Report on Digital Health Inequities and the Sustainable Development Goals

Executive Summary

A multi-country study conducted from June 2024 to January 2025 in Colombia, Ghana, Kenya, and Vietnam reveals that the digitalization of healthcare systems, while promising, perpetuates and creates new forms of gender inequality. These digital disparities directly undermine progress on several Sustainable Development Goals (SDGs), including SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 10 (Reduced Inequalities). Young women, particularly those from marginalized communities, face significant economic, social, and security barriers to accessing digital health information. This report outlines these challenges and recommends targeted actions to ensure digital justice and uphold fundamental human rights, aligning digital health strategies with the 2030 Agenda for Sustainable Development.

Introduction: Digital Health and the Sustainable Development Goals

The transition to digital healthcare offers potential advancements in health information access, aligning with SDG 3 (Good Health and Well-being). For young women in low- and middle-income countries, digital platforms can provide crucial access to sexual and reproductive health information, a key target of SDG 5 (Gender Equality). However, research indicates that pre-existing gender inequalities are migrating to the digital sphere, creating a digital divide that threatens to leave the most vulnerable behind. This report analyzes the findings of the study, “Paying the Costs of Connection,” highlighting how digital barriers directly impact the achievement of the SDGs and the fundamental right to health.

Research Methodology

The findings are based on a community-engaged qualitative study involving over 300 young adults and 40 officials and experts across four countries. The methodology included:

• 33 focus group discussions conducted in six languages.
• Representation from rural, urban, and peri-urban regions.
• Direct participation of young people in shaping the research based on lived experiences.
• In-depth interviews with United Nations (UN) officials, government representatives, and community leaders.

Key Findings: Gendered Barriers to Achieving SDGs in the Digital Age

The study identified significant, gender-specific challenges that hinder access to digital health services and information, thereby impeding progress on multiple SDGs.

Economic and Social Barriers Impeding SDG 5 and SDG 10

Economic precarity and social norms create substantial obstacles for young women, directly challenging SDG 5 (Gender Equality) and SDG 10 (Reduced Inequalities).

1. Economic Dependence: In Colombia and Kenya, women reported being unable to afford mobile data or depending on male partners to pay for internet access. This forces a choice between essential goods, like food, and the fundamental right to health information, exacerbating conditions targeted by SDG 1 (No Poverty).
2. Social Stigma: In northern Ghana, ownership of a smartphone by a young woman was viewed with suspicion, linking technology access to negative moral judgments and reinforcing harmful gender stereotypes.
3. Intimate Surveillance: The necessity of sharing phones with family members or partners exposes women’s private health searches to scrutiny, creating a chilling effect on their ability to seek information related to sexual and reproductive health, a core component of SDG 3 and SDG 5.

Risks to SDG 3, SDG 5, and SDG 16

Online participation exposes young women to significant risks, undermining their health, safety, and access to justice, which are central to SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), and SDG 16 (Peace, Justice and Strong Institutions).

• Technology-Facilitated Abuse: A staggering 75% of young adults surveyed reported experiencing or witnessing technology-facilitated abuse, including cyberbullying, stalking, and blackmail. This form of gender-based violence is a direct contravention of SDG 5.2, which calls for the elimination of all forms of violence against women and girls.
• Privacy and Security Threats: For marginalized groups like sex workers and women living with HIV, digital platforms are essential yet dangerous. The non-consensual sharing of personal data can lead to stigma, violence, and severe mental health harms, compromising their right to health and security.
• Lack of Justice: The prevalence of online abuse without effective recourse highlights a failure to provide access to justice for all, a key target of SDG 16. This impunity deters women from participating online, further deepening the digital divide.

Youth-Led Initiatives and Empowerment

Despite the challenges, the research found that young women are actively using digital tools to advocate for their rights and support their peers, demonstrating the potential of technology to advance SDG 5.b (enhance the use of enabling technology to promote the empowerment of women).

• Peer-to-peer support networks via online chat groups to share health information.
• Creation of online platforms to document abuse and advocate for official intervention.
• Advocacy by sex workers for funding for data bundles to enhance safety.

Recommendations for Policy and Action

To ensure that the digitalization of health contributes positively to the SDGs, national and global agencies must take decisive action. The following recommendations are critical for fostering an inclusive and safe digital environment:

