IMPACT OF DIGITAL DIVIDE ON HEALTHCARE ACCESS AND HEALTH OUTCOMES IN RURAL POPULATIONS

Abstract

Background: The global shift toward digital healthcare has the potential to improve service delivery; however, it has also amplified existing inequities for rural populations lacking access and literacy. In Pakistan, where rural healthcare access is already limited, the digital divide presents an additional barrier that may further deteriorate health outcomes.

Objective: To investigate the extent of digital health access disparities in rural Pakistan and examine their association with patient-reported health outcomes.

Methods: A mixed-methods study was conducted over eight months (August 2024–April 2025) in the rural districts of Punjab, Sindh and KPK. A total of 120 adult participants were enrolled through purposive and convenience sampling. Quantitative data were gathered using the eHealth Literacy Scale (eHEALS), the EQ-5D-5L, and EQ-VAS instruments. ANOVA and Pearson correlation were applied to assess associations. Additionally, semi-structured interviews with 20 participants were conducted to explore contextual barriers and experiences, with thematic analysis used for interpretation.

Results: Among participants, 72.5% had primary education or less, 39.2% owned a smartphone, and only 28.3% had internet access at home. eHEALS scores revealed low digital literacy in 40.8% of participants. Those with higher eHealth literacy reported better EQ-VAS scores (mean: 74.6) compared to the low literacy group (mean: 53.4), with statistical significance (p < 0.001). Qualitative findings identified digital exclusion, dependency on others for access, and preference for face-to-face care as major themes.

Conclusion: Digital health disparities are a significant determinant of rural health outcomes in Pakistan. Bridging this divide requires integrated efforts in infrastructure, education, and policy reform to ensure equitable access to digital healthcare.