Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan’s Evolving Healthcare Landscape

Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan’s Evolving Healthcare Landscape | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan’s Evolving Healthcare Landscape Muhammad Fayez, Ruqayya Begum, Laiba Khan, Manzoor Ahmad, Wasiq Ahmed, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5138453/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 11 You are reading this latest preprint version Abstract Background: Digital health technology (DHT) offers great promise for revolutionizing healthcare delivery in limited-resource settings such as Pakistan due to existing challenges, including low infrastructure, scarcity of resources, and digital partitioning. The purpose of this study was to explore the affordability and adoption status of health technology among diabetic patients in Pakistan. Methods: A descriptive approach was employed, and primary data were collected via questionnaires from 600 diabetes patients from different areas of Pakistan. The use of a random sampling technique enabled collection from different geographical areas, leading to the recruitment of a broad range among the diabetic population. The descriptive analysis was performed via SPSS 23, and Excel 16 was used to categorize the data into different patterns/trends concerning DHT awareness, usage, and affordability. Results: The results reveal that 65% of the population is aware of DHT, and this high awareness has translated into practical usage at a rate of approximately 58%, illustrating additional barriers to adoption beyond simple knowledge, namely, costs and perceived utility. Additionally, 60% indicated that they could not afford DHT, and only 36.1% reported that they had health insurance. The study also noted variability in DHT use, with blood glucose meters and insulin pens being the most common devices used. There is a significant willingness to adopt DHT (97%), although this comes with a range of challenges. Conclusion: This study underscores the need to address the digital divide in Pakistan by improving affordability, access, and support for DHT. Bridging these gaps could enhance healthcare access and quality, particularly for managing chronic conditions such as diabetes. Effective public policies and initiatives are crucial to promoting DHT adoption and ensuring equitable healthcare delivery across the country. Digital health technology (DHT) healthcare access digital divide diabetes management Pakistan affordability adoption healthcare disparities. Background Digital health technology can transform the delivery of healthcare by improving patient outcomes and reducing healthcare costs. Despite this, the acceptability and utilization of digital health technologies in resource-constrained settings are critical issues that need to be addressed meticulously. Barriers to a lack of infrastructure access, resource constraints, and training capacity could limit adoption [ 3 ]. In the face of multiple challenges, digital health technologies can revolutionize healthcare in Pakistan. Unfortunately, in Pakistan, digital health technology has not yet been applied on a large basis, and many problems still need to be solved. The digital divide is a major hurdle in regard to accessing health technologies, especially in countries such as Pakistan, where there are wide disparities in the level of digital literacy, availability of technology, and economic resources [ 30 ]. The digital divide is the gap between individuals and communities that have access to free modern information and communication technology (ICT), such as the internet, or not. This gap extends beyond access to an internet connection, covering the type of access available and literacy with digital use, i.e., how many people can effectively connect over tech–skills–gaps, which is not just important for much more than health [ 4 ]. The challenges posed by the digital divide for health service delivery and the implementation of eHealth in Pakistan impact the ability to address healthcare inequities and enhance broader population health outcomes. Affordability is one of the major reasons why people in Pakistan do not use health technologies. The expensive nature of digital health devices and services is a hurdle among most Pakistanis, especially for those in middle- or lower-income brackets [ 28 ]. A similar economic blockade was created by digital health solutions being created for markets with better healthcare than most other countries and where the cost of the technology was less of a concern. This study highlights the need for reduced costs through subsidization, frugal design, and local innovation policies for digital health technologies to proliferate nationwide [ 6 ]. The adaptability of health technologies, in addition to economic drivers, is also sociocultural dependent. There is a notable difference in the extent of readiness for new technologies among different demographic groups working around Pakistan. Older people, especially those in rural areas, are less likely to use digital health interventions because they have low levels of trust in new technologies and favor traditional ways of accessing care [ 29 ]. Moreover, differences between women and men also exist in some regions around the globe; cultural norms prevent women from using technologies, digital literacy, etc. [ 1 ]. The results from our survey highlight the importance of culturally aware campaigns for a successful drive to make digital health mainstream in Pakistan. The Pakistani healthcare system is fraught with several problems, including a dearth of resources and poor infrastructure as well as an inadequate number of health workers. Pakistan is one of the countries where per capita healthcare spending is far below that recommended by the WHO, which is 6% of GDP care. Low financing, as a result of inadequate resources and equipment, has limited the ability of healthcare practitioners to offer high-quality care [ 30 ]. Pakistan’s healthcare system is also quite centralized, with the majority of its facilities being in urban areas. As a result, rural and remote populations have more uneven access to healthcare, limiting options for care. The World Bank also mentions that more healthcare personnel are required in Pakistan, as there are just 0.8 doctors and 1.3 nurses per thousand people [ 29 ]. This need for more healthcare experts has led to long wait times and delayed diagnosis. Diabetes is a major health issue in Pakistan, and its burden has increased considerably over the last few years. The development of digital health technologies can greatly advance the enhancement of diabetes care because diabetes is a chronic condition that requires ongoing management [ 28 ]. Digital Health Technologies for Diabetic Patients and Doctors Blood Glucose Meters Diabetic individuals use these tools to check their blood sugar levels. It offers a fast and accurate assessment of blood glucose levels and is portable and simple to use. Certain blood glucose meters may also be linked to a smartphone app, enabling users to share their data with their doctor and follow them over time. Continuous Glucose Monitoring (CGM) CGM systems continually measure blood glucose levels by inserting a sensor under the skin. It gives patients access to real-time blood glucose data that they can use to make educated decisions about their diet, medications, and physical activity. When blood glucose levels are too high or too low, CGM systems also send alerts, which can help patients avoid potentially dangerous complications. Insulin Pens Diabetic patients are injected with insulin via insulin pens. Compared with conventional syringes, they are portable and simple to use, providing a more convenient and discrete method of administering insulin. Some insulin pens also include built-in dose calculators that can assist patients in choosing the appropriate insulin dosage. Significance of the study This planned study on the affordability and uptake of digital health technology in Pakistan created major discoveries to make clear to policymakers, officials or investors where investment is needed. The results of this investigation can be used to design strategies and methods that can overcome the barriers to the successful adoption of digital healthcare technologies. Specifically, the project aimed to explore how digital health technology can help manage diabetes in Pakistan and provide evidence to inform the implementation of diabetes programs. In addition, insights into how to design patient-centered healthcare services can be gained by examining the views of patients with diabetes and doctors about digital health technology. In short, the implications of this study are widespread in Pakistan's healthcare system, which may ultimately qualify itself to meet international standards in delivering precision-based health services. The Digital Divide in Healthcare Digital divide is a term used for the division between, on the one hand, those sections of society or businesses at different levels in the economy that own and use information and communication technologies (ICTs; such as internet uses), probably more than other groups/nations do [ 11 ]. In healthcare, this gap appears in