Abstract
INTRODUCTION/OBJECTIVES: Digital health literacy (DHL) is increasingly recognised as a core competency for frontline health workers in digitalising health systems, particularly in resource-constrained settings. This study examined how Tanzanian primary care workers understand and apply DHL, as well as the contextual factors that influence its development and use. METHODS: A qualitative descriptive design was used. In-depth interviews were conducted with 30 health workers, including nurses, clinical officers, and community health workers, from urban and rural public primary healthcare facilities in the Dodoma region. Data were analysed thematically using Braun and Clarke's framework, supported by NVivo 15. RESULTS: Three main themes emerged: (a) varied conceptualisations of DHL, ranging from basic operational use to applied understanding for clinical decision-making and patient education; (b) DHL's influence on data quality, care continuity, and patient communication; and (c) disparities shaped by infrastructure, cadre, training access, and organisational culture. Rural staff and community health workers reported lower DHL and less access to support. CONCLUSIONS: Improving DHL requires not only technical training but also ongoing mentorship, supportive organisational cultures, and equity-focused strategies. Tailored interventions are needed to build DHL capacity across all cadres and facility levels.