehealth among adults in Mogadishu. Methods: We conducted a 6-month cross-sectional survey in Mogadishu (December 2024 to May 2025) using convenience sampling in community settings and online. A forward–backward translated questionnaire captured sociodemographic data and four composite scores. Nonparametric tests compared median scores across groups, and Spearman's rank correlations assessed associations among outcomes. Results: We analyzed 423 eligible responses. Scores indicated moderate knowledge and perceived benefits, consistently high concerns, and modest predisposition to use telehealth. Knowledge was higher among participants with university education, employment, and better self-rated health, and showed a very weak inverse association with predisposition. Previous telehealth users reported higher perceived benefits, which increased with intention to use telehealth. Predisposition was higher among unemployed participants and those with previous telehealth use. Perceived concerns were high across all subgroups. Knowledge showed a very weak positive association with concerns, while perceived benefits were positively associated with both concerns and predisposition, with small effect sizes. Conclusion: Mogadishu residents had moderate knowledge and interest in telehealth but persistent concerns about reliability, quality, and data privacy. Education, employment, and prior exposure shaped attitudes, yet greater knowledge did not necessarily increase adoption. Targeted digital literacy, user-centred pilot programmes, and clear safety and privacy regulations are needed to realise the promise of telehealth in Somalia.