terms of inequitable disparities in digital health tools and technologies, which have a physical as well as neurophysiological or physiological impact on health behaviors, particularly among low- to middle-income countries (LMICs), and Pakistan falls into one such country [ 14 , 15 , 16 ]. Global Perspective on the Digital Divide in Healthcare The use of technology across nations in the healthcare sector is a barrier to attaining health equity or equal health status among all populations [ 5 ]. As the WHO noted, these technologies, which include EHRs, telemedicine, mobile health (mHealth), and health information systems, can transform health systems and improve health outcomes, especially in low-resource settings [ 31 ]. However, inequitable access to these technologies still reinforces the difference in health status between rich and poor countries as well as within countries. Research has reported that the use of and access to digital health technologies are significantly lower in older adults, individuals with low education, and people living in rural areas. The fast-growing field of technology can be a challenge for some people who do not have either the means or ability to adapt to such rapidly changing conditions, increasing the generation of the digital divide [ 2 , 4 , 9 ]. The Digital Divide in Healthcare in LMICs Great digital inequality also exists among LMICs on the basis of undeveloped infrastructure, financial limitations, and a lack of policy supporting the adoption potential for utilization in these health systems [ 3 ]. A review revealed that an increasing number of healthcare consumers are becoming aware of pharmacology due to the use of digital technologies. This study revealed that while implementation enhances access quality and the efficiency of care for health service delivery, more important facilities, such as internet access connectivity problems and intermittent or nonexistent power supplies, inhibit progress in all LMICs [ 6 , 7 ]. The Digital Divide in Healthcare in Pakistan In Pakistan, the digital divide in healthcare is a major concern, especially among rural and underserved populations. Pakistan has a fragile healthcare system characterized by corruption and widespread poverty. In Pakistan, remote and rural areas have minimal access to digital health resources [ 32 ]. Researchers have concluded that many healthcare facilities in rural Pakistan are resource poor and have limited (or no) digital infrastructure, two critical factors requiring very advanced technology to implement the solutions needed to take advantage of digital health. Second, cultural and societal considerations contribute to the formation of a digital gap in the healthcare sector within Pakistan [ 34 ]. Research that studies technology adoption shows that digital health tools women are particularly less likely to use as long as they live in rural areas on the basis of cultural norms, which also does not allow them to access many technologies, which limits their capacity for full autonomy in defining health decisions. Research has shown that the participatory design and implementation of digital health projects involving women would enhance their uptake and utilization [ 28 , 29 ]. The poor digital literacy of healthcare providers and patients in Pakistan further exacerbates this divide. A study on the adoption of telemedicine in Pakistan reported that numerous healthcare providers do not have prerequisite skill sets or knowledge for using digital health tools efficiently [ 30 ]. The literature points to the provision of training and support for healthcare professionals, along with their engagement in digital health project development and implementation as potential enablers that could improve uptake [ 20 ]. Affordability of Health Technologies Affordability is a key dimension of access to and use of health technologies, especially in low- to middle-income countries (LMICs), such as Pakistan [ 17 ]. Health technologies (e.g., telemedicine, mHealth applications; EHRs) and diagnostic devices are expected to greatly contribute to more efficient delivery of healthcare services, enhanced accessibility, and outcomes for patients globally [ 20 ]. The costs of the procurement, installation, and maintenance of these technologies are still obstacles to ensuring that eHealth is widely implemented, as in the case of Pakistan, where resources are limited. The costs of health technologies in Pakistan vary because the cost is either direct or indirect [ 34 ]. Direct costs are defined as the cost of purchasing the equipment, software, and infrastructure needed for health technology delivery. These costs also consider maintenance, upgrades, and ongoing technical support [ 26 , 27 ]. These indirect fixed costs include training of the healthcare workforce, regulatory compliance, and potential disruption to healthcare delivery during the system digitalization process. Some studies have demonstrated that healthcare providers in LMICs, where health budgets are limited, find direct and indirect costs serious obstacles to new technological adoption [ 19 , 25 ]. Economic disparities exist in Pakistan, where the purchasing power of people living in urban and rural areas increasingly differs because of an upward-trending economy. Those in rural healthcare facilities often cannot afford to pay out of pocket for expensive health technologies, as these patients commonly lack financial resources. In most rural settings, healthcare providers work at a lower cost, and they also have no provision for budgets to buy expensive digital health solutions [ 28 , 29 ]. That fiscal burden is typically passed along to patients, the majority of whom are already challenged, paying even for basic health care. As a result, while health technologies hold promise as tools to increase access to and quality of healthcare in underserved regions around the world, their high costs often act as an effective barrier against adoption due to a lack of purchasing power [ 31 , 33 ]. Adaptability of Health Technologies Health technology adaptability, especially in developing countries such as Pakistan, is encapsulated by the amalgamation of various factors, such as technological literacy, cultural attitudes, and the availability of physical infrastructures [ 18 ]. It is important to understand these factors in regard to evaluating the readiness of health technologies for integration within healthcare and ultimately addressing digital disparities [ 21 ]. Despite being a fundamental aim in Pakistan, technological literacy is largely cited as impeding the ability to adopt digital health solutions. A large segment of the population (particularly in rural areas) still does not have access to even basic digital skills that are critical for adopting health technologies. Not only patients but also health care providers may order them without adequate training to use more advanced health technologies. Research has concluded that digital literacy is a prerequisite for increasing the utility of health technologies in Pakistan [ 22 , 23 , 32 ]. Health technologies are additionally influenced by cultural attitudes and societal norms. A study revealed that digital health solutions, in general, are met with skepticism on account of concerns around the lack of trust as well as those centered around privacy and data security. Researchers say that to increase adaptability, targeted awareness campaigns are essential to address these cultural impediments and start building trust in digital health solutions [ 8 ]. Another important factor of the adaptability process is infrastructure availability to deliver health technologies. In Pakistan, health care facilities are generally not available, and even where they exist, one will find the same facility falling short in proper healthcare amenities owing to a lack of specialized doctors. From the perspective of rural areas, the reliability of internet access and power supply in these regions greatly affects how much digital health solutions can be leveraged [ 34 ]. According to the study, significant infrastructural investments are required for health techs to be successfully implemented and utilized. Governmental initiatives are crucial for the adaptability of health technologies [ 10 ]. To promote digital health, the Pakistani government has initiated multiple endeavors, such as Digital Pakistan Vision. However, these efforts have frequently failed to clarify their approach to implementation and realistic budgets, thereby limiting the substantial impact of the majority of them [ 24 , 28 ]. The training and support of healthcare providers are essential for the adoption of health technologies. Owing to the lack of training and support, numerous healthcare providers in Pakistan are scared of adopting new technologies. In this study, healthcare providers who were properly trained and equipped to use digital health solutions adopted these tools at a higher rate themselves and passed them on to patients. Great health technologies also have to be usable and user friendly for them to be adopted first, in addition to all other factors [ 12 , 29 ]. Challenges and Opportunities in Pakistan’s Healthcare Landscape Healthcare in Pakistan is known for its complex landscape of challenges