Digital Health and Health Equity in India: Are Digital Interventions Leaving Vulnerable Populations Behind?  

Abstract

Received: 15-09-2026 Accepted: 19-09-2026 Background: India has rapidly expanded digital health infrastructure through telemedicine, mobile health applications, digital public infrastructure, and artificial intelligence-enabled services. While these technologies promise to overcome geographical and resource barriers, their equity implications remain contested. This review synthesises Indian and international evidence to examine whether digital health is narrowing or widening health inequities. We develop a layered equity framework—comprising digital access, ability to use, ability to understand, ability to trust, ability to obtain care, quality of care, and health outcome—as the authors' synthesis, not as an established published framework. Evidence indicates that digital health has demonstrated genuine equity-promoting potential under specific conditions: assisted telemedicine models, community health worker facilitation, and hybrid care pathways. However, digital-by-default service models, low digital health literacy, gender gaps in device ownership, disability accessibility barriers, and privacy concerns systematically disadvantage rural populations, older adults, women, persons with disabilities, and socioeconomically marginalised groups. India's policy architecture has achieved supply-side enrolment equity but remains weak on demand-side equity and algorithmic accountability. Digital health neither universally leaves vulnerable populations behind nor inherently advances equity. Its net effect depends on deliberate design, implementation, and governance decisions. Digital health should generally complement rather than replace non-digital care pathways for populations at risk of exclusion.