Understanding digital health needs: a qualitative study to explore urban and peri-urban user experiences and challenges in strengthening digital health services in Bangladesh

Abstract Background Bangladesh is moving toward digitizing its healthcare system through internet-based services, telemedicine, and mobile health platforms. Despite various digital health initiatives and supportive policies, uptake remains limited. This study applies the digital inclusion framework to examine how access, skills, content, inclusive design, and enabling environments influence the use of digital health platforms, particularly for sensitive services such as sexual and reproductive health and rights (SRHR). Methodology This qualitative study followed a participatory action research (PAR) approach. Data were collected through 26 in-depth interviews and 18 focus group discussions with young adults (18–35 years), including persons with disabilities and gender-diverse individuals. Thematic analysis was guided by the digital inclusion framework, structuring inquiry around access to technology, digital skills, content relevance, inclusive system design, and supportive policy environments. Ethical approval was obtained from the BRAC James P Grant School of Public Health (IRB-19 March ’23 − 009). Results Fewer than half of participants (44%) reported positive experiences with digital health platforms, while most lacked awareness or the skills to use them effectively. Key barriers included limited access to private devices, low digital literacy, insufficiently tailored content for marginalized groups, cost (29%), and privacy concerns (64.5%). Knowledge of digital health laws and user rights was limited. These findings reveal persistent gaps across all five dimensions of digital inclusion. Conclusions Adopting a digital inclusion lens is essential to build a sustainable and equitable digital health system in Bangladesh. This includes improving digital literacy, promoting inclusive and culturally sensitive content, and strengthening policy enforcement to ensure trust- and rights-based access, particularly for marginalized communities. The findings provide practical guidance for policymakers and developers to design accessible, inclusive digital SRHR services and demonstrate how applying a digital inclusion perspective can systematically identify barriers and facilitators to digital health engagement.