Dr. Uzodinma Adirieje
Global Health and Development Projects Consultant | Conferences Organiser | Trainer| Facilitator | Researcher | M&E Expert | Civil Society Leader | Policy Advocate | Climate-Health Specialist
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Dear Neil,
Health information dissemination is frequently designed around an implicit assumption that all members of a community access, interpret, and act on information in the same way. This assumption does not hold in most African and low-resource settings, where gender shapes who owns a phone, who controls household decision-making, who has time to attend a community meeting, and who is permitted to act on health guidance once received. The result is a recurring pattern across maternal health, HIV, immunization, reproductive health, and outbreak response programming: messages reach a population, but not the population, with women and girls disproportionately left at the margins of systems intended to serve them.
Diverse National Contexts Across Africa
Across Africa, these challenges are evident in different forms. In Nigeria, persistent gender disparities in literacy, digital access, and household decision-making continue to affect women's access to maternal, child health, and immunization information, particularly in rural and conflict-affected communities. In the Democratic Republic of the Congo (DRC), recurrent humanitarian crises and population displacement have further complicated equitable dissemination of health information, especially for women and adolescent girls in internally displaced persons (IDP) camps.
In Egypt, despite relatively stronger digital infrastructure, women in some rural and underserved communities continue to experience barriers associated with educational attainment and social norms that influence health-seeking behaviour. Similarly, in Zimbabwe, economic instability, migration, and disparities between urban and rural populations have highlighted the continued importance of community health workers and radio-based communication for reaching women with essential health information.
This article examines what current evidence from Kenya, Tanzania, Malawi, Mozambique, and experiences from Nigeria, the DRC, Egypt, and Zimbabwe reveal about gendered access to health information, and what that evidence implies for building health information systems that are not only inclusive in design but durable in impact.
THE ACCESS GAP IS STRUCTURAL, NOT INCIDENTAL
Digital and Social Barriers to Information Access
Health information systems across Africa often assume a neutral user, an assumption that obscures real, gendered barriers to access. Across Sub-Saharan Africa, women remain 29% less likely than men to use mobile internet, the primary channel through which health information increasingly travels in low-resource settings. Similar digital gender gaps have been documented in Nigeria and Zimbabwe, where unequal access to mobile technologies and internet services limits women's opportunities to receive timely health information. In the DRC, poor telecommunications infrastructure in conflict-affected provinces compounds these inequalities, while in Egypt, digital access has improved but disparities remain among poorer and rural households.
Evidence from Malawi and Mozambique
Evidence from Malawi and Mozambique further illustrates these challenges. Women constituted only 30% and 10% respectively of callers to national health hotlines in 2024, despite these platforms being central to maternal and reproductive health guidance. These are not usage anomalies; they reflect entrenched disparities in literacy, mobile ownership, household decision-making power, and time poverty that are mirrored across many African countries.
LESSONS FROM THE FIELD
Lessons from Nigeria, the DRC, Egypt and Zimbabwe
Comparable lessons have emerged elsewhere. In Nigeria, community-based health volunteers, traditional birth attendants, religious leaders, and Ward Development Committees have played important roles in improving acceptance of immunization, maternal health services, and disease prevention messages, particularly in underserved communities. During responses to Ebola, COVID-19, and other public health emergencies, the DRC demonstrated the importance of trusted local leaders and community engagement in overcoming misinformation and increasing acceptance of public health interventions.
Egypt has expanded the use of digital health platforms alongside community outreach to improve women's access to reproductive and family health information, while Zimbabwe continues to demonstrate the effectiveness of village health workers and community radio in reaching rural women with maternal and child health messages.
Community-Based Communication in Kenya
A 2025 radio intervention in a Nairobi informal settlement offers a useful counter-example. By pairing a seven-week broadcast series with parent-adolescent listening sessions, the programme strengthened communication on sexual and reproductive health within households rather than treating adolescents as isolated recipients of information. This illustrates a principle that Afrihealth Optonet Association (AHOA) has consistently applied across its network namely that health information dissemination succeeds when it is routed through existing social structures including households, peer groups, faith communities, women's associations, and traditional leadership structures, rather than around them.
Inclusive Digital Health Design
In Tanzania, an mHealth data model designed through participatory action research improved reproductive and child health information access by building reminder systems around women without mobile phones, rather than excluding them by default. The lesson for system designers is precise: gender-responsive design must account for non-users, not only users.
IMPLICATIONS FOR HEALTH SYSTEMS STRENGTHENING
Core Principles for Sustainable Practice
Several principles follow for sustainable, system-level practice.
Diversify Communication Channels
Channel diversity matters more than channel sophistication; voice messaging, radio, interpersonal communication, and community health worker contact remain indispensable where smartphone penetration or digital literacy remains limited.
