Abstract
The integration of digital tools in healthcare is profoundly reshaping global health systems, particularly within the One Health framework, which emphasizes the interconnectedness of human, animal, and environmental health. This article advocates for transitioning from a “human-centered” to a “humanity-centered” design approach to address the multifaceted health challenges faced by diverse populations. By embracing this paradigm, the article underscores the potential of digital health technologies to reduce health inequities, promote inclusivity, and foster multisectorial collaboration. It further highlights the necessity of bridging the digital divide to ensure that innovations are both equitable and sustainable, aligning with the overarching goals of global health advancement.
Keywords: Digital health, Mobile health, Health equity, Human-centered design, Humanity-centered design, One health
1. Introduction
Digitalization, when viewed in a larger context, represents a dynamic relationship between societal developments and digital technologies rather than just a technological phenomenon. Digital tools are permeating the healthcare industry more and more, changing relationships, practices, institutions, and social structures. This transformation can be seen in the rise of telemedicine, AI-driven diagnostics, wearable health monitors, and digital platforms that enable remote care, data sharing, and more personalized treatment pathways. Therefore, comprehending the digitalization of healthcare requires an interdisciplinary approach that addresses concerns about technological innovation, positive and negative societal impacts, and the swift and pervasive nature of development.
In this framework, the “human-centered design” [1] approach also includes the critical component of supporting people and understanding the intricate problem of bolstering health systems in the digital age.
But what if all humanity could benefit from the “human-centered” approach? Are we ready to embrace this new perspective?
Where “human-centered” focuses on people's needs as individuals, “humanity-centered” [2] expands this view much further, to the societal level of world populations who deal with an extensive number of deeply interconnected problems that are frequently entangled in complex, high-tech systems that are “caused by humans”. This new perspective represents the ultimate challenge for designers to help people improve their lives. It aligns with the One Health approach, addressing interconnected health challenges at the human, animal, and environmental interface, and emphasizing inclusive, collaborative solutions for global well-being.
We will explore the complex relationship between digital tools and users, focusing on future perspectives for mobile health (mHealth). The World Health Organization defines mHealth as the “use of mobile and wireless technologies to support the achievement of health objectives.” [3]. In this context, we examine current and future challenges in “humanity-centered” design to address all stakeholder needs in the evolving field of healthcare.
As stated in literature, transition from human-centered to humanity-centered design entails not only addressing individual user needs but also considering the broader ethical, social, and ecological implications of technology [2,4]. In this light, digital tools such as mHealth must be understood as part of a complex socio-technical ecosystem, where design decisions influence and are influenced by multiple stakeholders—including non-human actors—across interconnected systems [5].
Subsequent sections critically analyze three key areas of mHealth technologies in fostering Humanity-Centered Design: (1) mHealth platforms for disease management in developing countries, (2) enhancing exercise and physical activity, and (3) integrating mHealth within the One Health framework to address interconnected human, animal, and ecosystem health.
2. Humanity-centered design for mobile health platforms for disease management in developing countries
Globally, the integration of mobile health (mHealth) systems into healthcare delivery is accelerating, with an increasing number of patients already experiencing improved access and outcomes. Developing nations double burden of Communicable Diseases and Non-Communicable Diseases (NCDs), as well as the fact that there is insufficient healthcare service delivery and manpower, necessitates the incorporation of mobile health solutions into the healthcare system [6].
Notably, developing countries such as those in Sub-Saharan Africa (SSA) currently have a rather low adoption rate for high tech mHealth technologies [7]. To address the health challenges in developing nations, it is crucial to investigate effective design strategies for mobile health and to successfully deploy them.
Barriers and enablers in developing a mobile health platform for chronic disease management in SSA revealed several challenges [8]. Barriers included the lack of established mobile health systems, security concerns, inconvenient features, digital illiteracy, unreliable infrastructure, inadequate training and local context adaptation. Key barriers to the adoption of mobile health (mHealth) technologies in low-resource settings include socio-economic and infrastructural challenges, such as limited internet connectivity and cultural differences that require tailored solutions, like using local languages. A. Moreover, when digital tools are introduced without adequate training, they are often not used effectively or widely adopted. Evidence from successful implementations highlights that low-cost, scalable interventions co-designed with local stakeholders are critical to addressing these barriers. However, the rise of advanced mHealth technologies risks exacerbating inequities between high- and low-income populations due to disparities in resources, training, and access to cutting-edge tools. To bridge these gaps, global collaborations should focus on low-cost alternatives or open-source platforms, ensuring accessibility, training, and sustainable implementation in resource-limited settings.
A humanity-centered approach would build on such platforms by incorporating cultural insights, local languages, and partnerships with community health workers to enhance adoption and scalability. It also ensures inclusivity and sustainability by addressing socio-political factors, unreliable infrastructure, and environmental considerations, such as using low-energy servers. This broader perspective is critical for bridging the digital divide and fostering equitable, scalable, and contextually relevant mHealth solutions.
