Beyond Digitisation: Making Digital Health Truly Accessible to the Population

Written by: Aminu Muhammad Bello

Introduction

Every morning, nurses, community-health workers and patients across Sub-Saharan Africa log into digital health platforms, open mobile apps, or reboot electronic health-record systems. They do this believing that simply switching from paper to digital will solve long-standing problems: missing records, delayed diagnoses, poor communication, and inefficient referrals.

Yet the truth is more uncomfortable and urgent: digitisation alone rarely transforms health outcomes when populations remain unable to access or use these digital tools.

The numbers don’t lie. According to the most recent data from the International Telecommunication Union (ITU), only about 38% of Africa’s population used the internet as of 2024 – the lowest rate among all global regions. Meanwhile, in rural areas the digital gap remains stark: whereas urban Internet penetration approached 57% in 2024, rural access lagged at just 23%.

What this means in practice: a digital health app deployed in Lagos or Nairobi may never reach a mother in rural Kano or a pregnant woman in a remote village – not because the app is bad, but because the infrastructure, access, and context are missing.

Beyond connectivity, issues of device cost, unstable electricity, poor network quality, limited digital and health literacy, and lack of supportive policy frameworks conspire to keep large segments of the population offline and underserved.

As a result, many “digitised” health systems remain ghosts — assets on paper or on servers, but invisible to the communities that need them most.

So here’s the challenge we face: How do we move from simply digitising health systems to making digital health truly accessible, equitable, and useful to every person — urban or rural, rich or poor?

This article argues that accessibility must be the central metric of success. We must address the structural, socioeconomic, and cultural barriers that prevent real-world usage — before we claim victory for digital health.

To do so, we must change not just our technology, but our mindset: from “digital health deployment” to “digital health inclusion.”

In the sections that follow, we unpack four core barriers to accessibility, make the case for a new “digital impact” mindset, and propose practical pathways to ensure that digital health tools fulfill their promise — not for some, but for all.

The Four Barriers of Accessibility

1. Infrastructure Accessibility: The Foundation That Fails Too Many

Digital health only works when the infrastructure behind it works.

Across Africa, clinics and communities still struggle with unstable electricity, weak mobile networks, and low device penetration. These structural gaps block people from accessing even the most basic digital health tools.

According to the African Digital Transformation Strategy, more than 300 million Africans live in areas without reliable broadband—a reality that instantly excludes them from most digital health innovations.(African Union Strategy)

Even where networks exist, power supply remains a threat. Health workers report losing patient data during outages, abandoning telemedicine mid-consultation, or waiting hours to charge devices. The WHO’s Digital Health Strategy notes that inconsistent electricity and connectivity remain the leading barriers to digital health in low-resource settings. Digital health cannot scale when basic infrastructure collapses under it. Until we design offline-first, low-bandwidth, and battery-efficient solutions, digital health will continue to benefit only those who already have access — not those who need it most.

2. Literacy Accessibility: When Digital Tools Outpace Human Skills

Technology moves fast, but people learn at their own pace.Digital health tools fail when the intended users – patients and frontline health workers – cannot understand, navigate, or trust them. A recent study in BMC Digital Health shows that limited digital literacy and low health literacy significantly reduce the adoption of digital health tools in Africa, even when technology is available (BMC Digital Health Study)

Examples are everywhere:

Patients abandon apps they cannot read or navigate.

Health workers revert to paper because digital interfaces feel complex.

Communities mistrust platforms that use unfamiliar languages or technical jargon.

If users cannot understand the tool, they cannot benefit from it. To improve accessibility, we must design tools with simple interfaces, voice instructions, local languages, and user-centred methods that meet people where they are. Digital health becomes accessible when the most digitally inexperienced person can use it confidently – not just the tech-savvy few.

3. Financial Accessibility: When the Cost of Access Becomes a Barrier

Digital health often assumes that users own smartphones, can afford data plans, or can pay subscription fees. For millions of low-income individuals, these assumptions are unrealistic. The ITU reports that mobile broadband remains unaffordable for a large proportion of the African population, with data prices consuming a significant share of monthly income (ITU Africa Digital Development Report 2025).

