Building a blueprint

for digital first health systems

Findings from global youth consultations

This report was developed in 2024 by the Digital Transformations for Health Lab (DTH-Lab).
The work was supported by Fondation Botnar.

Authors: Louise Holly, Whitney Gray, Arundhati Rajan and Ilona Kickbusch.
Project conceptualisation: Sally Fawkes, Whitney Gray and Louise Holly.
Design: Amine Youcef Ali and front cover graphics by RC Design.

Acknowledgments
Thanks to Anurag Agrawal, Aferdita Bytyqi, Imane Lakbachi, Rohinton Medhora, Nojus Saad
and Yifan Zhou for their input on the report.

Thanks to all the young people who contributed to the global consultations,
#MyHealthFutures advocacy campaign, surveys and essays. Thank you to our external
partners from youth-led organisations that supported the development of the consultations
including Arwa Hany Sharaby [IFMSA], Neira Budiono [YET4H] and Karishma Jadeja & Jade
Murray [AI Future Lab].

A collection of youth-authored essays is published alongside this report as a partnering

document. A special thanks to contributions made by Regional Youth Champions (2023-
2024) Lydia Gara, Caroline Knop, Imane Lakbachi, Soe Yu Naing, Nojus Saad, Philip Yauma
and Yifan Zhou.

Suggested citation
Digital Transformations for Health Lab (2024) Building a blueprint for digital first health
systems: Findings from global youth consultations. Interim report. Geneva: Digital
Transformations for Health Lab.

Date of publishing: May 2024.

Contents
Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .6
Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .7
Methodology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .10
Key findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
Recommendations and key takeaways . . . . . . . . . . . .13
Learning and limitations . . . . . . . . . . . . . . . . . . . . . . . . .15
Next steps in building a blueprint . . . . . . . . . . . . . . . .17
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .19
Annex 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Annex 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
 Executive Summary
The Digital Transformations for Health Lab (DTH-Lab) is collaborating with young
people around the world to develop a blueprint for digital first health systems. This
blueprint will set out young people’s vision for digital first health systems and guide
different actors—from policy makers to technology companies—on the steps
required to make this vision a reality.

The DTH-Lab’s work builds on the report of The Lancet and Financial Times
Commission on Governing health futures 2030: Growing up in a digital world.
The Commission recommended that for young people’s health and well-being to
thrive in an age of digital transformations, stakeholders must enfranchise and
empower youth to co-design and critically engage with digital first health
systems as part of efforts to increase public participation and digital health
citizenship.

This global interim report summarizes the first

100 stage of a three-year project to develop the

blueprint. Over nearly a year and a half long
process, more than 100 young people under
30 years old from 36 countries were
consulted through a social media campaign,
call for essays and series of six virtual

36 consultations with global youth networks.

The many rich and diverse contributions make

clear that young people know what kind of
health futures they want to see, they have

06 expectations of what an equitable digital first

health system can achieve, and they want to
be actively involved in co-creating the
solutions.

DTH-Lab | Building a blueprint for digital first health systems | 4

 Humanistic

Youth around the world are strongly aligned on the

importance of a human rights-based approach and the
fundamental values and principles that should shape the
design and governance of any digital first health system.
Equitable / Trustworthy / Humanistic / Ethical / Inclusive

Principles and values

that must underpin
digital first health Young people want digital first health systems to be
systems effective at predicting and preventing future physical and
mental health challenges, as well as supporting young
Health issues that a people to promote and manage their health and well-being.
digital first health
system should address Mental health / Climate-related health issues / Fitness and nutrition /
Sexual and reproductive health / Non-communicable diseases

Essential design features Young people want high quality personalized

Global youth to enable a digital first health services, delivered through user friendly
priorities for digital health system to support tools. Digital first health systems should also equip
young people’s health and
first health systems well-being everyone with the knowledge and skills required
to make best use of digital health solutions and
become confident digital health citizens.

