Submission ID 130929
| Issue/Objective | Digital health is increasingly positioned as a solution to improve access, efficiency, and equity in health systems. In Kenya, rapid digital transformation aligns with national and global priorities for Universal Health Coverage. However, limited attention has been paid to how governance gaps, structural inequalities, and rights protections shape lived experiences of digital healthand the hidden social, economic, and safety costs required to stay connected. The study examined the upstream determinants influencing digital health access, safety, and equity among marginalized young people, and their implications for rights-based governance. |
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| Methodology/Approach | As part of a 2023-2025 four-country initiative, this study utilized Transnational Participatory Action Research (T-PAR), centering marginalized communities as knowledge co-creators and contributors to policy-relevant insights. In Kenya, 109 young people (ages 18-30) from Nairobi, Mombasa, Kitui, and Migori participated. The cohort included young women, people living with HIV, sex workers, and LGBTQ+ individuals. The study was co-designed with the Kenya Community Advisory Team, a 12-member youth advisory group. Data were collected through focus group discussions, key informant interviews, and in-depth interviews to explore digital access, use, and experiences of harm. |
| Results | Access is dictated by intersecting barriers such as poverty, gender inequality, and criminalization. High costs for data and devices force trade-offs against basic needs, while phone sharing frequently compromises privacy. Participants reported widespread technology-facilitated abuse-including blackmail and non-consensual data sharing-compounded by limited awareness of rights and lack of effective reporting mechanisms. Family and community exposure were identified as greater privacy risks than state surveillance. Despite existing data protection laws, implementation gaps in health services erode trust and lead some users to disengage from digital platforms entirely to avoid harm. |
| Discussion/Conclusion | The findings illustrate that social inequalities and power dynamics are deeply embedded in digital health systems. Without targeted policy intervention, digital transformation may exacerbate exclusion rather than reduce it. Advancing health equity requires strengthening data protection enforcement, recognizing technology-facilitated abuse as a public health priority, and investing in equitable access and digital empowerment. Institutionalizing meaningful and sustained community participation in governance is critical. This study underscores that rights-based digital health governance is essential to ensuring that no one is left behind. |
| Presenters and Affiliations | Simon Ondiek KELIN James Kiilu KELIN |
