The present study explored healthcare worker preparedness for snakebite management in selected hospitals in Zambia and identified important deficiencies in training, protocol utilization, and awareness of national management guidelines. These findings contribute to the growing body of evidence highlighting healthcare system challenges affecting snakebite management in sub-Saharan Africa.

A key finding was the limited access to formal snakebite management training. More than one-third of participants reported never having received any training related to snakebite management [5,9,11,17,21]. Similar findings have been reported in several African countries where healthcare workers frequently encounter snakebite patients but receive little or no formal instruction on diagnosis, antivenom administration, and management of complications [7,22]. Inadequate training has been associated with inappropriate first aid recommendations, delayed administration of antivenom, and inconsistent clinical management practices. These gaps can contribute to incorrect initial treatment, weak adherence to clinical protocols, and poor referral decisions, all of which may worsen patient outcomes. Strengthening pre-service and in-service training for healthcare workers is therefore essential to improve the quality and consistency of snakebite care [13–15,23–25].

Despite these training deficiencies, most participants reported high levels of confidence in managing snakebite patients. This finding suggests a potential mismatch between perceived preparedness and actual preparedness [5,26]. Similar observations have been reported in studies conducted in Nigeria, Kenya, Uganda, and Ghana, where healthcare workers often relied on experiential learning acquired through clinical practice rather than structured professional training. This pattern suggests that snakebite care capacity in these settings may depend heavily on informal workplace learning, which can contribute to variation in knowledge, first aid advice, and treatment decisions [27]. While confidence can enhance decisiveness and clinical responsiveness, excessive confidence in the absence of sufficient evidence-based knowledge may predispose clinicians to inappropriate management decisions and medical error [28–30].

The study also identified poor awareness and utilization of clinical guidance documents. Less than one-third of participants reported using local snakebite treatment protocols, while only a minority had seen the most recent national guidelines [22,31]. Clinical guidelines are essential for standardising patient management, promoting evidence-based practice, and reducing unnecessary variation in care. They are systematically developed to support clinical decisions, translate research into practice, and improve the consistency and quality of care across patients and settings [32–34]. Limited dissemination and implementation of guidelines have been identified as major barriers to effective snakebite management in many low-resource settings [1,5]. The findings suggest that guideline development alone is insufficient unless accompanied by targeted dissemination strategies, training activities, and supportive supervision [7,22].

The relatively high proportion of participants who reported recent exposure to snakebite patients indicates that snakebite remains a clinically relevant condition within participating facilities [3,22]. Consequently, strengthening healthcare worker preparedness has the potential to improve patient outcomes and contribute to broader national efforts aimed at reducing snakebite-related morbidity and mortality. The WHO snakebite roadmap emphasises healthcare worker capacity building as a critical pillar for improving access to safe and effective treatment [1]. The present findings therefore support ongoing efforts to strengthen clinical capacity within Zambia’s health system.

Taken together, the study highlights the need for a comprehensive approach to healthcare worker capacity development. Such an approach should include pre-service training, continuing professional development, routine mentorship, dissemination of national guidelines, and periodic competency assessments [22,31]. These interventions could contribute significantly to improving the quality and consistency of snakebite care in Zambia.

The observed knowledge gaps in this study suggest an urgent need to strengthen dissemination and implementation of national snakebite management guidelines throughout Zambia’s health system. Integrating structured in-service training into continuing professional development programmes and ensuring the routine availability and use of standardised treatment protocols could improve adherence to evidence-based management. Regular mentorship and supportive supervision may further reinforce appropriate clinical practice and enhance the quality of snakebite care.

Future research should employ larger, nationally representative samples and incorporate objective clinical scenarios or direct observation to assess healthcare worker competence beyond self-reported knowledge. Additional implementation research is also needed to identify organisational, contextual and behavioural barriers to guideline uptake and participation in training programmes.

Several limitations should be considered when interpreting the findings. First, the study involved a small purposively selected sample of healthcare workers from seven hospitals and may not be representative of all healthcare workers in Zambia. Second, the study relied on self-reported information, which may be subject to recall bias and social desirability bias. Third, the study assessed perceived preparedness rather than objective clinical competence and therefore could not determine whether reported confidence translated into appropriate clinical practice. Finally, the exploratory design limits the generalisability of findings beyond the participating facilities.