Background
Digital health solutions are rapidly transforming healthcare access across Africa, yet their environmental impact remains greatly under-studied in the region. The Academy for Health Innovation presents a strategic cross-cutting perspective on the integration of carbon footprint assessment into a cluster randomized controlled trial (cRCT) evaluating the delivery of antiretroviral therapy (ART) by drones in Kalangala District, an island on Lake Victoria with longstanding challenges in healthcare delivery and access.
Methods
The ongoing cRCT compares drone-based ART delivery to boat-based supply chain. As part of this trial, we are leading a nested carbon footprint sub-study that employs a longitudinal study design to compare greenhouse gas emissions from both ART delivery models. This carbon sub- study integrates digital health innovation and health systems strengthening with climate action, aligning with the Sustainable Development Goals three (Good Health and Well-Being) and 13 (Climate Action). Using a life cycle assessment approach, the sub-study collects real-world data on fuel and electricity use, trip frequency, payload weights, and logistical inputs associated with each delivery model.
Results
Though the sub-study is still in the data collection phase, this effort marks one of the first few attempts in Sub-Saharan Africa to embed climate accountability into new and emerging technologies and digital health research. It responds to the urgent need for health interventions that not only improve service delivery and equity but also support planetary health goals. Our approach illustrates how environmental data and/or metrics can be operationalized in digital health projects, enabling policymakers make more informed and sustainable decisions.
Conclusion
By incorporating carbon footprint analysis into evaluation of health technologies, we act as a catalyst for broader conversations on climate-smart health systems in Africa. Digital data and artificial intelligence tools are very power hungry and we need to understand the risks as well as benefits to the environment of their use. This work highlights the value of cross-sectoral thinking and supports the growing call for integrating environmental sustainability into digital health policy and planning in low-resource settings.
Keywords: Carbon Footprint; Medical Drones; Digital Health; Life Cycle Assessment; Planetary Health; Health Systems Strengthening