3. Leveraging mobile health technologies for exercise and physical performance
In addition to improved healthcare, mobile health technologies are also increasingly used in sports and exercise. Throughout all levels of society, mHealth can play a role in helping individuals achieve their goals, whether by encouraging active lifestyles for general health, supporting rehabilitation programs, or enhancing performance among amateur and elite athletes. Related to key challenges in the adoption of mHealth in a sports and health context, it has been stressed that all stakeholders within the training and recovery process should support the use of (mobile) technology and be well-informed about the capabilities and limitations [9]. These stakeholders may not only include the active individuals, but also their coaches, physiotherapists, sport scientists, nutritionists, etc. A challenge in (elite) sports is the potential over-reliance on technology by athletes. Coaches want them to stay ‘in tune’ with their inner sense effort, rather than becoming reliant on data [10]. Furthermore, the challenge of equity in access is present for various domains. Specific to sports performance, the digital divide between teams and organizations can exacerbate unfair competitive advantages.
Despite these challenges, significant opportunities exist. Mobile health technologies enable personalized training and rehabilitation, tailoring regimens to individual physiological and psychological profiles, thus enhancing both performance and recovery. Furthermore, these technologies facilitate community building, providing platforms for knowledge sharing and support among athletes, coaches, and fans. Lastly, ethical and sustainable practices in technology development, coupled with data-driven public health insights, can contribute to the overall well-being of society, highlighting the broader potential impact of these innovations.
4. mHealth within the One Health framework to address the interconnected health of humans, animals, and ecosystems
The One Health (OH) concept, which integrates human, animal, and environmental health, has gained momentum globally over the past decade. The concepts of One Health and humanity-centered design intersect in their focus on holistic approaches to health and well-being, emphasizing the interconnectedness of human, animal, and environmental health.
The concept of humanity-centered design has emerged as an extension of Human Centered Design, considering long-term ecosystem impacts and emphasizing participatory design [2,11]. Wakkary advocates for a design approach that is responsive to the lifeworld - that is, the lived experiences, practices, and contexts of all those affected by the design - it impacts, integrating both human and non-human perspectives [11].
The integration of mobile health technologies into the One Health framework presents both challenges and opportunities in advancing a humanity-centered future.
The One Digital Health (ODH) [5] framework has been developed to integrate digital technologies to enhance collaboration across human health, animal health, and environmental sectors. This approach aims to address operational barriers by enhancing insights and enabling data-driven public health strategies. A key challenge is the fragmented data landscape, which hinders the development of integrated solutions across human, animal, and environmental data. Additionally, rapid advancements in digital health raise ethical and legal concerns about data privacy and equitable benefit sharing, underscoring the need for a global One Digital Health (ODH) framework to promote fair data sharing [12].
An example of a mHealth intervention that integrates human, animal, and environmental health is the Predictive Livestock Early Warning System (PLEWS). By combining wearable sensors, GPS, and satellite data, PLEWS monitors livestock health, predicts zoonotic disease outbreaks, and assesses environmental risks such as droughts. This system supports the One Health agenda by facilitating cross-sectoral collaboration, enabling timely interventions to prevent zoonotic spillover, and promoting sustainable livestock management practices.
Leveraging mobile health technologies within the One Health framework offers significant potential for improving health outcomes through better data integration and collaboration. However, overcoming data fragmentation, ethical concerns, and the need for equitable frameworks is essential for a humanity-centered future in health. The development of One Digital Health can support these efforts by promoting a more integrated approach across human, animal, and environmental domains [12].
5. Recommendations and conclusions
In conclusion, the exploration of these three critical areas within mobile health (mHealth) technologies highlights the pivotal role of a One Health approach, integrated with Humanity-Centered Design, in advancing health outcomes globally. Digital technologies in healthcare are ultimately intended to enhance societal health outcomes in a sustainable and equitable manner. Humanity-centered design is a problem-solving and innovation framework that places the well-being of all people—and the planet—at the core of the design process. While rooted in human-centered design principles, humanity-centered design expands its scope to address systemic, societal, ethical, and environmental considerations.
As underscored in this manuscript, digital technologies such as mHealth can only fulfill their transformative potential when embedded within a broader ecosystemic framework that incorporates ethical foresight, environmental awareness, and participatory methodologies [2,13]. From this perspective, digital innovation is not an end but a medium through which designers, engineers, and health professionals can co-create sustainable futures that include both human and non-human stakeholders [2,4,5].To harness the full potential of mHealth technologies through a combined perspective, the following recommendations should be considered:
-
1.
Promote equitable access to technology: Ensure that mHealth solutions are accessible to underserved populations by adopting low-cost, efficient alternatives and addressing the digital divide. Invest in infrastructure and capacity-building in low-resource regions to ensure fair distribution of digital health innovation.
