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Background <p>Digital healthcare platforms (DHPs) hold transformative potential for bridging healthcare gaps in resource-constrained settings. However, their adoption is hampered by ethical concerns and distrust. This study investigates how perceptions of transparency, health data security, and ethicality influence adoption intentions.</p> Method <p>We analyzed survey data from 240 primary healthcare recipients in Tanzania using a two-wave, time-lagged design. Data were analyzed using partial least squares structural equation modeling (PLS-SEM) to test the direct and mediated relationships between the ethical constructs and adoption intention.</p> Results <p>Both perceived transparency (β = 0.27, <i>p</i> &lt; 0.01) and health data security (β = 0.30, <i>p</i> &lt; 0.01) significantly influenced adoption intention. Perceived ethicality was the strongest predictor (β = 0.32, <i>p</i> &lt; 0.01) and explained how transparency and security influence intention, indicating that users interpret these features as signs of an ethical platform.</p> Conclusions <p>For DHPs to succeed in low-resource contexts, they must be perceived as ethical. Developers should prioritize user-friendly, transparent designs and offline features, while policymakers should establish clear data governance rules. Focusing on ethics is key to ensuring DHPs improve healthcare access for all.</p>

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Beyond functional utility: ethical stewardship as a driver of digital healthcare platform adoption in low-resource settings

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月16日

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  • James Cosmas Kalulu,
  • Min Wang

摘要

Background

Digital healthcare platforms (DHPs) hold transformative potential for bridging healthcare gaps in resource-constrained settings. However, their adoption is hampered by ethical concerns and distrust. This study investigates how perceptions of transparency, health data security, and ethicality influence adoption intentions.

Method

We analyzed survey data from 240 primary healthcare recipients in Tanzania using a two-wave, time-lagged design. Data were analyzed using partial least squares structural equation modeling (PLS-SEM) to test the direct and mediated relationships between the ethical constructs and adoption intention.

Results

Both perceived transparency (β = 0.27, p < 0.01) and health data security (β = 0.30, p < 0.01) significantly influenced adoption intention. Perceived ethicality was the strongest predictor (β = 0.32, p < 0.01) and explained how transparency and security influence intention, indicating that users interpret these features as signs of an ethical platform.

Conclusions

For DHPs to succeed in low-resource contexts, they must be perceived as ethical. Developers should prioritize user-friendly, transparent designs and offline features, while policymakers should establish clear data governance rules. Focusing on ethics is key to ensuring DHPs improve healthcare access for all.