Knowledge building / Quality personalized services / User-

friendly tools / Everyone (inter)connected

Promising tech
solutions
Young people imagined many ways for new digital
Barriers to realizing
technologies to be integrated into their healthcare journeys
young people’s vision
but also want to see existing digital health solutions adapted
for digital first health
and scaled up so that more people can benefit from them.
systems
Digital wearables / Virtual interactions / Automation / Discreet
devices / Tech implants / Decision support software

Overall, participants felt confident that their digital-first

health systems could become a reality by 2045. However,
they identified many significant barriers that need to be
urgently addressed.
Weak data governance / Digital divides / Under-equipped health
workforce / Fragmented digital health services / Low political will

DTH-Lab | Building a blueprint for digital first health systems | 5

Introduction
Digital technologies and data have become The Commission therefore recommended that
fundamental tools for health promotion, for young people’s health and well-being to
enhancing healthcare delivery and improving thrive in an age of digital transformations,
health outcomes globally. Countries at all stages policymakers and other stakeholders must
of economic development and digital maturity enfranchise and empower young people to co-
are exploring ways to build or strengthen design and critically engage with digital first
equitable digital first health systems that health systems as part of efforts to increase
effectively respond to the health needs of their public participation and build digital health
populations and support their paths to universal citizenship. (Kickbusch et al., 2021)
health coverage. Lower-income countries with
weak health infrastructure and/or acute To take forward this recommendation, the
shortages of health workers are effectively DTH-Lab is collaborating with young people
leveraging digital health solutions to expand from across the world to develop a blueprint for
essential health services to underserved digital first health systems. The blueprint aims
communities. (Olu et al., 2019) to set out young people’s collective vision for
equitable digital first health systems that
As part of their inputs into The Lancet Financial respond to their diverse health needs and
Times Commission on Governing Health Futures priorities. The blueprint will guide stakeholders
2030’s (hereon Governing Health Futures 2030) —from policy makers to technology companies—
report, young people communicated concerns on the steps required to realize this vision.
about the lack of opportunities available to
them to meaningfully shape their health futures
and build health systems that respond to their
needs and priorities. (Wong et al., 2021)

The DTH-Lab aims to better understand young people’s hopes and concerns about digital
transformations of health, and to identify common trends of what an ideal digital first health system
might look like for young people across the world. This report introduces the concept of digital first
health systems and why youth must play a central role in the co-design process. It presents the key
findings from the first phase of activities to build a blueprint for digital first health systems,
describes the diverse range of methods used and outlines the next steps for the project.

DTH-Lab | Building a blueprint for digital first health systems | 6

Background: Young people’s health
and views on digital transformations
The concept of a digital first health system (see In a survey of 23,000 young people conducted
Box on page 8) is relatively new and, to our by the Governing Health Futures 2030
knowledge, there have been no previous Commission and UNICEF, 88% of respondents
attempts to consult young people on how such reported that they already use some form of
health systems should be designed and digital technology to support their health and
governed. However, previous research and well-being. Fitness was found to be the most
consultations carried out by the Governing popular health-related purpose for users of
Health Futures 2030 Commission and other digital technologies (Governing Health Futures
organizations offer valuable insights into young 2030 Commission, 2021). Young people believe
people’s health priorities, their views about the they could benefit greatly from digital health,
digital transformation of health systems and yet they often feel excluded or less prioritized in
specific digital health solutions, as well as what the consultation, content development, and
digital transformations might mean for their design of digital health interventions.
health, well-being and rights. (Transform Health, 2022)

Whilst young people’s individual health needs Public health services are often criticized by
vary considerably, on average, youth face adolescents and youth for not being responsive
different health risks and seek different kinds of to their needs. (Hargreaves et al,. 2012) Many
health services and support compared to youth report that they do not use health
younger children and older adults. Injuries, services due to fear of stigma, discrimination,
mental health disorders and maternal health lack of health workers, and high out-of-pocket
conditions are among the leading causes of costs (World Health Organization, 2019). An
death and disability among adolescents and inability to seek medical assistance
youth aged between 10 and 24 years. (World autonomously deters young people from getting
Health Organization, 2023) On a day-to-day help in a safe and private manner. Young people
basis, young people tend to prioritize have expressed the need for a health system
preventative care and maintaining healthy that provides youth-friendly support in a non-
lifestyles, and are often characterized as being judgemental manner, while safeguarding their
more health-conscious than earlier generations. confidentiality. (Walker and Reibel, 2014)
(International Food Information Council, 2018)
They value a holistic approach to health and Digital environments can—if designed and used
well-being that addresses determinants of appropriately—provide a safe and confidential
health such as poverty, education and housing. space for youth to seek health advice and
(World Health Organization, 2023) Learning, overcome some of their priority health
education and skills, and a safe and supportive concerns. Half of the respondents to the
environment have been identified by youth as Governing Health Futures 2030/UNICEF survey
top priorities for their future well-being. thought that accessing health information was
(Partnership for Maternal Newborn and Child the biggest way that digital technologies can
Health, 2023) help young people manage their health and

DTH-Lab | Building a blueprint for digital first health systems | 7

well-being, yet inaccurate health information
was also young people’s biggest concern about
digital health solutions, followed by concerns
about their privacy, and use of digital
technologies contributing to poor health, for
example by making them less physically active.

