Co-creating Digital Health Service: Activity Theory and Communicative Ecology Framework Analysis.

Globally, there has been an increase in digital health interventions over the last decade. These interventions aim to improve maternal and infant health outcomes and treatment adherence, as well as HIV/AIDS education and prevention, immunization rates, and communicable disease prevention. The creation of digital health services that incorporated users’ dynamic, multi-level, and complexities are crucial to the advancement of digital healthcare. These services are, at best, co-created by developers, community health workers, and government representatives. However, due to the presence of multiple stakeholders, the co-creation of digital health services is a complex process. The paper presents a case study of the digital health co-creation process, to understand and describe the activities taken by different stakeholders during a co-creation process. Additionally, the use of activity theory and a communicative ecology framework as analytical lenses to identify contradictions, as well as to gain insight into the co-creation of digital health services, are both presented in this paper.