and opportunities that influence real-world use-case scenarios across all levels, from policymakers to tech developers. Understanding how these dynamics interact to bridge the digital divide and strengthen the affordability and acceptance of health technology amidst an ever-changing healthcare climate is vital [ 30 ]. A major bottleneck in healthcare services is the poor condition of the real estate where all these health facilities are to be built, especially for rural and underserved centers that cover over 80% of the population. Multiple healthcare units across Pakistan suffer from poor physical infrastructure, such as the lack of stable electricity and internet connections, which we know are necessary for the successful implementation and use of digital health technologies [ 32 ]. No country has that infrastructure, and it is a very difficult problem to solve, especially in remote areas where one may need the most applications. Moreover, the lack of these developments is even worsened by the scarcity of trained healthcare professionals who can make practical use of them and hence undermine their ultimate impact on enhancing health outcomes [ 12 , 16 ]. Financial constraints are also major issues in healthcare scenarios facing China. Some of the population lives in poverty and is unable to afford basic healthcare services due to a lack of accurate data, let alone the addition of digital health technologies. For example, telemedicine and electronic health records are tools that never have cost in the end — there is too a propositional spin; at some exuberant price points, these things become unaffordable to low-income groups. Consequently, these technologies cannot overcome the healthcare digital divide without some form of financial assistance or subsidies [ 19 , 23 , 26 ]. Moreover, along with financial and infrastructural constraints, there is a lack of an enabling regulatory/policy environment that currently impedes the scalability and sustainability of HTS interventions in Pakistan [ 34 ]. Digital health regulation in Pakistan is a new concept with unclear guidelines and no standardized protocols for the implementation and operationalization of digital health solutions. However, it is very much an optimistic view of the adoption landscape for health technologies in Pakistan [ 28 ]. One of the major opportunities lies in increased penetration heralded by mobile phones and ever-increasing internet access across the country. According to the Pakistan Telecommunication Authority, the number of mobile and internet users has increased in recent decades. This trend provides an exceptional opportunity to use mHealth solutions that reach out to underserved areas, specifically those in geographically isolated and disadvantaged regions with no previous access to healthcare services [ 32 ]. With governments and the private sector becoming more invested in digital health, there is another opportunity to seize. To brace digitalization, the government of Pakistan has launched several initiatives, such as Vision Digital Pakistan, to connect all sectors through information technology (IT), including the healthcare service domain [ 29 ]. The accessibility of healthcare might be addressed by the use of digital health solutions, such as telemedicine, which enables patients from remote/rural areas to connect with the corresponding healthcare provider without moving physically. Second, the increasing usage and adoption of digital health technologies by healthcare providers as well as end users (patients) in Pakistan [ 4 ]. There has been an encouraging change in stance by health systems, which now understand that digital technology can improve patient quality throughout the patient journey. Similarly, patients are increasingly willing to employ digital health tools as they become increasingly accustomed to technology, among other potential advantages [ 10 ]. Methodology This research aimed to investigate problems with the accessibility and adoption of health technology in Pakistan by concentrating more on diabetic patients. Pakistan has a large population of diabetic patients and has proven to be an ideal place for investigating the role of health technology in bridging the digital divide; thus, it was selected as our study area. For data collection, we employed both primary resources such as questionnaires and personal interviews with diabetic patients. This method was selected to allow for individual and in-depth thoughts of participants on how they live health technologies. Data sampling was performed via a random technique to guarantee that the data obtained a fair stay. This technique helps with participant selection from all over Pakistan, i.e., Khyber Pakhtunkhwa (KPK), Punjab, Gilgit-Baltistan, Baluchistan and Sindh. This approach was selected to ensure that access to and adoption of health technology across regions in the country were truly diverse. The sample size of this study consisted of 600 diabetes patients. A descriptive analysis method was used as the primary approach to look at and interpret the data. The analytical approach in this case involves summarizing and organizing the key features of the dataset in question. Descriptive analysis is an important component of the data analytic approach and includes grouping into observations, patterns, trends, or key insights into health technology use and affordability among diabetic patients. The analysis was carried out via the use of statistical software, i.e., SPSS 23 and Excel 16. Table 1 Characteristics Variable/Characteristic N (%) Age 20–30 40 (6.66%) 31–40 80 (13.33%) 41–50 210 (35%) 51–60 180 (30%) 61 and above 90 (15%) Gender Male 350 (58.3%) Female 250 (41.7%) Marital-status Married 560 (93.3%) Unmarried 40 (6.7%) Job-Status Employed 350 (58.3%) Unemployed 250 (41.7%) Education Primary 90 (15%) Matric 90 (15%) Intermediate 120 (20%) Bachelors 80 (13.3%) Masters 140 (23.3%) Illiterate 80 (13.3%) Monthly Income 120 thousand 113 (18.3%) Family Members 0–3 70 (11.66%) 4–6 300 (50%) 7–9 200 (33.3%) 10–12 30 (5%) Residence Rural 360 (60%) Urban 240 (40%) As summarized in Table 1 , the comprehensive data include demographic characteristics such as age, gender, marital status, employment, education, income levels, family size, and residential distribution. This multifaceted breakdown allows us to explore the socioeconomic status and lifestyle of the target audience, revealing its demographic characteristics from different angles. Age distribution is another demographic characteristic whereby a noticeable majority of the population sample is in the 41–50 and 51–60 age categories. Specifically, 35% of the population belongs to the 41–50 age group, and 30% of the population falls within the 51–60 age range. Fifteen percent of the individuals belong to the 61 years and above age category, indicating the presence of the older generation. Young adults comprising 20–30 and 31–40 categories constitute 6.66% and 13.33% of the sample, respectively. The second demographic characteristic evident from the sampled population is the gender distribution between male and female individuals, where there are 58.3% and 41.7% males and females, respectively. This is an indication of a male-dominated population, with the male population making up a greater percentage of the sample population than female members do. Another central demographic characteristic presented in the data is the marital status of the population; 93.3% of the people are married, and only 6.7% of the people are unmarried. Employment and unemployed status among the population sample are estimated at 58.3% who are employed and 41.7% unemployed. The educational status of the sample population varies in that 23.3% of the population have a master’s degree, 20% have intermediate education, and 15% have primary and matric levels. Similarly, 15% have a bachelor’s degree, 13.3% are illiterate, and 13.3% are estimated to have a primary income. The family size among the population presents varied responses, whereby 50% of people have a family size of 4–6 members, 33.3% have a family size of 7–9 members, and 11.66% and 5% have a family size of 0–3 and 10–12 members, respectively. With respect to family size, while 60% of the population resides in a rural setting, 40% lives in an urban setting. This rural–urban split highlights the demographic and geographic diversity within the population, suggesting different lifestyle patterns, access to resources, and socioeconomic conditions between rural and urban dwellers. Table 2 Data on Affordability and Adaptability of DHT Variable n (%) Awareness Of DHT Yes 390 (65%) No 210 (35%) Using DHT Yes 350 (58%) No 250 (42%) Type of DHT used Insulin Pens 120 (20%) CGM 50 (8.3%) Glucose Meter 160 (26.7%) All of the above 70 (11.7%) None of the above 200 (33.3%) Frequency of Usage Daily 70 (11.7%) Weekly 150 (25%) Monthly 100 (16.7%) Occasionally 120 (20%) Rarely or Never 160 (26.7%) Health Insurance Yes 217 (36.1%) No 383 (63.8%) Digital Literacy Yes 498 (83%) No 102 (17%) Internet Accessibility Yes 552 (92%) No 48 (8%) Reason For Using DHT To Monitor health status 370 (61.7%) To track fitness goal 50 (8.3%) To receive medical advice 180 (30.0%) Challenges Faced Cost (Non-affordable) 360 (60%) Technical difficulties 