What is a digital first health system?

A digital first health system is one where digital channels and platforms serve as a users’ first point of
contact, or initial entry point, into a healthcare system. In a digital first health system, digital
technologies and data are primary and foundational elements of health promotion, prevention and
healthcare delivery. A digital first health system can expand the traditional framing of a health system
towards a broader ecosystem of interconnected tools and services to fulfil a variety of health and well-
being needs.

Digital solutions offer benefits for both users and healthcare professionals because of their potential to
improve health system accessibility, outcomes and efficiency. Instead of travelling to a health facility for
a face-to-face medical appointment, a digital first health system allows an individual to access a range of
personalized health services and health information from any location through digital tools and
platforms. These include virtual consultations with healthcare professionals, online patient support
groups, wearable sensors to monitor vital signs, and AI-assisted health information tools. Public health
authorities can share timely and targeted prevention and health promotion messages and tools directly
with individuals via their mobile phones and social media platforms.

A unique feature of digital first health systems is the range of opportunities available for social
connectivity and community building. Digital platforms and tools can not only facilitate more regular
two-way communication with health professionals, but they also provide access to wider online
communities that offer social support, empowerment and a sense of belonging. Digital first does not
mean digital only: a digital first health system can also include hybrid elements (blended digital and non-
digital methods of care) and enhance important non-digital aspects of care and support.

Overcoming potential drawbacks of first health systems offer advantages for both
digital first health systems individualized healthcare and wider health
systems, these benefits are yet to be fully
Digital first health systems aim to harness the realized. Particularly in low and middle-income
transformative potential of digital technologies countries, divides in access to and effective use
to create more responsive, user-centered and of digital health technologies, coupled with
fficient healthcare ecosystems. Whilst digital uneven levels of digital health literacy and weak

DTH-Lab | Building a blueprint for digital first health systems | 8

governance, are exacerbating health inequalities monitor and manage their health. Digitally-
and risk undermining people’s trust in digital connected youth also proactively use social
health solutions. (Kickbusch et al., 2021) media and other digital platforms to seek health
information, connect to others to share lived
More inclusive approaches to health system experiences and emotional support, as well as to
governance can address many of the potential produce health promoting content of their own.
drawbacks of digital first health systems by (Lupton, 2021) In parallel, young people’s overall
ensuring that their design and implementation is experiences of digital environments and
people-centred, participatory and equitable. By datification are impacting their health and well-
actively involving marginalized and under- being in both positive and negative ways. (Holly
represented groups in the design and et al., 2023)
governance of health systems, inclusive
approaches can help mitigate the impact of Investing in young people’s health will
universal or biased policies that may accelerate progress towards universal health
disproportionately affect different groups, build coverage. (World Health Organization, 2019)
trust and improve access to healthcare services, However, since adolescents and youth are often
ultimately reducing health disparities. perceived as a healthy cohort, their health
services are given lower priority by
policymakers and funders (Goodburn and Ross,
Why youth must play a central role 2000). In lower-and-middle income countries
in co-designing digital first health where up to 45% of young people can face
difficulties in accessing services, this is a large
systems
population that is currently underserved.
The importance of including and (UNICEF, 2023) As health systems become
institutionalizing youth participation in both increasingly digital first, these systems must not
digital and non-digital health programmes is only respond to the needs and expectations of
being recognized by policymakers. For example, today’s 1.8 billion young people aged 10-24 but
WHO guidance on youth-centred digital health also anticipate and adapt to address future
interventions recommends the meaningful and health-related benefits and risks of digital
sustainable involvement of young people at transformations.
every stage of the design and implementation
process. (World Health Organization, 2021) Co-creating a digital first health system with
Young people are eager to see such youth is not about creating a health system only
recommendations put into practice. for young people but rather a system where
adults and youth actively work together as co-
Growing up in an era of significant digital creators, leveraging the unique experiences and
transformation, today’s youth have different contributions of different generations. By
expectations of health systems—and the role of involving youth, stakeholders can also design
technologies in those systems—compared to health systems that are fit for all with specific
older populations. Young people’s expectations health services available to address young
and experiences of digital transformations vary people’s unique health needs. More inclusive
within and between countries. However, in design and accountability processes can
general, those who access the internet and use improve desired health outcomes for everyone
devices such as smartphones at an early age are while simultaneously improving the
proficient at leveraging a range of digital health sustainability of the healthy system for
technologies, such as apps and wearables, to generations to come.

