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The concept of digital literacy has been defined in numerous ways over the last two decades to incorporate rapid technological changes, its versatility, and to bridge the global digital divide. Most approaches have been technology-centric with an inherent assumption of cultural and political neutrality of new media technologies. There are multiple hurdles in every stage of digital literacy implementation. The lack of solutions such as local language digital interfaces, locally relevant content, digital literacy training, the use of icons and audio excludes a large fraction of illiterate people. In this article, we analyse case studies targeted at under-connected people in sub-Saharan Africa and India that use digital literacy programmes to build knowledge and health literacy, solve societal problems and foster development. In India, we focus on notable initiatives undertaken in the domain of digital literacy for rural populations. In Sub-Saharan Africa, we draw from an original project in Kenya aiming at developing digital literacy for youth from low-income backgrounds. We further focus on Senegal, Mali, Burkina Faso and Tanzania, where field studies have been conducted on the use of digital technologies by low-literacy people and on how audio and icon-based interfaces and Internet lite standard could help them overcome their limitations. The main objective of this article is to identify key performance indicators (KPIs) in the context of digital literacy skills as one of the pillars for digital inclusion. We will learn how digital literacy programmes can be used to build digital literacy and how KPIs for sustainable development can be established. In the final discussion, we offer lessons learned from the case studies and further recommendation for stakeholders and decision-makers in the field of digital health literacy.

The concept of digital literacy has been defined in numerous ways over the last two decades to incorporate rapid technological changes, its versatility, and to bridge the global digital divide. Most approaches have been technology-centric with an inherent assumption of cultural and political neutrality of new media technologies. There are multiple hurdles in every stage of digital literacy implementation. The lack of solutions such as local language digital interfaces, locally relevant content, digital literacy training, the use of icons and audio excludes a large fraction of illiterate people. In this article, we analyse case studies targeted at under-connected people in sub-Saharan Africa and India that use digital literacy programmes to build knowledge and health literacy, solve societal problems and foster development. In India, we focus on notable initiatives undertaken in the domain of digital literacy for rural populations. In Sub-Saharan Africa, we draw from an original project in Kenya aiming at developing digital literacy for youth from low-income backgrounds. We further focus on Senegal, Mali, Burkina Faso and Tanzania, where field studies have been conducted on the use of digital technologies by low-literacy people and on how audio and icon-based interfaces and Internet lite standard could help them overcome their limitations. The main objective of this article is to identify key performance indicators (KPIs) in the context of digital literacy skills as one of the pillars for digital inclusion. We will learn how digital literacy programmes can be used to build digital literacy and how KPIs for sustainable development can be established. In the final discussion, we offer lessons learned from the case studies and further recommendation for stakeholders and decision-makers in the field of digital health literacy.

The concept of digital literacy has been defined in numerous ways over the last two decades to incorporate rapid technological changes, its versatility, and to bridge the global digital divide. Most approaches have been technology-centric with an inherent assumption of cultural and political neutrality of new media technologies. There are multiple hurdles in every stage of digital literacy implementation. The lack of solutions such as local language digital interfaces, locally relevant content, digital literacy training, the use of icons and audio excludes a large fraction of illiterate people. In this article, we analyse case studies targeted at under-connected people in sub-Saharan Africa and India that use digital literacy programmes to build knowledge and health literacy, solve societal problems and foster development. In India, we focus on notable initiatives undertaken in the domain of digital literacy for rural populations. In Sub-Saharan Africa, we draw from an original project in Kenya aiming at developing digital literacy for youth from low-income backgrounds. We further focus on Senegal, Mali, Burkina Faso and Tanzania, where field studies have been conducted on the use of digital technologies by low-literacy people and on how audio and icon-based interfaces and Internet lite standard could help them overcome their limitations. The main objective of this article is to identify key performance indicators (KPIs) in the context of digital literacy skills as one of the pillars for digital inclusion. We will learn how digital literacy programmes can be used to build digital literacy and how KPIs for sustainable development can be established. In the final discussion, we offer lessons learned from the case studies and further recommendation for stakeholders and decision-makers in the field of digital health literacy.

Background Health workers have traditionally delivered health promotion and education to rural communities in the Global South in paper leaflet formats or orally. With the rise of digital technologies, health promotion and education can be provided in innovative and more effective formats, which are believed to have a higher impact on disease prevention and treatment. Objective The aim of this tutorial is to illustrate how a multi- and interdisciplinary approach can be applied in the design process of digital health messages for use in the Global South. Methods The multi- and interdisciplinary team of the Non-discriminating access for Digital Inclusion (DigI) project digitalized and customized available government-approved paper-based health promotion messages into a screen-suitable format. The team worked closely together and used its diverse expertise to develop digital health messages with disease-specific content in Tanzania's national language (Swahili) as well as English. The development process included the following phases: a local needs assessment; identification of government-approved health promotion materials in a nondigital format; identification of key health messages; creation of a practical and engaging story, easy to understand for the general public; drafting of a storyboard for an animated video with review, feedback, and revisions; forward and backward translation; audio recording of the story in both languages; finalization and presentation of the animations; development of relevant questions related to the health messages in each domain; and development of web and mobile apps to access the digital health messages. Results Between 2017 and 2019, we developed key health messages, quizzes, and animated health videos to address HIV/AIDS, tuberculosis, Taenia solium cysticercosis and taeniasis, and anthrax, all of which are of public health importance in Tanzania. Feedback from local stakeholders and test users was included in various phases of the process. The 4 videos and other content are available in local information spots on a digital health platform (DigI platform), established by the DigI project, in both Tanzanian Swahili and English. Conclusions Our methodological multi- and interdisciplinary approach ensures that the digital health messages for the public are clear, high quality, and align with the government's objectives for health promotion. It also demonstrates the diversity of scientific disciplines required when collaborating on a digital health project. We recommend this approach to be applied to the development of other digital health messages for a wide range of diseases. International Registered Report Identifier (IRRID) RR2-10.2196/25128