-
2.
Educate and inform stakeholders: Engage healthcare professionals, patients, and communities through educational initiatives that raise awareness of the benefits and challenges of mHealth and One Health.
-
3.
Balance technology with human intuition: While integrating advanced technologies, maintain the essential role of human expertise and intuition in health decision-making.
-
4.
Prioritize User-Centered innovation: Keep users at the core of mHealth design, ensuring that technologies are developed with their needs and contexts in mind, and involve stakeholders in the innovation process. In the inclusivity vision of a humanity-centered design world, all living beings are included in the term “user”.
-
5.
Collaborate and share knowledge: Foster collaboration across sectors to avoid proprietary silos and scale solutions globally.
-
6.
Monitor and evaluate progress: Implement robust monitoring and evaluation systems to assess the effectiveness of One Health and mHealth initiatives.
-
7.
Foster formal multisectoral coordination: Strengthen global collaboration and reduce fragmentation in education, research, and funding through multisectoral governance structures.
By addressing these recommendations, the global community can leverage mHealth technologies to create a future that is not only more integrated and data-driven but also one that is inclusive, equitable, and humanity-centered in its approach to health across sectors.
CRediT authorship contribution statement
F. Masci: Writing – review & editing, Writing – original draft, Conceptualization. J. Gielen: Writing – review & editing, Writing – original draft. G. Tadese Aboye: Writing – review & editing, Writing – original draft. J.M. Aerts: writing- review & editing - Conceptualization.
Ethical considerations
None.
Funding
None.
Declaration of competing interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Data availability
No data was used for the research described in the article.
References
- 1.Norman D.A., Draper W.S. first ed. 1986. User Centered System Design; New Perspectives on Human-Computer Interaction. Hillsdale, New Jersey. [Google Scholar]
- 2.Norman D.A. first ed. 2023. Design for a Better World; Meaningful, Sustainable, Humanity Centered. Cambridge, Massachusets. [Google Scholar]
- 3.WHO Global Observatory for eHealth . Global Observatory for eHealth Series - Volume 3; 2011. mHealth; New horizons for health through mobile technologies.https://iris.who.int/handle/10665/44607 (accessed 27 May 2025) [Google Scholar]
- 4.van Velsen L., Ludden G., Grünloh C. The limitations of user-and human-centered design in an eHealth context and how to move beyond them. J. Med. Internet Res. 2022;24 doi: 10.2196/37341. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Masci F. In: Exploring Research through Co-Design: Multiple Perspectives for Collaborative Inquiry. Busciantella-Ricci D., Scataglini S., editors. CRC Press; Boca-Raton: 2025. (in press). Humanity-centered co-design: Shaping the future of healthcare innovation. [Google Scholar]
- 6.Aboye G.T., Vande Walle M., Simegn G.L., Aerts J.M. mHealth in sub-Saharan Africa and Europe: context of current health, healthcare status, and demographic structure. Digit Health. 2023;29 doi: 10.1177/20552076231178420. 20552076231178420. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7.Aboye G.T., Vande Walle M., Simegn G.L., Aerts J.-M. Current evidence on the use of mHealth approaches in sub-Saharan Africa: a scoping review. Health Policy Technol. 2023;12 doi: 10.1016/j.hlpt.2023.100806. [DOI] [Google Scholar]
- 8.Aboye G.T., Simegn G.L., Aerts J.-M. Assessment of the barriers and enablers of the use of mHealth Systems in sub-Saharan Africa According to the perceptions of patients, physicians, and health care executives in Ethiopia: qualitative study. J. Med. Internet Res. 2024;26 doi: 10.2196/50337. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Luczak T., Reuben B., Lewis E., Chander H., Ball J. State-of-the-art review of athletic wearable technology: what 113 strength and conditioning coaches and athletic trainers from the USA said about technology in sports. Int. J. Sports Sci. Coach. 2020;15:26–40. doi: 10.1177/1747954119885244. [DOI] [Google Scholar]
- 10.Wells L., Konoval T., Bruce L. An examination of how and why triathlon coaches use a suite of technologies in their practice. Int. J. Sports Sci. Coach. 2022;18:687–694. doi: 10.1177/17479541221144129. [DOI] [Google Scholar]
- 11.Wakkary R. first ed. 2021. Things we Could Design; for More than Human-Centered Worlds. Cambridge, Massachusets. [Google Scholar]
- 12.Scott P., Adedeji T., Nakkas H., Andrikopoulou E. One health in a digital world: technology, data, information and knowledge. Yearb. Med. Inform. 2023;32 doi: 10.1055/s-0043-1768718. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Ystgaard K.F., De Moor K. Envisioning the future: a multi-disciplinary approach to human-centered intelligent environments. Qual. User Exp. 2023;8 doi: 10.1007/s41233-023-00064-5. [DOI] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
No data was used for the research described in the article.