Engage Trusted Community Gatekeepers
Household and community gatekeepers, including husbands, mothers-in-law, elders, religious leaders, and traditional authorities, should be engaged as information intermediaries rather than bypassed. Experiences from Nigeria, the DRC, Egypt, and Zimbabwe demonstrate that culturally trusted actors often determine whether health information is accepted and acted upon.
Strengthen Gender-Responsive Monitoring
Monitoring frameworks must routinely disaggregate indicators by sex, age, location, disability, and socioeconomic status, since aggregate uptake figures frequently mask exclusion among women and girls.
Build Resilient Information Systems
Health information systems must be designed with sufficient flexibility to operate effectively during humanitarian emergencies, conflict, displacement, disease outbreaks, and economic crises. The experiences of the DRC and Nigeria, together with lessons from Zimbabwe and Egypt, underscore the importance of resilient, community-based communication systems that continue functioning when conventional health services are disrupted.
CONCLUSION
Health information systems that ignore gendered access patterns do not merely underperform - they reproduce inequity within the very systems meant to correct it. Embedding gender analysis into dissemination design from inception, rather than retrofitting it afterwards, is what distinguishes durable health system strengthening from short-lived information campaigns. As African countries continue to pursue Universal Health Coverage (UHC) and strengthen resilience against future health emergencies, gender-sensitive health information systems should be recognised not as optional programme components but as essential pillars of equitable and effective health systems.
REFERENCES
1. GSMA. (2025). Mobile Gender Gap Report 2025. London: GSMA.
2. Maina, B. W., Nyakangi, V., Mbuthia, M., Kabiru, C. W. (2025). Using radio programming to reach young adolescents with gender and sexual health information in a low-income urban setting in Kenya. Reproductive Health.
3. Thobias, J., Kiwanuka, A. (2018). Design and implementation of an m-health data model for improving health information access for reproductive and child health services in low resource settings using a participatory action research approach. BMC Medical Informatics and Decision Making.
4. Powelson, J., Gondwe, L., Akama, E., Kachule, H., Dambe, R., Muchanga, V., et al. (2026). A qualitative, participatory study to identify barriers and facilitators to women's uptake of National Health Hotline Solutions in Malawi and Mozambique. Oxford Open Digital Health, 4, oqaf035. https://doi.org/10.1093/oodh/oqaf035
5. Regional Committee for Africa, 73. (2023). Strengthening community protection and resilience: regional strategy for community engagement, 2023–2030 in the WHO African Region: report of the Secretariat. World Health Organisation. Regional Office for Africa. https://iris.who.int/handle/10665/372392
6. United Nations Children's Fund (UNICEF). (2023). The State of the World's Children 2023: For every child, vaccination. https://www.unicef.org/reports/state-of-the-worlds-children-2023
7. Federal Ministry of Health. (2019). Second National Strategic Health Development Plan (NSHDP II) 2018-2022. https://health.gov.ng/doc/NSHDP%20II%20Final.pdf
8. Nigeria Centre for Disease Control and Prevention. (2025). Nigeria Multi-Hazard Risk Communication Guidelines. Breakthrough ACTION and RESEARCH. https://breakthroughactionandresearch.org/resource-library/nigeria-multi...
“Technological tools, including computers, search engines, statistical software, AI, and other digital applications routinely employed in contemporary scholarship, assisted in the preparation of this work. However, the conceptualisation, analysis, interpretation, verification of information, conclusions, and responsibility for the content remain solely those of the author.”
— Dr. Uzodinma Adirieje (June 2026)
HIFA profile: Dr. Uzodinma Adirieje is a leading voice in health education, community health, and advocacy, with decades of experience advancing people-centered development across Africa and beyond. His approach to health education emphasizes participatory learning, knowledge transfer, and behavior change communication, ensuring that individuals and communities gain the skills and awareness to make informed decisions about their health. He develops and delivers innovative health promotion strategies tailored to local realities, particularly in resource-limited settings. In community health, Dr. Adirieje has championed integrated primary health care, preventive medicine, and grassroots health initiatives. Through Afrihealth Optonet Association (AHOA), which he leads, he connects civil society, community groups, and health institutions to strengthen healthcare delivery, tackle health inequities, and improve access to essential services for vulnerable populations. His work addresses infectious diseases, maternal and child health, nutrition, climate and health, environmental health, and emerging public health challenges. As a passionate advocate, Dr. Adirieje works with governments, NGOs, and international organizations to influence health policy, mobilize resources, and promote sustainable development goals (SDGs). He amplifies community voices, ensuring that health systems are inclusive, accountable, and responsive. His advocacy extends beyond health to governance, environment, and social justice, positioning him as a multidisciplinary leader shaping healthier and more equitable societies. afrepton AT gmail.com