The new normal of eHealth equity: Transforming chronic disease management amid rural technological constraints and digital divides

Caleb Kadiri 1, * and Babatunde O. Owolabi 2

1 Pharmacist and Health Analyst, Kwara State University, Nigeria.
2 Department of Community Medicine, College of Medicine, Ladoke Akintola University of Technologies, Oyo State, Nigeria.
 
Review
International Journal of Science and Research Archive, 2020, 01(01), 251-269.
Article DOI: 10.30574/ijsra.2020.1.1.0014
Publication history: 
Received on 11 October 2020; revised on 21 December 2020; accepted on 29 December 2020
 
Abstract: 
 In the new health landscape "new normal" in healthcare has seen an irreversible pivot toward digital health systems, radically reshaping the landscape of chronic disease management. Central to this transformation is the deployment of telehealth platforms, remote diagnostic tools, AI-powered clinical decision support, and mobile health applications, all promising to increase efficiency, coverage, and continuity of care. However, these innovations are often designed with high-bandwidth, urban ecosystems in mind-leaving rural, low-income, and infrastructurally disadvantaged regions at the margins of healthcare innovation. This digital inequity poses profound risks for populations already burdened by higher rates of chronic diseases such as type 2 diabetes, hypertension, COPD, and cardiovascular disorders. This paper critically examines how the "new normal" can be reimagined to include digital parity in chronic care delivery. It dissects infrastructural barriers such as unreliable internet, electricity scarcity, fragmented data governance, and the absence of regionally contextualized digital health architecture. It further analyzes sociotechnical challenges, including low eHealth literacy, cultural mistrust in digital platforms, and limited integration between community-based care and formal health systems. Drawing from case studies across sub-Saharan Africa, South Asia, and remote North American territories, the study identifies scalable innovations like asynchronous telemedicine, hybrid online-offline mHealth platforms, community-powered digital navigators, and low-code platforms that address the unique needs of bandwidth-constrained areas. The analysis calls for a redefinition of digital health equity through inclusive infrastructure investment, adaptive technology design, and cross-sectoral policy alignment. The “new normal” must not merely digitize health systems but democratize them ensuring rural communities are central actors in chronic disease management through equitable digital transformation.
 
Keywords: 
Digital Health Equity; Chronic Illness Informatics; Rural Telemedicine; Low-Bandwidth eHealth; Infrastructure-Inclusive Design; Public health emergency
 
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Copyright © 2020 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0