1. Integrate Digital Rights into SDG Frameworks: Recognize that access to digital technology and online safety are prerequisites for achieving SDG 3, SDG 5, and SDG 10. Policies must treat digital inclusion as a fundamental right.
2. Promote Meaningful Youth Engagement: In line with the recommendations of the Lancet and Financial Times Commission on Governing Health Futures, ensure young women are included in the governance and design of digital health strategies and policies.
3. Strengthen Legal and Justice Systems (SDG 16): Implement and enforce laws against technology-facilitated gender-based violence. This includes providing training for police, judges, and lawyers, and establishing accessible support services for survivors.
4. Invest in Digital Literacy and Economic Empowerment (SDG 4 & SDG 5): Address the root causes of the digital gender divide by investing in technology training and economic opportunities for young women, particularly in rural and marginalized communities.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being: The article’s central theme is access to health information, specifically sexual and reproductive health for young women, through digital platforms. It discusses how digital systems promise “greater access to health information and services.”
• SDG 5: Gender Equality: The article extensively details how “gender inequality has followed young women into the digital age.” It highlights issues like intimate family surveillance, economic dependency for internet access, and technology-facilitated abuse, which disproportionately affect women and hinder their empowerment.
• SDG 9: Industry, Innovation, and Infrastructure: The discussion revolves around digital infrastructure, including access to smartphones, mobile data (“airtime”), and the internet. The article points out the “digital divide” and the challenge of affordable access, as seen in the choice between “mobile data or buy bread.”
• SDG 10: Reduced Inequalities: The article focuses on inequalities faced by specific groups, stating that concerns were highest among “young women… living in rural areas, sex workers, trans women, and women living with HIV.” It describes how economic precarity and location (rural vs. urban) create significant barriers to digital inclusion.
• SDG 16: Peace, Justice, and Strong Institutions: The article calls for “justice for online harms” and mentions the need for “legal reforms, training for police, judges, and lawyers, and support services for survivors of technology-facilitated abuse,” which directly relates to ensuring access to justice and building effective institutions.

2. What specific targets under those SDGs can be identified based on the article’s content?

• Under SDG 3: Good Health and Well-being
  • Target 3.7: “By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education…” The article directly addresses this by focusing on young women’s opportunity “to access sexual and reproductive health information online,” such as information on “safe abortions and HIV testing.”
• Under SDG 5: Gender Equality
  • Target 5.2: “Eliminate all forms of violence against all women and girls in the public and private spheres…” This is relevant to the article’s description of “technology-facilitated abuse,” including “cyberbullying to blackmail,” stalking, and the non-consensual sharing of intimate photos.
  • Target 5.b: “Enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of women.” The article explores both the potential of technology to empower women (feeling “empowered by being able to use their smartphones to obtain and share health information”) and the significant barriers that prevent this, such as cost, surveillance, and violence.
• Under SDG 9: Industry, Innovation, and Infrastructure
  • Target 9.c: “Significantly increase access to information and communications technology and strive to provide universal and affordable access to the Internet…” The article highlights the lack of affordable access, citing examples where women in Kenya face a choice to “purchase mobile data or buy bread” and women in Colombia depend on their husbands to “pay for internet access.”
• Under SDG 10: Reduced Inequalities
  • Target 10.2: “By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex… or other status.” The article shows the digital exclusion of marginalized young women, including those in rural areas, sex workers, and women living with HIV, who are being “left behind” in the digital health landscape.
• Under SDG 16: Peace, Justice, and Strong Institutions
  • Target 16.1: “Significantly reduce all forms of violence and related death rates everywhere.” The article connects online abuse to severe consequences, noting it can lead to “mental health harms, self-harm, and in some cases, physical violence.”
  • Target 16.3: “Promote the rule of law… and ensure equal access to justice for all.” This is addressed by the article’s call for “justice for online harms” and the need for “legal reforms” and “support services for survivors” who currently lack adequate recourse.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• For Target 3.7 (Access to sexual/reproductive health info): An implied indicator is the ability of young women to seek and receive health information online without fear of stigma or violence. The article notes that “every time a woman can’t seek health information without fear… the digital divide deepens,” suggesting that the level of fear and safety in accessing this information is a key measure.
• For Target 5.2 (Violence against women): The article provides a direct quantitative indicator from its research: “A staggering three-quarters of the young adults we spoke to across Colombia, Ghana, Kenya, and Vietnam reported technology-facilitated abuse against themselves or their friends.” This suggests measuring the proportion of women and girls subjected to technology-facilitated violence.
• For Target 5.b (Women’s empowerment through technology): Implied indicators include the proportion of young women who own a smartphone and can afford data bundles independently. The article points to the lack of progress by describing how some young women are “presumed to have traded sex for their device or for data bundles” and others depend on husbands to “pay for internet access.”
• For Target 9.c (Affordable internet access): An indicator is the affordability of mobile data relative to basic needs. The article provides a stark qualitative measure: the choice between purchasing “mobile data or buy[ing] bread for their children,” which highlights that the cost of access is prohibitively high for some.
• For Target 16.3 (Access to justice): An implied indicator is the availability and accessibility of support systems for survivors of online abuse. The article identifies a gap by stating that young women need “support services for survivors of technology-facilitated abuse,” implying that such services are currently insufficient or non-existent.

4. SDGs, Targets, and Indicators Table

Source: openglobalrights.org