Article Text

Download PDFPDF

Prioritarian principles for digital health in low resource settings
  1. Niall Winters1,
  2. Sridhar Venkatapuram2,
  3. Anne Geniets1,
  4. Emma Wynne-Bannister2
  1. 1 Department of Education, University of Oxford, Oxford, UK
  2. 2 Department of Global Health and Social Medicine, King’s College London, London, UK
  1. Correspondence to Professor Niall Winters, University of Oxford, Oxford OX2 6PY, UK; niall.winters{at}


This theoretical paper argues for prioritarianism as an ethical underpinning for digital health in contexts of extreme disadvantage. In support of this claim, the paper develops three prioritarian principles for making ethical decisions for digital health programme design, grounded in the normative position that the greater the need (of the marginalised), the stronger the moral claim. The principles are positioned as an alternative view to the prevailing utilitarian approach to digital health, which the paper argues is not sufficient to address the needs of the worst off. As researchers of digital health, we must ensure that the most globally marginalised are not overlooked by overtly technocentric implementation practices. Consequently, the paper concludes by advocating for use of the three principles to support stronger critical reflection on the ethics involved in the design and implementation of digital health programmes.

  • information technology
  • public health ethics
  • health workforce
  • distributive justice
  • philosophical ethics

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

View Full Text

Statistics from


  • Twitter @sridhartweet

  • Contributors NW and AG: conceived the manuscript. SV: lead on discussions of distributive justice. All authors contributed substantially to drafting, critically reviewing and editing the manuscript.

  • Funding This work was funded by the Wellcome Trust, grant number 204878/Z/16/Z.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data is contained within the paper.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.