DTH-Lab | Building a blueprint for digital first health systems | 9

Methodology: Garnering youth insight on
digital first health systems
Conceptualizing digital first health Futures thinking with global youth
systems with young people networks
In the year following the publication of the To have more in-depth discussions with young
Governing Health Futures 2030 report, young people about their ideal digital first health
people participated in translating the systems, virtual consultative workshops were
Commission’s recommendations into action organized in partnership with five global youth
through advocacy and dissemination of the networks focused on global health and digital
report’s findings. This included taking forward transformations: One Young World, Young
recommendations to enfranchise young people Experts: Tech 4 Health, AI Future Lab, the
and other under-represented communities in International Federation of Medical Students’
the co-design and implementation of digitally Associations (IFMSA) and two cohorts of
transformed health systems. Governing Health Futures/DTH-Lab Regional
Youth Champions.
On International Youth Day 2022, the
GHFutures2030 Youth Network launched the During the session, participants were asked to
#MyHealthFutures campaign, aimed at creating consider the following questions with the year
space for young people under 35 years to share 2045 in their mind:
their hopes, concerns and ideas for improving
health futures. During the campaign, young 1. What are young people’s biggest
people were invited to share responses to the health priorities likely to be?
questions: “What does a digital first health 2. What principles or values have been
system mean to you?” and “How could a system embedded in digital first health
deliver better health futures for young people?” systems?
3. What essential design features are in
Through this campaign, youth shared their place to enable the digital first health
insights through various channels including system to support young people’s
social media platforms, online polls and two calls health and well-being?
for essays. Fourteen essays were submitted 4. If you could time travel, what kind of
from authors aged under 30 from 11 countries artefact would you bring back to the
(see Annex 1). present that symbolizes a digital first
health system in 2045?
5. What are some risks and challenges
arising from digital-first health
systems that you hope would get
addressed by 2045?
6. How confident are you about digital-
first health systems becoming a
reality by 2045?

DTH-Lab | Building a blueprint for digital first health systems | 10

Participants' inputs and ideas were collated The global consultations brought diverse groups
from each workshop through various mediums of young professionals together from all regions
including virtual whiteboards, online polls, and of the world. In total, six consultations were
written notes taken by assigned rapporteurs. held between September 2022 and January
Inputs from all six workshops were compiled 2024 involving 97 young people under 30 years
and grouped into themes. old from 36 countries (see Annex 2 for
participant information).

Key Findings
Ideas and themes shared through the workshops, essays and other channels were fairly consistent,
indicating that young people have many common expectations of their future health system, regardless
of the context they are coming from. Although each participant holds a unique lived experience, a general
consensus arose on the values, features and health issue areas that need to be considered when
designing an ideal digital first health system that meets the needs of young people.

1. Health priority areas that a digital

first health system should address AI could help young people better
control their health by providing
Workshop participants highlighted five health timely, accurate, personalised, and
issues that they believe will be of greatest confidential answers to SRHR
questions. This is a game-changer,
priority to youth globally in the year 2045 and especially in settings where these
that digital health systems need to be designed issues are still taboo. Lydia Gara
to address: mental health; fitness and nutrition;
sexual and reproductive health; climate-related
health issues; and non-communicable diseases.
These are the same issues that concern youth 2. Core values and principles that
today with mental health and sexual and
should underpin a digital first health
reproductive health, in particular, being
highlighted as priority issues in several youth system
essays as well as other global consultations. Across all six consultations, participants agreed
(World Health Organization, 2023) on the fundamental values and principles that
should shape the design and governance of any
Beyond addressing specific health priority areas, digital first health system. There was a strong
youth also indicated that a digital first health consensus that a human rights-based approach
system should be effective at predicting and to digital first health systems is essential for
preventing future physical and mental health promoting and protecting their right to health
challenges, including building resilience against and addressing health inequalities. A human
pandemics, as well as promoting ways for young rights-based approach to health allows youth
people to stay as healthy as possible. and others in their communities to be

DTH-Lab | Building a blueprint for digital first health systems | 11

 recognized as rights-holders and involves
holding governments and other duty bearers To ensure the system is friendly to
marginalized youth, a group of
accountable for realizing universally agreed diverse youth should be consulted
norms and legal obligations. on the language and design of
digital tools integrated into the
health system. Yifan Zhou
Five core values are considered to be essential
to any digital first health system:

A very strong recommendation from youth is that they want digital first health systems to make
health services and health outcomes more equitable. Youth demand that digital innovations improve
healthcare accessibility for underserved or marginalized groups, including people with disabilities.
Moreover, these services must be affordable and covered by national insurance programmes.
Equitable

A trustworthy digital first health system is absolute. Young people need to trust the health
system not only because their personal health information and data will be shared but also
because the system will not be used effectively if this value is not adhered to by all
stakeholders. Transparency about how information is being used and decisions are made is
key to building trust. Young people also want to see stronger legal and regulatory
Trustworthy
frameworks in place for data and digital technologies so they can be assured that digital
health services are effective and safe and that their data is not being misused.
Inclusive
CORE VALUES

A very strong recommendation from youth is that they want digital first health
systems to make health services and health outcomes more equitable. Youth demand
that digital innovations improve healthcare accessibility for underserved or
Humanistic marginalized groups, including people with disabilities. Moreover, these services must
be affordable and covered by national insurance programmes.

Participants discussed many of the ethical issues faced by the integration of health
technologies, such as concerns around privacy, data protection, exclusion, discrimination
and bias. Ethical considerations are essential for young people to ensure that digital first
health systems are developed and used in a way that respects the rights and dignity of
Ethical
patients, healthcare providers, and other stakeholders

Meaningful involvement of young people from different backgrounds in the design and governance
of digital first health systems was deemed to be essential for ensuring that systems are accessible
and beneficial for all. More inclusive processes will also help to make digital health services more
Inclusive user-friendly and responsive to young people’s priorities. Young people also wanted to see greater
collaboration and partnership

DTH-Lab | Building a blueprint for digital first health systems | 12

The values highlighted by youth are closely 3. Features and user experience of a
intertwined. This value system is reinforced by digital first health system
many of the principles that countries have
committed to through human rights instruments The experience of a digital first health system is
and agreements on the Sustainable shaped by the features and attributes of the
Development Goals and Health for All. They system. Key features highlighted by young
also align with the value-based approach to people included both those relating to the
governance that was put forward by the overall health system and specific digital, data-
Governing Health Futures 2030 Commission driven products or services that need to be in
(Kickbusch et al., 2021). The consultations place to address young people’s health priorities
reiterate the relevance and importance of this Young people’s preferred features for a digital
value-based system to health being realized in first health system are grouped into four broad
practice. categories:

Young people want digital first health systems to have strong education and capacity
building components so that everyone can use digital tools and make informed decisions
about which services to choose, which health information is reliable and how to protect
Knowledge their personal health data. In addition, youth want to see improved investment in health
building workers’ digital skills and better use of digital tools for their training.

Many of the features proposed by participants corresponded to their expectations

of health services and how they should be delivered. For example, youth desire an
efficient, quick and reliable health system, which can meet their health needs in a
timely fashion. The system must be flexible and adaptable to provide localized and
Quality
contextual health services that are tailored to the individual needs and backgrounds
personalized of each person. Finally, young people want to see health systems become more
services precise in their predictions about both individual and public health risks and
accurately recommend appropriate, high quality services.
KEY FEATURES

User experience was a recurring feature of digital first health systems identified by
young people in the consultations. Youth want a one-stop digital health platform
where they can access multiple services. These services should be designed with
young people to ensure they are user-friendly, accessible and non-discriminatory.
The interface of digital health solutions should not only be intuitive but also have
User gamified features to improve user engagement and create a fun experience.
Friendly Participants were cognizant of the fact that digital may not always be the only
solution and that a hybrid model with some physical components will ensure
seamless service delivery in situations where beneficiaries may not have access to
digital devices or prefer face-to-face interactions.

EParticipants recognized that thriving digital first health systems depend on a foundation
of strong digital and health infrastructure as well as seamless interoperability between
Everyone digital health services and providers. To reap the benefits of digital health innovations,
young people want to see barriers to reliable internet access and digital devices resolved.
(inter) They also want greater international collaboration so they can use digital tools to connect
connected with health providers, patients and communities across the globe, transcending traditional
geographical and social boundaries.