When a patient must choose between data and food, digital health becomes a luxury. When a health worker must use personal airtime to run digital platforms, adoption drops. When clinics must pay recurring software fees, systems go offline. True accessibility requires that digital health be designed as a public good, not a private commodity.

Strategies like zero-rating, government subsidies, donor-supported access, and low-cost device programs can significantly reduce financial barriers. Digital health should not widen inequality; it should close it.

4. Cultural & Trust Accessibility: The Human Side of Digital Adoption

Even the best digital health tool collapses when people do not trust it. Trust determines whether communities adopt or reject digital solutions – especially in healthcare. The WHO notes that concerns about privacy, stigma, cultural norms, and data misuse often limit digital health uptake (WHO Digital Health Atlas Reference)

Communities may ask:

Who owns my data?

Will the government monitor me?

Will this replace my local nurse?

Is this culturally appropriate?

Health workers may fear job loss, surveillance, or being replaced by AI-based tools. Patients may distrust automated decision systems they do not understand. Digital health becomes accessible only when we build trust, transparency, and cultural relevance into every layer of technology design. This means:

engaging community leaders
explaining data protection in clear language
ensuring cultural sensitivity
positioning digital tools as support, not replacement, for human care.

The Digital Impact Mind Shift

Digitisation is no longer Africa’s biggest challenge, impact is.

We have reached a point where building more apps, dashboards, and telemedicine portals does not automatically translate into better health outcomes. The problem is not innovation; the problem is misalignment. Digital health succeeds only when it aligns with the realities, behaviours, and constraints of the people it intends to serve.

To make digital health accessible, we must shift from a technology-first mindset to an impact-first mindset.

1. From “Build It” to “Make It Work in Real Life”

Many digital health projects focus on features, platforms, and interfaces — but forget the lived realities of end users. A maternal-health app may have excellent functionality, but it fails if the only woman who needs it lives in a community with no electricity to charge her phone.

The new mindset forces innovators to ask:

Can this survive the real conditions of rural clinics, crowded cities, low-bandwidth environments, and low-income households?

Impact begins when digital health adapts to reality, not when reality is forced to adapt to digital health.

2. From “Scaling Technology” to “Scaling Trust”

Trust is the true currency of digital health adoption. Communities don’t embrace digital tools because they are new; they embrace them because they feel safe, understood, and respected. A digital tool becomes accessible only when the patient believes:

their data is protected,
the system is not replacing their doctor,
the technology respects their culture,
and the tool genuinely helps them.

The impact mindset places trust-building at the centre of digital health strategy — not as an afterthought.

3. From “Digital Infrastructure” to “Human Infrastructure”

We often invest heavily in servers, software, and connectivity — but invest very little in the human beings who will actually run these tools. A well-designed digital system fails instantly when the health worker operating it lacks training or confidence. The impact mindset recognises that frontline health workers, community volunteers, and patients are the true infrastructure of digital health.

Technology becomes accessible when humans feel empowered to use it.

4. From “Adoption Metrics” to “Outcome Metrics”

Many digital health programmes measure success by:

number of downloads
number of registered facilities
number of active users

But these metrics are misleading. A downloaded app that no one opens is not a success. A pilot project that ends after six months is not transformation. The impact mindset demands that we measure what truly matters:

Are we diagnosing earlier?
Are we reducing hospital visits?
Are patients adhering to treatment?
Are health workers making safer decisions?
Are communities healthier?

Impact is not digital for its own sake; it is digital that improves lives.

5. From “Innovation Excitement” to “Inclusive Design”

Too many digital health solutions are created in boardrooms, research labs, or global conferences — far away from the communities they are meant to serve. The impact mindset mandates co-creation with real users: pregnant women, farmers, market traders, community health workers, elderly patients, low-income families.

We create accessible digital health only when the people on the ground help shape the tools designed for them.

6. From “Technology Ownership” to “Community Ownership”

Digital health becomes sustainable when communities see it as their solution, not as an external project “brought” to them.

Ownership builds continuity.
Continuity builds adoption.
Adoption builds impact.

The impact mindset shifts power from developers to communities — ensuring tools remain relevant long after pilots, donors, or grants end.

