The use of technology to access healthcare: an exploration of eHealth literacy and related disparity in Bangladesh

Given the development potential of technology, globally policy makers and other health actors are in the process of embracing Information Communication Technology (ICT) as a solution to various development challenges. However, this may result in inequitable access to services if the evident digital divide is not addressed. In Bangladesh, the digital divide may be the reason for the low use of Electronic Health (eHealth) to access healthcare as well as health information and services, despite huge household ownership of mobile devices, a large subscriber base and a strong political mandate. This thesis takes a bottom-up approach to understand what makes people access eHealth using their electronic devices and what barriers inhibit this action. Being inspired by the theory of diffusion of innovation, the Capability Approach (CA) and the choice framework, this thesis demonstrates, through a mixed method approach in semi-urban Bangladesh, that access to eHealth is influenced by socio-demographic dimensions and that this puts young and educated adults at the forefront of technological use. It further explains that it is also important to have eHealth literacy, which is a combination of health, information and technology literacy, to enable owners of devices to use eHealth to access healthcare. As sequential steps, the thesis presents a framework to shows how young and educated adults make use of their agency, resources and structural factors to attain (or not) eHealth literacy. Considering these steps as equity dimensions, this framework offers a philosophical and methodological reference point to policy makers and other relevant stakeholders in Bangladesh and similar contexts, for effective and equitable integration of eHealth to ensure access to healthcare by all.