DTH-Lab | Building a blueprint for digital first health systems | 13

4. Promising tech solutions for a There is a strong demand for digital solutions
digital first health system that are integrated seamlessly and discreetly
into young people’s everyday lives. These
Future thinking exercises generated insights technology driven solutions must adhere to the
into possible technology-driven solutions that core values outlined by young people while
could be incorporated into a digital first health taking into account the features and experience
system. Participants were mainly inspired by young people want to see in digital first health
artefacts that are already available today—such systems. In both the consultations and essay
as wearable devices—but that are not yet being contributions, youth entrepreneurs were
used to their full potential for health promotion highlighted as being key to driving future
and delivery. Participants believe there is scope innovations that are not just technologically
for existing digital health solutions to be scaled sophisticated but also practical and applicable
up, upgraded and used in new ways. For within local contexts.
example, gamification features and greater
personalization of digital health solutions could The kinds of tech solutions that young people
make them more appealing to young users. were especially excited about are categorized
below:

Virtual interaction-based services

From telemedicine and metaverse-based hospitals to virtual reality healing pods
and digital self-tests, young people are keen for technology to facilitate remote
interactions with healthcare providers and ancillary services such as diagnostic
centres and pharmacies.

Decision support software

Decision support software, such as clinical support systems for doctors and mobile
applications for lifestyle management and monitoring is an important part of the
backbone of digital first health systems that must be strengthened and scaled up.

Automation

Young people see many benefits of automation for improving the efficiency of
health systems and improving user experience. Many existing or emerging
technologies, such as chatbot-powered medical assistance and counselling
services as well as other automated services such as delivery of medication by
drones, robot surgery, nanobots, and haptic technologies need to be scaled up
to benefit more people.

Discrete devices

Young people value discrete systems and devices that enable a private and secure
exchange of health data. Many respondents shared their desire to move from paper
records to more digital health records which can be easily accessed through
portable devices. To keep their electronic data safe, several respondents proposed
the increased use of biometric security systems

DTH-Lab | Building a blueprint for digital first health systems | 14

 Wearable
Wearable
devicesdevices

Wearable devices such as watches, rings, patches and glasses, connected to

smart phones or computers,Discrete
already devices
allow young people to track their own
health information and share data with trusted health professionals. There is
scope for such tools to be applied to other areas of health and not just
traditional avenues of seeking health care. Connecting to other social networks
with shared lived experiences or focusing on preventative behaviours and
healthy habits are other ways in which young people expect these technologies
to support their overall health and well-being although they are not focused on
health service delivery

Tech implants

Going beyond the idea of wearable devices, young people were also open to digital
devices being used in the body such as artificially grown organs, smart implants or
tattoos, and microchips to collect information.

Recommendations and takeaways

The core values and priority features expressed by young people for an ideal digital first health system
are a reflection of their concerns about the potential negative consequences of these systems.
Across all six consultations, young people identified significant barriers and challenges that need to be
addressed urgently.

1. Strengthened health data 2. Equitable access not greater

governance divides
Policymakers and tech companies must Surprisingly, there was not a strong focus on
strengthen data health governance to balance creating additional digital health solutions;
the benefits of sharing health data with young rather, participants focused on the need to
people’s desire to withhold privacy and expand equitable access to existing health
confidentiality. The next phase of this project technologies. There is a persistent, shared
will explore how incorporating a solidarity- concern about whether divides in digital
based approach to data governance could allow infrastructure and digital literacy will be closed
digital first health systems to address young by 2045. Regardless of their current situation
people’s concerns, for example, risks associated and experience with the digital transformation
with data breaches, misuse of personal data and of health, young people from low-income and
abuses of privacy. fragile settings alongside youth from high
income countries are equally concerned that the
benefits of the digital transformations in health
will be shared by all and not just perpetrate
further health inequities.

