What it will take to spur meaningful behaviour change in adolescent health

The global development sector is going through a period of recalibration. Funding models are shifting, institutions are under pressure, and long-standing assumptions about how innovation moves from pilot to scale are being tested in real time. In this context, digital health, especially digital interventions aimed at adolescents, sits at a critical intersection of opportunity and responsibility.

The question before us is no longer whether digital interfaces can influence behaviour in adolescent health. The evidence increasingly suggests they can. The more important question is how we design, govern, and scale these tools in ways that are safe, trusted, and institutionally sustainable, particularly in low- and middle-income contexts.

“This is not a matter of inclusion for its own sake. It is a system necessity. Youth-centred governance helps surface blind spots early, reduces the risk of harm, and strengthens long-term adoption.”

Across recent global conversations, including at the Global Digital Health Forum, one signal has been consistent: the centre of gravity is shifting away from pilots and promise toward governance, safeguards, evidence, and systems that can hold scale. African-led digital innovation is no longer aspirational; it is increasingly expected. What matters now is whether we are building the pathways that allow good ideas to move responsibly from concept to institutional adoption.

Adolescents at the centre, not the margins

Adolescence is a uniquely sensitive life stage. Digital tools that engage young people on issues such as mental health, sexual and reproductive health, nutrition, or climate-related risks are operating not just in a technical space but in a deeply social, cultural, and emotional terrain.

Too often, adolescents are framed as end-users or beneficiaries of digital health solutions. A more durable approach recognises them as co-designers, co-creators, and, critically, co-governors of the systems intended to serve them. When youth voices shape not only content but also decision-making, escalation pathways, and accountability mechanisms, digital interfaces are far more likely to be relevant, trusted, and effective.

This is not a matter of inclusion for its own sake. It is a system necessity. Youth-centred governance helps surface blind spots early, reduces the risk of harm, and strengthens long-term adoption.

Read also: US urges Nigeria to invest in youth, adolescent skills development

Responsible AI is not optional

As artificial intelligence becomes more embedded in digital health interfaces, from chatbots to decision-support tools, the stakes rise. In adolescent health, questions of safeguarding, consent, data protection, and escalation are not secondary considerations; they are foundational.

Responsible AI in this context requires more than ethical statements or design principles. It demands clear safeguards, defined thresholds for risk, and agreed protocols for when and how digital systems escalate to human support. It also requires sensitivity to local norms, languages, and realities, recognising that algorithms trained elsewhere may not translate seamlessly into new contexts.

Trust is built not through speed, but through transparency and accountability. Adolescents, carers, and governments alike need confidence that digital systems will do what they claim, and, just as importantly, that they will not do harm.

From pilots to institutions

One of the persistent challenges in digital health has been the gap between innovation and institutional adoption. Promising pilots proliferate, yet few transition into government-owned or nationally scaled systems.

Bridging this gap requires a shift in posture. For organisations operating at scale, the role is not only to implement solutions but also to help shape the enabling conditions around them, from regulatory navigation and field validation to evidence generation and partnership models that align with public systems.

In a climate where traditional funding flows are becoming more uncertain and multilateral cooperation is under strain, this systems-oriented approach is no longer optional. Governments are rightly asking harder questions: What evidence supports this intervention? How does it integrate with existing services? Who is accountable if something goes wrong? And what happens when donor funding ends?

Digital interfaces that cannot answer these questions will struggle to move beyond the pilot phase.

Collaboration as infrastructure

None of this can be achieved by any single actor. Progress in adolescent digital health depends on deliberate collaboration across sectors, governments, researchers, implementers, funders, technologists, and, crucially, young people themselves.

The most productive convenings are not those that showcase tools but those that create space for shared sense-making: grappling openly with trade-offs, risks, and design choices. Consensus is less important than clarity, clarity about roles, responsibilities, and the standards we are collectively willing to uphold.

In this sense, collaboration is not a soft add-on. It is a form of infrastructure, enabling trust, alignment, and long-term impact.

Moving forward with intention

The opportunity ahead in adolescent digital health is not about moving faster. It is about moving with intention. That means converting dialogue into disciplined action and experimentation into learning that institutions can use.

It also means recognising that behaviour change is rarely driven by technology alone. Digital interfaces are most effective when they are embedded within broader systems of care, policy, and social support, and when they respect the agency and realities of the young people they seek to engage.

As we look toward 2026 and beyond, the task is clear: to codify what “responsible scale” looks like in practice. Shared safeguards. Credible evidence thresholds. Adoption pathways that governments can trust.

If we get this right, digital interfaces can do more than deliver information. They can help create conditions in which adolescents are empowered, supported, and able to make healthier choices, not just online, but in the systems that shape their lives.

Ota Akhigbe is the Director of Partnerships & Programmes at eHealth Africa, where she leads cross-sector collaborations at the intersection of digital health, public systems, and scale across Africa. Her work focuses on building trusted, evidence-driven pathways that enable responsible adoption of digital and AI-enabled health solutions.