150 (25%) Lack of information 90 (15%) Affordable Yes 250 (41.7%) No 350 (58.3%) Incurred Cost 1000–4000 383 (63.8%) 4000–8000 198 (33%) More than 8000 19 (3.16%) Benefits of DHT Improved access to healthcare service 200 (33.3%) Better quality of healthcare service 260 (43.3%) Enhanced healthcare efficiency 110 (18.3%) Public health surveillance 30 (5%) Perceived Health Improvement due to DHT Yes 390 (65%) No 130 (21.7%) Not Sure 80 (13.3%) Concerned about cost Yes very Concerned 330 (55%) Somewhat concerned 130 (21.6%) Not concerned at all 140 (23.3%) Cultural Resistance to Adoption Yes 69 (11.5%) No 531 (88.5%) Government Support Yes 80 (13.3%) No 520 (86.7%) Hospital Access Yes 400 (66%) No 200 (34%) Willingness to Adopt to DHT Yes 582 (97%) No 18 (3%) The critical findings of this research are presented in Table 2 . The presented data shed light on all possible corners of the DHT landscape in Pakistan, from awareness, usage, and challenges to factors that impact this adoption. A closer look at these data reveals a more nuanced view of digital health technologies and their role in a country with a changing healthcare landscape. First, DHT awareness is relatively common, with 65% of respondents (390 people) reporting being aware of digital health technologies. That said, 35 percent—or slightly more than two hundred people—have never even heard of these technologies, suggesting an opportunity to increase awareness through campaigns that are specifically targeted at minority business owners. Although there is widespread awareness and knowledge of DHTs, the practice among survey respondents was slightly lower, with 58% (those individuals using) of this technology contrasting with the majority not doing so; on an individual basis, the remainder percentage was reported as 42% (individuals without such use). The difference between awareness and the usage gap indicates that factors other than awareness (such as affordability, accessibility, or perceived usefulness) are important in the decision to subscribe to digital solutions for health intervention. The types of DHT used are as expected all over the place in regard to the overall and specific taste of what tenants deploy. The most commonly used equipment was a glucose meter (26.7%, n = 160), followed by an insulin pen (120, 20%). A small subset of individuals (50) use continuous glucose monitors (CGMs), and only 11.7% (n = 70) of users use all three device types. Most notably, more than a third of these people (200 individuals) do not have even one device. The usage frequency data highlight the degree of engagement presented to a DHT. A small percentage of these technologies are used daily (11.7%, 70 individuals). The most common form of use was weekly (25%; 150 subjects), followed by monthly (16.7%; 100 subjects). Occasional users were 20% (120 persons) and rarely/never used them; it is also important to show that many users cannot rely too much on those technologies, i.e., 160 (26.7%). Only 36.1% (217 persons) of respondents have health insurance, which could dramatically affect the price they pay for DHT; the vast majority — 63.8% (383 individuals) do not have health insurance. This uniquely widened distribution gap supports the likelihood that financial difficulty is likely a considerable limitation to narrower uptake and maintenance of DHT, particularly among those without insurance. Another important precursor to technology absorption is digital literacy, and in this category, 83% (498 individuals) claim that they are digitally literate. In comparison, 102 (17% of the overall sample) are digitally illiterate, which may hinder their use of DHT. Internet accessibility is a necessary component of many digital health tools and should be prioritized with additional investment in digital literacy. People in this region have high internet availability, as 92% (552) have internet access, and the remaining 48 (8%) do not. While wide internet access is promising for the potential large-scale adoption of DHT, it must also go hand in hand with digital literacy and affordability if one does not wish to become trapped in locked-in services. On the other hand, many problems prevent DHT from being used more often. The cost is the most common barrier, with 60% (360 people) being unable to afford this. A quarter of the participants (150) faced tech challenges, and 15% (90) reported a lack of information as a barrier. Affordability concerns understandably, as only 250 individuals (41.7%) say DHT is affordable, and a majority of 350 persons (58.3%) do not think it is affordable. This was supported by the data on incurred costs, with most users (63.8%, 383 individuals) spending between 1,000 and 4,000 PKRs on DHT, 33% (198 individuals) spending between 4,000 and 8,000 PKRs, and a small fraction (3.16%, 19 individuals) spending more than 8,000 PKRs. These numbers underscore the economic hardship that DHTs can impose, especially on individuals who do not have health insurance or for whom this financial outlay would constitute a substantial portion of income. Nonetheless, some people see the advantages of DHT. The quality of health care services improved, as observed by 43.3% (260 respondents), whereas 33.3% (200 respondents) reported that access to health care services improved. Enhanced healthcare efficiency was reported by 18.3% (110 respondents), whereas 5% (30 respondents) noted the usefulness of DHT in public health activities. Reported health improvements due to DHT are enjoyed by 65% (390 respondents), suggesting that a portion of the users seem to receive actual benefits from the usage of such applications. On the other hand, 21.7% (130 respondents) do not feel such improvements, whereas 13.3% (80 respondents) indicate that they are not sure of such improvements more than how they appear to the public, which is unfavorable for DHT. Concerned that costs continue to be a popular factor, with 55% (330 respondents) being very concerned about DHT-related costs, 21.6% (130 respondents) being somewhat concerned and 23.3% (140 respondents) not concerned at all. Cultural resistance to DHT adoption does not seem to be a serious problem, as only 11.5% (69 individuals) reported resistance, whereas 88.5% (531 individuals) did not face cultural barriers. This is a good finding, as it implies that cultural issues do not act as barriers to DHT taking root within Pakistan. Government support, or lack of support, is also a major issue that affects DHT adoption. Only 13.3% (80 individuals) claim that they have ever been supported by the government, in contrast to 86.7% (520 individuals) who do not. Sixty-six percent (400 individuals) have access to hospitals, whereas 34% (200 individuals) do not have access to hospitals. Most importantly, the acceptability of DHT is overwhelmingly high; 582 (97%) are willing to use these technologies, with only eighteen (3%) showing unwillingness. This high desire to take up DHT despite these barriers means that there is much potential for excellent utilization of this technology in Pakistan, given that paradoxical bottlenecks are mitigated. Conclusion Research on Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan’s Evolving Healthcare Landscape has provided valuable insights into the current level of digital health technology (DHT) adaptation among various demographics across verticals within the country. The large percentage of the population in the middle-aged groups, along with a significant proportion of elderly people, signals an acute requirement for health technologies that pertain to diseases at chronic levels, which are common among these age categories. The difference in gender distribution points toward potential sociocultural mechanisms that could affect engagement with DHT and uptake. The high proportion of married participants and heterogeneity regarding educational level and income provide further evidence for how socioeconomic determinants affect DHT adoption. This gap — between high awareness of DHT and its actual use — suggests that barriers are deeper than simple knowledge. On the other hand, only 65 percent of the respondents said that they are aware of DHT; furthermore, only 58 percent reported using these technologies, which demonstrates that becoming irrelevant, as awareness does not correlate with usage. This discrepancy highlights the need to work on affordability and accessibility as well as the perceived usefulness of these technologies. The data support this claim; financial constraints are a major barrier—60% of participants identified cost as their greatest issue. Those who are uninsured have these concerns amplified because they now lack the means to attempt a trial of DHT. The variety in the types of DHT used, most notably glucose meters and insulin pens, indicates that the technologies being adapted for specific health needs more than anything else regarding managing diabetes. The different usage patterns (daily, weekly, or occasional) used by the users reveal varying depths of engagement and perhaps levels of need perceived in terms of necessity. The high rates of digital literacy and internet availability suggest a promising terrain for the uptake of DHT, provided that this corresponds to accessibility and affordability. The financial burden can