DTH-Lab | Building a blueprint for digital first health systems | 15

3. Equipped health workforce biases to spread. It is therefore critical that
Participants highlighted the important role that action is taken to eradicate bias in all parts of
health workers of all cadres play in deploying the wider digital health ecosystem and to make
technology-driven services. However, data more representative.
particularly in low and middle-income countries,
young people noted that the—predominantly 5. Political will to listen to youth
female—health workforce lacked the knowledge
and skills to leverage digital tools effectively to Although the majority of young people are fairly
support young people’s health and well-being. confident that their ideal digital first health
The capacity of all health workers, and system will be a reality by 2045, there is still a
particularly those providing primary health care, large group of young people who have low
must be improved so they can efficiently carry confidence. With key concerns related to
out their roles within digital first health systems political instability and resistance to change, a
whilst preserving the critical human elements of concerted effort is required from multiple
healthcare that young people value. The views stakeholders to not only engage young people
and experiences of health professionals must in the design and governance of digital first
also be taken into account in the design and health systems, but to listen to and act upon
testing of digital health solutions as well as the their recommendations. Greater investment in
wider digital transformation of health systems. education, mentorship and innovation spaces is
needed to foster the next generation of health
workers, entrepreneurs and political leaders.
Fostering digital health citizenship can play a
4. Addressing bias and crucial role in addressing the lack of
discrimination across enfranchisement experienced by young people
in relation to digital transformations of health.
for digital first health systems to provide a fully Promoting digital health citizenship among
integrated and connected suite of services. children and youth not only increases their
However, some were concerned that ability to thrive in the digital age but also equips
connecting different systems and data sets them with essential skills to shape their health
without careful oversight could allow inherent futures.

Learning and limitations

Several key learnings from this first phase will systems strengthening and/or digital
need to be assessed moving forward in the transformations. Sampling such a group of well-
development of a blueprint for digital first informed young people may have framed the
health systems. discussions, use of language and overall findings
in a particular way. Secondly, consultations
Firstly, the global youth networks consulted are amongst global groups do not allow for national
highly knowledgeable and experienced with the or context-specific issues to be discussed in
ins and outs of global health governance health detail. To overcome these limitations phase two

DTH-Lab | Building a blueprint for digital first health systems | 16

 of this project will need to bring additional available, it was challenging for workshop
diversity of lived experience to reach context- participants to fully harness their imaginations
specific solutions. and think far beyond current digital health
solutions and the barriers and challenges that
Lastly, a key limitation to this phase of work was youth face in seeking health care services or
the superficial dive into how to achieve the ideal health promotion in general. Future
digital first health system. By focusing on the consultations will therefore use the global
overall values, health priorities, key features and findings as a launch pad to formulate concrete
challenges of a digital health system, there was and actionable recommendations for
little time to adequately unpack these ideas and stakeholders to take in realizing digital first
capture solutions on how these ideals could be health systems.
put into practice. With the limited time

Next steps in building a blueprint for digital

first health systems
This global interim report summarizes the first stage of a three-year project to develop a blueprint for
designing digital first health systems that lay out tangible actions stakeholders can take in establishing
equitable, inclusive and sustainable digital first health systems.

GHFutures 2030 Regional and National

Report Workshop with global youth networks level report

2022 2024

2021 2023 2025

#MyHealthFutures Global Report on young Blueprint for

Campaign people’s priorities for digital designing
first health systems digital first
Pilot workshop at One health systems
Young World Summit Regional and national workshops

Phase 1: Global consultations - overcome to achieve it. The findings from these
Creating a vision (2022-2024) consultations reinforced the Governing Health
Futures 2030’s recommendation of putting
This first phase of this project painted a picture young people at the centre of digital
of young people’s vision for digital first health transformations of health by involving them in
systems and the barriers that need to be each step of the process from co-creation to

DTH-Lab | Building a blueprint for digital first health systems | 17

solution generation for them to be active digital This phase will also focus on outlining key
health citizens. Participants’ inputs also actions that stakeholders can take to create
validated the Governing Health Futures 2030’s digital first health systems that respond to
recommendations around closing digital divides, young people’s priorities. The findings from this
building trusted digital health ecosystems and phase will be published in a regional interim
strengthening data governance to ensure that report in early 2025.
the value of health data is harnessed for public
good. These findings reinforce the urgency of
the DTH-Lab’s work to translate the
Commission’s recommendations into action. Phase 3: Stakeholder consultations
- Testing a youth-designed
blueprint (2024-2025)
Phase 2: Regional and country-level
consultations - Making tangible In phase three, key stakeholder groups including
international organizations, academia and
action (2024-2025)
private actors will be consulted to ensure the
In moving forward, phase two of this work will blueprint and its recommendations are
harness the insights and imagination of more operational and reflective of current strategies.
young people, including medical students and This phase aims to build the buy-in and
young healthcare professionals, on the future readiness of different actors to take forward
design and governance of digital first health young people’s recommendations in creating
systems with a stronger emphasis on capturing digital first health systems built for young
different regional and national perspectives people.

Act on youth priorities now!

Young people agree on the health future they want and the essential elements of a digital first health
system. They also know they are the rightful co-creators of this future and want greater opportunities
and support to fulfil this role.

