Towards a justice-based reimagination of digital health research and innovation: actionable considerations for learning health systems

The need to embed decolonising methodologies in health-care practice has been recognised globally. The term decolonising health, which has become a topic of increasing public and academic discourse since 2021, refers to the dismantling of colonial systems of dominance and oppression ingrained within health systems and structures. Despite the growing recognition of the need for decolonisation in broader health research and practice, the application of a decolonial lens to the rapidly evolving field of digital health remains largely underexplored. An active commitment to decolonisation should be driven by a quest for social justice. However, a key concern for those committed to decolonisation in any field of inquiry is the continuing hegemony of western Eurocentric knowledge and knowledge systems that dominate much of the global research machinery. Hence, we suggest that decolonisation of digital health should start at the ontological level of coloniality. In this Viewpoint, we present a justice-based reimagination of digital health using the established research paradigm framing of ontology, epistemology, axiology, and methodology. We also map decolonial recommendations across the learning health system model and provide a translational reflexivity checklist to support digital health project teams in decolonising research and innovation activities.