be seen from the spending data, where most users are found to spend between 1,000–4,000 PKR, while a very small fraction spends even more; this highlights the economic strain associated with DHT. This is coupled with technical difficulties and a lack of information, which reinforces the fact that support systems should be upgraded to promote adoption and use. Despite these hurdles, 97% of the participants were willing to use DHT. This willingness implies high growth potential for DHT adoption, provided that the single most commonly cited barrier is addressed. There is low cultural resistance toward the use of DHT, which bodes well for the integration of these technologies into routine practices influenced by culture. A major problem that needs to be resolved is that there has been no government assistance given for DHTs. Since only 13.3% reported receiving support at all of the sample sizes, an obvious conclusion is that public policies and efforts should have a more comprehensive nature through active cooperation with digital health tools. Owing to the clear disparity in hospital access, DHT can play a greater role in increasing healthcare accessibility for those presented with geographic and logistical challenges. Although there is a high willingness for and possibility of DHT among participants in Pakistan, corresponding barriers such as cost, accessibility, and support need to be rigorously mitigated. Bridging the digital divide involves not only challenging awareness and literacy but also affordability problems that mimic sustainability challenges as well as support mechanisms. This will address primary healthcare challenges and further contribute significantly to enhancing the overall reach and quality — making a significant portion of health service provision in Pakistan more accessible, efficient and equitable. Recommendations The government needs to include DHT in policies of financial support for low-income countries and as a category eligible under economic aid or insurance amelioration. This might involve producer or health tech partnerships to reduce costs and provide flexible payment plans. Create government-backed programs that target DHT adoption. This includes funding for research, public awareness campaigns, and programs that provide technical support to users. Awareness is elevated among the population, but efforts need to be concentrated on these 35%, as they are unaware of DHT. These campaigns need to explain the advantages and where to obtain DHT, if it can be integrated into our daily health management, etc., and make digital health tools accessible to all, including remote and rural areas. Purpose: To enhance local infrastructure, offer regional education and support + obtain DHT in multiple languages/formats, develop friendly tools & support assisting users in overcoming the pain associated with using DHT. This may involve producing tutorials, providing customer support services and designing tech that is user friendly and intuitive. Keep funding digital literacy programs so that people who need to use DHT can. On the one hand, training programs should be conducted to improve digital skills and guide users in drawing and addressing health technologies. Set up feedback mechanisms: repeat, include other people in your user base on the experience that DHT. This enables one to more easily identify things that are preventing usage and where improvements can be made. Surveys, focus groups, and user reviews help in collecting feedback. Keep researching the ways that DHT works in your body. This research must seek to understand the different needs and barriers for various population segments as well as evaluate the outcomes of DHT adoption. Limitations Understanding the exploratory nature of this research is crucial, and while broadly thoughtfully done, there are caveats to my comprehensive study. The study had various limitations: it relied mostly on self-reported data gathered via questionnaires and interviews, which can introduce biases and inaccuracies. While the 600 samples are not small in number, they fail to capture fully our diverse population diversity seen in more remote or less served areas. The same is true for this study; it is no doubt interesting and important, but its localized interest does not do full justice to the spread of DHT adoption in all regions in Pakistan. For subsequent studies, it will be important to increase the sample size and include other regions as well as follow-up longitudinal studies to detect the dynamic implications of DHT adoption. Abbreviations DHT Digital health technology SPSS Statistical Package for the Social Sciences WHO World Health Organization GDP Gross domestic product CGM Continuous glucose monitoring LMICs Low and Middle Income Countries mHealth Mobile health KPK Khyber Pakhtunkhwa PKR Pakistani Rupee ERC Ethics and research committee Declarations Acknowledgments We extend our heartfelt gratitude to everyone who made this research possible. We are indebted to the Honorable Management and Faculty of Government Postgraduate College Nowshera for extending their support in carrying out this research. We acknowledge our fellow researchers and coauthors, Laiba Khan, Ruqayya Begum, Wasiq Ahmad, Manzoor Ahmed, and Fatima Sana, for their valuable guidance in research. This research would not have been possible without their collaboration, insights, and dedication. The depth of their experience and dedication were immeasurably valuable to the study. Most importantly, we would like to thank the participants of our research study because without them, we never had these valuable data about their experiences and opinions about digital health technologies. Funding This research did not benefit from any specific grant from public, commercial, or not-for-profit funding organizations. The author of the study did not receive any funding for the research work to be done in the course of the study; hence, all the costs incurred were borne directly out of pocket by the authors. Ethics Approval and Consent to Participate This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics and Research Committee (ERC) at Government Postgraduate College Nowshera. It has sought ethical approval and rights for participation from the participants. Each participant was told the aim of the research, the processes that would be undertaken together with their right to refuse to continue participating at any time without any repercussions. Competing Interests The authors have no competing interests to report. Data availability statement Data is provided in the form of supplementary information files. Informed Consent Statement Ethics statement Informed consent was obtained from all individual participants included in the study. Parents or legal guardians provided informed consent for participants younger than 18 years and children or adolescents themselves gave assent. This statement signifies that all required consents from adults and parents (guardians) for minors were achieved in accordance with ethical standards on research of human subjects. Author Contribution Muhammad Fayez : Muhammad Fayez, who is the main author and corresponding author for this paper, has an excellent role in study design as well. He designed this study, coordinated with the coauthors, and prepared the first draft of the manuscript and associated correspondence. He was also responsible for ultimately curating the content, integrating feedback, and ensuring that the paper was of high quality with good flow. Ruqayya Begum : A literature review and formulation of the theoretical framework were accomplished by Ruqayya Begum. She conducted an extensive literature search and shared an understanding of the current theories of the problem. Laiba Khan : From a human resource perspective, Laiba Khan also contributed greatly to the data collection and analysis. She was in charge of data collection, data quality assurance, and initial data processing. Manzoor Ahmad : Manzoor Ahmad helped with the statistical analysis and data presentation. He underwent various statistical examinations and passed the study. Wasiq Ahmad : The methodology and data interpretation were performed by Wasiq Ahmad. He led the study design, designed the analytic approach, and interpreted the results. Fatima Sana : Fatima Sana provided input in the writing of the introduction and discussion parts of the research. She developed the story that is used in guiding this study, and she also deliberated on the consequences of the research outcomes. References Bergier, H., Duron, L., Sordet, C., Kawka, L., Schlencker, A., Chasset, F., & Arnaud, L. (2021). Digital health, big data and smart technologies for the care of patients with systemic autoimmune diseases: where do we stand? Autoimmunity reviews, 20 (8), 102864. Thomason, J. (2021). 