Digital Health, Development and Social Exclusion: DHIS2 and HIV Prevention Among Adolescent Girls, Young Women and Key Populations

The dominant philosophy guiding digital health studies on interventions is that of ‘equity’ of healthcare services. This study takes on a different approach, that of equity of health, basing on a capability lens, which sees equity as a differential phenomenon, and extends this to technology development and implementation. This is particularly fitting in contexts where the focus is on populations who have traditionally been exposed to disparities in healthcare due to stigma and discrimination. The study follows an initiative which sought to promote uptake of health services by socially excluded members of society. The initiative was aimed at implementing digital health technologies to support adolescent girls, young women, and key populations in Zimbabwe. This study sought to understand the role digital health plays, and can play, in addressing the problems of social justice, and particularly health equity, in the context of socially deprived groups. It discusses the phenomenon in relation to emerging conceptualisations of health equity which go beyond utilitarian perspectives that focus on the distribution of healthcare services. The study does this by complementing conceptual ideas from Amartya Sen’s capability approach, with those from Shoshana Zuboff’s smart machine perspective. This helps to trace the specific ways in which technology is implicated in development and, specifically, social justice and equity.