How Rwanda Made Digital Health Accessible Through the Babyl–RSSB Partnership

Rwanda offers one of Africa’s strongest examples of what happens when a country moves beyond simply digitising health systems and instead designs digital health around access, affordability, and equity. In 2020, the Rwandan government—through the Rwanda Social Security Board (RSSB)—partnered with Babyl, a digital telemedicine provider, to bring primary healthcare directly to citizens using basic mobile phones. The country did not just deploy a digital tool; it built an ecosystem that allowed people to use it easily and affordably, regardless of their socioeconomic status.

At the heart of the system is a simple principle: healthcare must be accessible by default. Rwanda operationalised this principle by integrating Babyl into its national health insurance scheme (Mutuelle de Santé). This integration allowed insured individuals to pay a heavily subsidised consultation fee—just 200 Rwandan francs (less than $0.20)—making digital consultations one of the most affordable primary care options in the region. By reducing the cost barrier, the government ensured that telemedicine would not become a luxury service but a tool for mass adoption.

Conclusion

Digital health will not transform Africa simply because we deploy apps, dashboards, or electronic records. Transformation happens when digital solutions remove the barriers that prevent people from accessing care in the first place. Many populations still face challenges such as limited connectivity, low digital literacy, financial constraints, and a deep mistrust of technology in clinical settings. Until we confront these obstacles directly, digitisation will remain a surface-level change that benefits only a small segment of society.

The reality is clear: accessibility is the true measure of digital health success. When digital tools reach the most underserved populations—those in rural areas, informal settlements, and low-income groups—we move from digitising health systems to democratising them. Rwanda’s Babyl–RSSB model demonstrates that inclusive design, affordability, and system integration can scale digital health rapidly when they are built into policy and practice. The rest of the continent can learn from such intentional, equity-driven strategies.

Digital health is not only about technology; it is about public health, behaviour change, trust-building, and designing systems that reflect real human needs. As Africa accelerates its digital transformation agenda, the next wave of innovation must prioritise people before platforms. When we build for accessibility, digital health becomes a catalyst for stronger systems, healthier populations, and resilient communities.

Recommendations

To move beyond digitisation and make digital health truly accessible, stakeholders—including policymakers, health organisations, digital health innovators, and communities—should prioritise the following:

1. Design for Low-Tech Environments

Digital health solutions must work on basic feature phones, USSD, SMS, or low-bandwidth platforms. High-tech apps should complement—not replace—low-tech options. This approach ensures no population is left out because of device limitations or poor internet access.

2. Integrate Digital Solutions into National Health Financing

Affordability is essential. Governments and insurers should integrate telemedicine, e-pharmacy services, and digital triage platforms into national health insurance schemes. Subsidised digital consultations, as seen in Rwanda, can dramatically increase uptake.

3. Build Trust Through Standards and Data Governance

Trust remains a major barrier. Governments must establish and enforce clear frameworks for data protection, consent, and clinical safety. Transparent policies build public confidence and encourage both providers and patients to adopt digital tools.

4. Invest in Digital Literacy for Health Workers and Communities

Health workers need digital training just as much as patients. Continuous capacity-building programs—through in-service training, community health worker education, and school curricula—will increase adoption and improve quality of care.

5. Prioritise Interoperability Across Health Systems

Digital tools must talk to each other. Ministries of Health should enforce interoperability standards to avoid fragmented systems. When platforms share data securely across facilities, patients enjoy smoother continuity of care.

6. Co-create Solutions with Local Communities

Communities must shape the design of digital tools. Co-creation ensures cultural relevance, builds trust, and helps developers solve actual pain points rather than theoretical problems. Community insights are essential for long-term sustainability.

7. Encourage Public–Private Partnerships

Digital health thrives when governments, startups, telecom operators, and donors collaborate. Partnerships can accelerate innovation, expand reach, and reduce costs for end users.

8. Implement Pilot Programs Before Scaling

Pilot studies allow stakeholders to test solutions, refine them with user feedback, and generate evidence for scale-up. Well-designed pilots reduce failure rates and increase the chance of adoption across entire health systems.