User-centered design and related participatory approaches in digital health innovations for low-resource settings: A...

The primary objective of this scoping review is to identify and synthesize the existing evidence on the applications, reported outcomes, and key methodological considerations of user-centered design (UCD) and related participatory design methodologies including human centered design (HCD), co-design, participatory design and co-creation of digital health innovations within resource constrained settings.

A critical challenge in global health is the high failure rate of technologically sound innovations. This is due in part to insufficient consideration of the end-user's environment, literacy levels, and socio-cultural beliefs. UCD is an iterative design process that grounds development in an understanding of the user's needs, contexts, and feedback. It sits within a wider family of related approaches such as HCD, co-design, participatory designs and co-creation, while related to UCD, is distinguished by its emphasis on equitable partnership, where end-users are not merely informants but co-designers and co-developers of the innovation. These approaches have emerged as promising methodologies to develop more relevant, acceptable, and sustainable digital health solutions. In disease diagnostics, despite increasing interest, there is lack of a consolidated review mapping the full scope of how these methodologies are applied, across which types of digital health and diagnostic innovations, and with what outcomes.

Studies conducted in low-resource settings, published between 2015 and 2026 that apply UCD or a related participatory design methodology to the development, adaptation or evaluation of a digital health innovation and, where reported, outcomes such as usability, patient satisfaction, innovation success, adoption, scalability and sustainability. Studies that name such an approach without describing the activities undertaken are also eligible, and the completeness of reporting will be recorded and reported as a finding of this review.

Guided by the JBI methodology for scoping reviews and reported in accordance with PRISMA-ScR, we will search MEDLINE, Embase, CINAHL, Scopus, Web of Science, IEEE Xplore, the ACM Digital Library, the WHO Global Index Medicus, and Google Scholar, together with named grey literature sources, for peer-reviewed articles, conference proceedings, and grey literature published in English and French from 2015 to 2026. Data extraction will include information on study characteristics, the design approaches and processes applied, the completeness with which they are reported as well as the outcomes.