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Jimenez, J., del Rio, A., Berman, A. N., & Grande, M. (2023). Personalizing Digital Health: Adapting Health Technology Systems to Meet the Needs of Different Older Populations. Healthcare 2023, 11, 2140. Garbe, C., & Sharma, R. (2024). Multiomics technologies to increase resilience, adaptability, and affordability of integrated traditional and modern healthcare. In Resilient Health (pp. 155–164). Academic Press. Krause, K. R., Chung, S., Fialho, M. D. L. S., Szatmari, P., & Wolpert, M. (2021). The challenge of ensuring affordability, sustainability, consistency, and adaptability in the common metrics agenda. The Lancet Psychiatry, 8 (12), 1094–1102. Singhal, S. (2023). Cost optimization and affordable health care using AI. International Machine learning journal and Computer Engineering, 6 (6), 1–12. Barlow, J., Köberle-Gaiser, M., Moss, R., Noble, A., Scher, P., & Stow, D. (2009). Adaptability and innovation in healthcare facilities. Lessons from the past for future developments . Barlow, J., Köberle-Gaiser, M., Moss, R., Noble, A., Scher, P., & Stow, D. (2009). Adaptability and innovation in healthcare facilities. Lessons from the past for future developments . Hillestad, R. (2006). Health care IT adoption could save USD162 billion. World hospitals and health services: the official journal of the International Hospital Federation, 42 (2), 36–38. Lomas, J. R. (2019). Incorporating affordability concerns within cost-effectiveness analysis for health technology assessment. Value in Health, 22 (8), 898–905. Towse, A., & Mauskopf, J. A. (2018). Affordability of new technologies: the next frontier. Value in Health, 21 (3), 249–251. Dolan, A., & Zingg, W. (1993). Health care technology: how can we tell if we can afford it? A Canadian viewpoint. Journal of Long-Term Effects of Medical Implants, 3 (4), 277–282. Glennie, H. R. (2012). Delivering Healthcare Cost-Effectively Using Available Technology. In Global Telehealth 2012 (pp. 73–82). IOS Press. Kazi, A. M., Qazi, S. A., Ahsan, N., Khawaja, S., Sameen, F., Saqib, M., … Stergioulas,L. K. (2020). Current challenges of digital health interventions in Pakistan: mixed methods analysis. Journal of medical internet research , 22 (9), e21691. Bilal, W., Qamar, K., Siddiqui, A., Kumar, P., & Essar, M. Y. (2022). Digital health and telemedicine in Pakistan: Improving maternal healthcare. Annals of Medicine and Surgery, 81 . Naeem, W., Nadeem, H. A., Javed, A., & Ahmed, W. (2022). Digital Health and Future of Healthcare in Pakistan. Annals of King Edward Medical University, 28 (2), 268–272. Wilson, D., Sheikh, A., Görgens, M., Ward, K., & Bank, W. (2021). Technology and Universal Health Coverage: Examining the role of digital health. Journal of Global Health , 11 . Muhammad, Q., Eiman, H., Fazal, F., Ibrahim, M., & Gondal, M. F. (2023). Healthcare in Pakistan: navigating challenges and building a brighter future. Cureus, 15 (6). Khan, S. J., Asif, M., Aslam, S., Khan, W. J., & Hamza, S. A. (2023). Pakistan’s healthcare system: a review of major challenges and the first comprehensive universal health coverage initiative. Cureus, 15 (9). Farooq, S., Ramzan, M., Ali, F. H., & Rashid, H. A. (2020). Analyzing the efficiency of health care in Pakistan: An application of data envelopment analysis to rural health centers in Punjab. Pakistan Vision, 21 (2), 273. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5138453","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":368725377,"identity":"d439422c-fe38-4a6b-b0e5-612348f3da7d","order_by":0,"name":"Muhammad Fayez","email":"data:image/png;base64,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","orcid":"","institution":"Government Postgraduate College Nowshera,","correspondingAuthor":true,"prefix":"","firstName":"Muhammad","middleName":"","lastName":"Fayez","suffix":""},{"id":368725378,"identity":"84bdd1d1-6b22-4641-bb31-f57a9c101240","order_by":1,"name":"Ruqayya Begum","email":"","orcid":"","institution":"Government Postgraduate College Nowshera,","correspondingAuthor":false,"prefix":"","firstName":"Ruqayya","middleName":"","lastName":"Begum","suffix":""},{"id":368725379,"identity":"1a71dd4a-1f3a-4f45-98b7-fc068d7c2fc4","order_by":2,"name":"Laiba Khan","email":"","orcid":"","institution":"Government Postgraduate College Nowshera,","correspondingAuthor":false,"prefix":"","firstName":"Laiba","middleName":"","lastName":"Khan","suffix":""},{"id":368725380,"identity":"f33ae577-d397-4fbb-a2fc-68e194e2d11f","order_by":3,"name":"Manzoor Ahmad","email":"","orcid":"","institution":"Government Postgraduate College Nowshera,","correspondingAuthor":false,"prefix":"","firstName":"Manzoor","middleName":"","lastName":"Ahmad","suffix":""},{"id":368725381,"identity":"6f8de869-b576-47c9-9639-1e1403681db5","order_by":4,"name":"Wasiq Ahmed","email":"","orcid":"","institution":"Government Postgraduate College Nowshera,","correspondingAuthor":false,"prefix":"","firstName":"Wasiq","middleName":"","lastName":"Ahmed","suffix":""},{"id":368725382,"identity":"598a1770-eeda-417d-b600-ca079974d828","order_by":5,"name":"Fatima Sana","email":"","orcid":"","institution":"Government Postgraduate College Nowshera,","correspondingAuthor":false,"prefix":"","firstName":"Fatima","middleName":"","lastName":"Sana","suffix":""}],"badges":[],"createdAt":"2024-09-23 13:24:54","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5138453/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5138453/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":68747129,"identity":"8adba0f9-6c56-4abc-bfbf-c6bbd035449a","added_by":"auto","created_at":"2024-11-11 15:35:21","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":671080,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5138453/v1/1efa9c11-d9cf-4ee1-b70e-7bea4add2a28.pdf"},{"id":68746713,"identity":"6162c6fa-1aee-44da-819f-3961caba3b08","added_by":"auto","created_at":"2024-11-11 15:27:20","extension":"xlsx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":76425,"visible":true,"origin":"","legend":"","description":"","filename":"ResearchData.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-5138453/v1/e05447e806f39c671955beb9.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan’s Evolving Healthcare Landscape","fulltext":[{"header":"Background","content":"\u003cp\u003eDigital health technology can transform the delivery of healthcare by improving patient outcomes and reducing healthcare costs. Despite this, the acceptability and utilization of digital health technologies in resource-constrained settings are critical issues that need to be addressed meticulously. Barriers to a lack of infrastructure access, resource constraints, and training capacity could limit adoption [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. In the face of multiple challenges, digital health technologies can revolutionize healthcare in Pakistan. Unfortunately, in Pakistan, digital health technology has not yet been applied on a large basis, and many problems still need to be solved. The digital divide is a major hurdle in regard to accessing health technologies, especially in countries such as Pakistan, where there are wide disparities in the level of digital literacy, availability of technology, and economic resources [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The digital divide is the gap between individuals and communities that have access to free modern information and communication technology (ICT), such as the internet, or not. This gap extends beyond access to an internet connection, covering the type of access available and literacy with digital use, i.e., how many people can effectively connect over tech\u0026ndash;skills\u0026ndash;gaps, which is not just important for much more than health [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The challenges posed by the digital divide for health service delivery and the implementation of eHealth in Pakistan impact the ability to address healthcare inequities and enhance broader population health outcomes. Affordability is one of the major reasons why people in Pakistan do not use health technologies. The expensive nature of digital health devices and services is a hurdle among most Pakistanis, especially for those in middle- or lower-income brackets [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. A similar economic blockade was created by digital health solutions being created for markets with better healthcare than most other countries and where the cost of the technology was less of a concern. This study highlights the need for reduced costs through subsidization, frugal design, and local innovation policies for digital health technologies to proliferate nationwide [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The adaptability of health technologies, in addition to economic drivers, is also sociocultural dependent. There is a notable difference in the extent of readiness for new technologies among different demographic groups working around Pakistan. Older people, especially those in rural areas, are less likely to use digital health interventions because they have low levels of trust in new technologies and favor traditional ways of accessing care [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Moreover, differences between women and men also exist in some regions around the globe; cultural norms prevent women from using technologies, digital literacy, etc. