The increasing digital transformation in public organisations, particularly within the public health sector, has facilitated smooth and bidirectional communication with stakeholders, enhancing the dissemination and reception of critical health information. However, emerging digital technologies have also exacerbated the spread of health misinformation. Researchers and practitioners recognise misinformation as an obstacle undermining public health work during the COVID-19 pandemic, particularly in countries with fragile healthcare infrastructures. This study examines socio-cultural factors influencing health misinformation in Ethiopia and Liberia during the COVID-19 pandemic. Using an online survey of 211 experts and the PLS-SEM analysis technique, we found that mistrust in institutions, cultural beliefs, community dynamics, and language barriers significantly contribute to the spread of misinformation. Furthermore, health literacy was found to mitigate the impact of misinformation, except in instances involving language barriers. The findings provide insights for developing contextually relevant strategies to combat misinformation in developing countries with fragile healthcare systems.