Digital health for shared value: A critique of legal infrastructures in a post-colonial context

Abstract The promise of digitalisation in achieving Universal Health Coverage in postcolonial contexts is undermined by the realities of insufficiently resourced public healthcare systems. In response, private health insurance is often seen as essential to healthcare delivery. The provision of this private health insurance is increasingly mediated through digital infrastructures, with providers leaning into the promise of data-driven behavioural economics to provide better and more efficient services. While an increasing number of studies focus on digital health, in this paper, we particularly focus on the less-explored question of how datafication – under the veil of shared value, and enabled by forms of legal access – reproduces inequalities. Using the case study of Discovery, a financial services company in South Africa providing health insurance, we analyse how a social value and data-driven behavioural economic model of health insurance commodifies health and wellness. We argue that legal infrastructures are central to this commodification. Through a socio-legal critique of digital health, our article makes an original contribution to broader debates on enduring postcolonial social inequalities by illustrating how infrastructural injustice manifest through datafication.