Evaluating a National Chatbot Deployed by the Ministry of Health in Malawi during the COVID-19 Pandemic: A Retrospective Data Analysis (Preprint)

BACKGROUND Malawi, was one of the pioneering countries across Africa to implement a coordinated government-led effort to streamline COVID-19 support with digital health tools. In response to the pandemic, a COVID-19 WhatsApp chatbot was developed to enable citizens to self-register as potential cases, report symptoms, and access essential information OBJECTIVE This study evaluates the national cross-intervention use of the WhatsApp chatbot during the COVID-19 pandemic in Malawi. METHODS A retrospective analysis examined user engagement with key chatbot functions, while a time-series analysis compared trends in COVID-19 cases with access patterns to both the chatbot and the call center of the Emergency Operations Center (EOC) and Chipatala Cha Pa Foni (CCPF), offering insights into public interaction throughout the pandemic RESULTS The chatbot was accessed 818,426 times, with 70% of validated WhatsApp accesses focused on COVID-19 statistics. Chatbot usage patterns closely aligned with COVID-19 case trends, particularly during the first and second pandemic waves, and surged after social lockdown events. Throughout the pandemic, the chatbot experienced 38% downtime, the most prolonged period coinciding with the national vaccine rollout in 2021, which required the addition of vaccine-related functionalities. Following this expansion, the chatbot received 198 COVID-19 vaccine-related rumors and recorded 644 accesses to vaccine frequently asked questions. CONCLUSIONS The chatbot’s adaptability in meeting emerging needs, such as providing real-time COVID-19 statistics and vaccine information, demonstrates its value as an effective digital health tool during a rapidly evolving pandemic