As the development phase of the blueprint is underway, policymakers and other stakeholders can
already begin to incorporate young people’s views into governance decisions and ensure that their
health, well-being and aspirations for the future are at the forefront of the digital transformation of
health systems.

DTH-Lab | Building a blueprint for digital first health systems | 18

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Transform Health (2022) ‘Closing the digital World Health Organization (2021) ‘Youth-
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World Health Organization (2019)

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DTH-Lab | Building a blueprint for digital first health systems | 20

Annex 1: Youth-authored essays on
digital first health systems
Series 1, published in December 2022
Health futures: Digital first health systems for and with young people.
Abdullah Rajeeb Al-Khafajy (Iraq). Youth-led digital first health systems: Challenges and
opportunities in the age of the disruptive entrepreneur.
Babajide Babayeju (Nigeria). Improving treatment outcomes via electronic prescribing.
Dominique Guillaume and colleagues (USA). Centering community perspectives in the development
of digital health interventions: A case example of an HIV prevention application.
Jade Murray (Trinidad and Tobago). Closing the digital health gap in the Caribbean: A call for digital
transformation of the health sector in the region.
Janil Devani (India). Digital health: The key to overcoming disparities in health.
Joseph Bruce (Ghana). Youth-focused digital first health systems in Africa.
Taofeekat Adigun (Nigeria). Advancing digital health systems and governance.

Series 2, published in April 2024

Creating and sustaining digital first health systems: Special priority areas for young people
Caroline Knop (Germany). ​Empowering Tomorrow's Health: The Transformative Potential of Digital
First Health Systems in Boosting Health Literacy.
Imane Lakbachi (Morocco). Digital Literacy's Central Role in Deploying Effective Digital-First Health
Systems.
Lydia Jummai Gara (Nigeria). Sexual and Reproductive Health and Rights and Digital Health.
Nojus Saad (Iraq). Youth Entrepreneurship: Redefining Digital Healthcare in Emerging Economies.
Philip Injendi Yauma (Kenya). Data Science and Research For Digital Health Technologies.
Soe Yu Naing (Myanmar). Empowering Communities: A Digital-First Health System Approach to
Pandemic Preparedness through Citizen Science.
Yifan Zhou (Canada). Digital health and intersectionality: Ensuring equity and inclusion of
marginalized youth.

DTH-Lab | Building a blueprint for digital first health systems | 21

Annex 2: Global consultation data
Number of
Date Group Countries represented
participants

Australia, Cameroon, Canada, Hong Kong (China), Japan,

07/09/2022 One Young World 20 Mexico, Netherlands, Nigeria, Sweden, Thailand, UK,
USA. (12)

YET4H & Regional Youth Champions Cameroon, Canada, Egypt, Germany, Indonesia, Jamaica,
05/12/2022 12
(2022/23 cohort) Kenya, Lithuania, Mexico, Solomon Islands, UK. (11)

Canada, Italy, Mexico, Nigeria, South Africa, Trinidad and

31/01/2023 AI Future Lab - group 1 12
Tobago, USA. (7)

Czech Republic, Italy, India, Indonesia, Kenya,

01/02/2023 AI Future Lab - group 2 12
Netherlands, Nigeria, Trinidad and Tobago, UK. (9)

Cameroon, Canada, Germany, Hong Kong (China), India,

Regional Youth Champions (2023/24
06/12/2023 15 Iraq, Jamaica, Kenya, Morocco, Myanmar, Nigeria,
cohort)
Portugal, Switzerland, UK. (14)

Brazil, Cameroon, Egypt, Germany, Ghana, India, Iran,

30/01/2024 IFMSA 26 Kenya, Morocco, Nepal, Nigeria, Oman, Sudan, Ukraine.
(14)

All countries represented in global consultations

Low income Lower-middle Upper-middle

High income countries
countries income countries income countries

Australia
Canada
Cameroon Czech Republic
Egypt Germany
Ghana Hong Kong (China)
Brazil
Kenya Italy
Indonesia
India Japan
Iraq
Iran Lithuania
Sudan Jamaica
Morocco Netherlands
Mexico
Myanmar Oman
South Africa
Nepal Portugal
Thailand
Nigeria Sweden
Solomon Islands Switzerland
Ukraine Trinidad and Tobago
United Kingdom
United States

DTH-Lab | Building a blueprint for digital first health systems | 22

Digital Transformations for Health Lab (DTH-Lab)
Hosted by: The University of Geneva
Campus Biotech, Chemin des Mines 9
1202 Geneva, Switzerland

www.DTHLab.org