Governance-by-Design as an Enabler of AI in Digital Health in Sub-Saharan Africa

To harness the benefits of artificial intelligence (AI)-enabled healthcare, access to data is a crucial component of AI in digital health technology development and adoption. This requires effective frameworks of digital and data governance. This paper highlights important digital, data, and data-related issues that present unique and pressing challenges to such adoption in sub-Saharan Africa (SSA). Specific non-exclusive challenges in SSA arise from issues around data integrity and quality, interoperability, and data provenance. Related emerging issues centre on surveillance capitalism, data commodification, and coloniality. Certain digital and data governance strategies and solutions in support of the public good are in place and include various legal rights, regulatory policies, and ethics frameworks. Building on these solutions, I advance an innovative and supplementary mechanism of grounding digital and data governance on the theoretical approach of human-centric design and on ideas of embedding ethics and law. As illustrated in India, this ‘third way’ of ‘governance-by-design’ practically embeds and operationalises rules as protocols within the infrastructure and architecture of the technology itself. Accordingly, an inclusive and augmented data and digital governance-by-design solution is offered as an enabler of AI in digital health in SSA.