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The results from our survey highlight the importance of culturally aware campaigns for a successful drive to make digital health mainstream in Pakistan. The Pakistani healthcare system is fraught with several problems, including a dearth of resources and poor infrastructure as well as an inadequate number of health workers. Pakistan is one of the countries where per capita healthcare spending is far below that recommended by the WHO, which is 6% of GDP care. Low financing, as a result of inadequate resources and equipment, has limited the ability of healthcare practitioners to offer high-quality care [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. Pakistan\u0026rsquo;s healthcare system is also quite centralized, with the majority of its facilities being in urban areas. As a result, rural and remote populations have more uneven access to healthcare, limiting options for care. The World Bank also mentions that more healthcare personnel are required in Pakistan, as there are just 0.8 doctors and 1.3 nurses per thousand people [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. This need for more healthcare experts has led to long wait times and delayed diagnosis. Diabetes is a major health issue in Pakistan, and its burden has increased considerably over the last few years. The development of digital health technologies can greatly advance the enhancement of diabetes care because diabetes is a chronic condition that requires ongoing management [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e"},{"header":"Digital Health Technologies for Diabetic Patients and Doctors","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eBlood Glucose Meters\u003c/h2\u003e \u003cp\u003eDiabetic individuals use these tools to check their blood sugar levels. It offers a fast and accurate assessment of blood glucose levels and is portable and simple to use. Certain blood glucose meters may also be linked to a smartphone app, enabling users to share their data with their doctor and follow them over time.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eContinuous Glucose Monitoring (CGM)\u003c/h3\u003e\n\u003cp\u003eCGM systems continually measure blood glucose levels by inserting a sensor under the skin. It gives patients access to real-time blood glucose data that they can use to make educated decisions about their diet, medications, and physical activity. When blood glucose levels are too high or too low, CGM systems also send alerts, which can help patients avoid potentially dangerous complications.\u003c/p\u003e\n\u003ch3\u003eInsulin Pens\u003c/h3\u003e\n\u003cp\u003eDiabetic patients are injected with insulin via insulin pens. Compared with conventional syringes, they are portable and simple to use, providing a more convenient and discrete method of administering insulin. Some insulin pens also include built-in dose calculators that can assist patients in choosing the appropriate insulin dosage.\u003c/p\u003e\n\u003ch3\u003eSignificance of the study\u003c/h3\u003e\n\u003cp\u003eThis planned study on the affordability and uptake of digital health technology in Pakistan created major discoveries to make clear to policymakers, officials or investors where investment is needed. The results of this investigation can be used to design strategies and methods that can overcome the barriers to the successful adoption of digital healthcare technologies. Specifically, the project aimed to explore how digital health technology can help manage diabetes in Pakistan and provide evidence to inform the implementation of diabetes programs. In addition, insights into how to design patient-centered healthcare services can be gained by examining the views of patients with diabetes and doctors about digital health technology. In short, the implications of this study are widespread in Pakistan's healthcare system, which may ultimately qualify itself to meet international standards in delivering precision-based health services.\u003c/p\u003e\n\u003ch3\u003eThe Digital Divide in Healthcare\u003c/h3\u003e\n\u003cp\u003eDigital divide is a term used for the division between, on the one hand, those sections of society or businesses at different levels in the economy that own and use information and communication technologies (ICTs; such as internet uses), probably more than other groups/nations do [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. In healthcare, this gap appears in terms of inequitable disparities in digital health tools and technologies, which have a physical as well as neurophysiological or physiological impact on health behaviors, particularly among low- to middle-income countries (LMICs), and Pakistan falls into one such country [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eGlobal Perspective on the Digital Divide in Healthcare\u003c/h2\u003e \u003cp\u003eThe use of technology across nations in the healthcare sector is a barrier to attaining health equity or equal health status among all populations [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. As the WHO noted, these technologies, which include EHRs, telemedicine, mobile health (mHealth), and health information systems, can transform health systems and improve health outcomes, especially in low-resource settings [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. However, inequitable access to these technologies still reinforces the difference in health status between rich and poor countries as well as within countries. Research has reported that the use of and access to digital health technologies are significantly lower in older adults, individuals with low education, and people living in rural areas. The fast-growing field of technology can be a challenge for some people who do not have either the means or ability to adapt to such rapidly changing conditions, increasing the generation of the digital divide [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eThe Digital Divide in Healthcare in LMICs\u003c/h3\u003e\n\u003cp\u003eGreat digital inequality also exists among LMICs on the basis of undeveloped infrastructure, financial limitations, and a lack of policy supporting the adoption potential for utilization in these health systems [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. A review revealed that an increasing number of healthcare consumers are becoming aware of pharmacology due to the use of digital technologies. This study revealed that while implementation enhances access quality and the efficiency of care for health service delivery, more important facilities, such as internet access connectivity problems and intermittent or nonexistent power supplies, inhibit progress in all LMICs [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eThe Digital Divide in Healthcare in Pakistan\u003c/h3\u003e\n\u003cp\u003eIn Pakistan, the digital divide in healthcare is a major concern, especially among rural and underserved populations. Pakistan has a fragile healthcare system characterized by corruption and widespread poverty. In Pakistan, remote and rural areas have minimal access to digital health resources [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Researchers have concluded that many healthcare facilities in rural Pakistan are resource poor and have limited (or no) digital infrastructure, two critical factors requiring very advanced technology to implement the solutions needed to take advantage of digital health. Second, cultural and societal considerations contribute to the formation of a digital gap in the healthcare sector within Pakistan [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Research that studies technology adoption shows that digital health tools women are particularly less likely to use as long as they live in rural areas on the basis of cultural norms, which also does not allow them to access many technologies, which limits their capacity for full autonomy in defining health decisions. Research has shown that the participatory design and implementation of digital health projects involving women would enhance their uptake and utilization [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The poor digital literacy of healthcare providers and patients in Pakistan further exacerbates this divide. A study on the adoption of telemedicine in Pakistan reported that numerous healthcare providers do not have prerequisite skill sets or knowledge for using digital health tools efficiently [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. The literature points to the provision of training and support for healthcare professionals, along with their engagement in digital health project development and implementation as potential enablers that could improve uptake [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eAffordability of Health Technologies\u003c/h2\u003e \u003cp\u003eAffordability is a key dimension of access to and use of health technologies, especially in low- to middle-income countries (LMICs), such as Pakistan [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Health technologies (e.g., telemedicine, mHealth applications; EHRs) and diagnostic devices are expected to greatly contribute to more efficient delivery of healthcare services, enhanced accessibility, and outcomes for patients globally [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The costs of the procurement, installation, and maintenance of these technologies are still obstacles to ensuring that eHealth is widely implemented, as in the case of Pakistan, where