A computational text analysis of recent African digital health strategies and their attention to vulnerable populations

Background Digital health offers opportunities to transform healthcare systems and improve access to care, particularly in low- and middle-income countries. However, there is concern that national digital health strategies may inadequately address the needs of vulnerable populations, risking the reinforcement of existing health inequalities. Objective This study investigates the extent to which recent African national digital health strategies consider and prioritize vulnerable populations particularly at risk of digital exclusion (women, children and the elderly). Methods We conducted a computational text analysis of 13 recent national digital health strategy documents from African countries to identify major topical priorities within the strategies and to systematically assess the frequency and context of references to vulnerable populations. Results Most strategies focus on broad goals such as health system strengthening, infrastructure development, and stakeholder coordination. While there are mentions of women and children, these references are often indirect and not accompanied by concrete plans or dedicated actions. References to the elderly are especially rare. Few strategies include specific measures to ensure digital inclusion or equity for these vulnerable populations. Conclusions Recent African digital health strategies currently prioritize systemic and infrastructural development, but the needs of vulnerable populations are often overlooked or superficially addressed. To prevent the digital divide from widening, national strategies should embed explicit equity targets, actionable plans, and mechanisms for meaningful inclusion and participation of all population groups.