Who Gets Left Behind? A Systematic Review of Marginalized Populations in Africa’s Digital Health Ecosystem
1
Public Science, University of Calabar, Calabar, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Africa’s digital health revolution is often celebrated for its innovation, yet beneath the headlines lies a quieter truth: not everyone is being carried forward. Rural communities, women, people with disabilities, and displaced populations remain at the margins of this transformation. While mobile apps and telemedicine platforms promise universal access, primary research has largely focused on technical feasibility, leaving equity outcomes underexplored.
OBJECTIVE:
This review poses a vital question: Who gets left behind?. Evidence was synthesized on how digital health innovations in Africa address or fail to address the needs of marginalized populations, and explore pathways toward inclusive innovation aligned with global health standards.
METHODS:
Guided by PRISMA protocols, PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar were searched for studies published between 2010 and 2025. Eligible studies examined digital health interventions in African contexts with attention to equity, inclusion, or marginalized groups. Data were extracted on populations, interventions, outcomes, and barriers, and analyzed thematically.
RESULTS:
Thirty two studies met inclusion criteria. Hackathons and mobile health apps showed promise in maternal health and literacy, yet rural adoption remained limited by infrastructure gaps. Women’s access was constrained by cultural norms and affordability, while disability inclusion was rarely addressed in design. Refugees and migrants were almost invisible in the literature. Across studies, equity outcomes were inconsistently measured, revealing a critical blind spot in primary research.
CONCLUSIONS:
Africa’s digital health ecosystem is expanding, but its benefits are unevenly distributed. Marginalized populations continue to face barriers that prevent full participation. To reach global health standards, innovation must be inclusive by design, embedding equity metrics, accessibility features, and policies that prioritize the most vulnerable. Without this shift, digital health risks reinforcing the very disparities it seeks to overcome.
Africa’s digital health revolution is often celebrated for its innovation, yet beneath the headlines lies a quieter truth: not everyone is being carried forward. Rural communities, women, people with disabilities, and displaced populations remain at the margins of this transformation. While mobile apps and telemedicine platforms promise universal access, primary research has largely focused on technical feasibility, leaving equity outcomes underexplored.
OBJECTIVE:
This review poses a vital question: Who gets left behind?. Evidence was synthesized on how digital health innovations in Africa address or fail to address the needs of marginalized populations, and explore pathways toward inclusive innovation aligned with global health standards.
METHODS:
Guided by PRISMA protocols, PubMed, Scopus, Web of Science, African Journals Online, and Google Scholar were searched for studies published between 2010 and 2025. Eligible studies examined digital health interventions in African contexts with attention to equity, inclusion, or marginalized groups. Data were extracted on populations, interventions, outcomes, and barriers, and analyzed thematically.
RESULTS:
Thirty two studies met inclusion criteria. Hackathons and mobile health apps showed promise in maternal health and literacy, yet rural adoption remained limited by infrastructure gaps. Women’s access was constrained by cultural norms and affordability, while disability inclusion was rarely addressed in design. Refugees and migrants were almost invisible in the literature. Across studies, equity outcomes were inconsistently measured, revealing a critical blind spot in primary research.
CONCLUSIONS:
Africa’s digital health ecosystem is expanding, but its benefits are unevenly distributed. Marginalized populations continue to face barriers that prevent full participation. To reach global health standards, innovation must be inclusive by design, embedding equity metrics, accessibility features, and policies that prioritize the most vulnerable. Without this shift, digital health risks reinforcing the very disparities it seeks to overcome.
| eISSN: | 2654-1459 |
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