resources are limited. The costs of health technologies in Pakistan vary because the cost is either direct or indirect [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Direct costs are defined as the cost of purchasing the equipment, software, and infrastructure needed for health technology delivery. These costs also consider maintenance, upgrades, and ongoing technical support [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. These indirect fixed costs include training of the healthcare workforce, regulatory compliance, and potential disruption to healthcare delivery during the system digitalization process. Some studies have demonstrated that healthcare providers in LMICs, where health budgets are limited, find direct and indirect costs serious obstacles to new technological adoption [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Economic disparities exist in Pakistan, where the purchasing power of people living in urban and rural areas increasingly differs because of an upward-trending economy. Those in rural healthcare facilities often cannot afford to pay out of pocket for expensive health technologies, as these patients commonly lack financial resources. In most rural settings, healthcare providers work at a lower cost, and they also have no provision for budgets to buy expensive digital health solutions [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. That fiscal burden is typically passed along to patients, the majority of whom are already challenged, paying even for basic health care. As a result, while health technologies hold promise as tools to increase access to and quality of healthcare in underserved regions around the world, their high costs often act as an effective barrier against adoption due to a lack of purchasing power [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eAdaptability of Health Technologies\u003c/h2\u003e \u003cp\u003eHealth technology adaptability, especially in developing countries such as Pakistan, is encapsulated by the amalgamation of various factors, such as technological literacy, cultural attitudes, and the availability of physical infrastructures [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. It is important to understand these factors in regard to evaluating the readiness of health technologies for integration within healthcare and ultimately addressing digital disparities [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Despite being a fundamental aim in Pakistan, technological literacy is largely cited as impeding the ability to adopt digital health solutions. A large segment of the population (particularly in rural areas) still does not have access to even basic digital skills that are critical for adopting health technologies. Not only patients but also health care providers may order them without adequate training to use more advanced health technologies. Research has concluded that digital literacy is a prerequisite for increasing the utility of health technologies in Pakistan [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Health technologies are additionally influenced by cultural attitudes and societal norms. A study revealed that digital health solutions, in general, are met with skepticism on account of concerns around the lack of trust as well as those centered around privacy and data security. Researchers say that to increase adaptability, targeted awareness campaigns are essential to address these cultural impediments and start building trust in digital health solutions [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Another important factor of the adaptability process is infrastructure availability to deliver health technologies. In Pakistan, health care facilities are generally not available, and even where they exist, one will find the same facility falling short in proper healthcare amenities owing to a lack of specialized doctors. From the perspective of rural areas, the reliability of internet access and power supply in these regions greatly affects how much digital health solutions can be leveraged [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. According to the study, significant infrastructural investments are required for health techs to be successfully implemented and utilized. Governmental initiatives are crucial for the adaptability of health technologies [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. To promote digital health, the Pakistani government has initiated multiple endeavors, such as Digital Pakistan Vision. However, these efforts have frequently failed to clarify their approach to implementation and realistic budgets, thereby limiting the substantial impact of the majority of them [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The training and support of healthcare providers are essential for the adoption of health technologies. Owing to the lack of training and support, numerous healthcare providers in Pakistan are scared of adopting new technologies. In this study, healthcare providers who were properly trained and equipped to use digital health solutions adopted these tools at a higher rate themselves and passed them on to patients. Great health technologies also have to be usable and user friendly for them to be adopted first, in addition to all other factors [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eChallenges and Opportunities in Pakistan\u0026rsquo;s Healthcare Landscape\u003c/h2\u003e \u003cp\u003eHealthcare in Pakistan is known for its complex landscape of challenges and opportunities that influence real-world use-case scenarios across all levels, from policymakers to tech developers. Understanding how these dynamics interact to bridge the digital divide and strengthen the affordability and acceptance of health technology amidst an ever-changing healthcare climate is vital [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e]. A major bottleneck in healthcare services is the poor condition of the real estate where all these health facilities are to be built, especially for rural and underserved centers that cover over 80% of the population. Multiple healthcare units across Pakistan suffer from poor physical infrastructure, such as the lack of stable electricity and internet connections, which we know are necessary for the successful implementation and use of digital health technologies [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. No country has that infrastructure, and it is a very difficult problem to solve, especially in remote areas where one may need the most applications. Moreover, the lack of these developments is even worsened by the scarcity of trained healthcare professionals who can make practical use of them and hence undermine their ultimate impact on enhancing health outcomes [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Financial constraints are also major issues in healthcare scenarios facing China. Some of the population lives in poverty and is unable to afford basic healthcare services due to a lack of accurate data, let alone the addition of digital health technologies. For example, telemedicine and electronic health records are tools that never have cost in the end \u0026mdash; there is too a propositional spin; at some exuberant price points, these things become unaffordable to low-income groups. Consequently, these technologies cannot overcome the healthcare digital divide without some form of financial assistance or subsidies [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Moreover, along with financial and infrastructural constraints, there is a lack of an enabling regulatory/policy environment that currently impedes the scalability and sustainability of HTS interventions in Pakistan [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Digital health regulation in Pakistan is a new concept with unclear guidelines and no standardized protocols for the implementation and operationalization of digital health solutions. However, it is very much an optimistic view of the adoption landscape for health technologies in Pakistan [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. One of the major opportunities lies in increased penetration heralded by mobile phones and ever-increasing internet access across the country. According to the Pakistan Telecommunication Authority, the number of mobile and internet users has increased in recent decades. This trend provides an exceptional opportunity to use mHealth solutions that reach out to underserved areas, specifically those in geographically isolated and disadvantaged regions with no previous access to healthcare services [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. With governments and the private sector becoming more invested in digital health, there is another opportunity to seize. To brace digitalization, the government of Pakistan has launched several initiatives, such as Vision Digital Pakistan, to connect all sectors through information technology (IT), including the healthcare service domain [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The accessibility of healthcare might be addressed by the use of digital health solutions, such as telemedicine, which enables patients from remote/rural areas to connect with the corresponding healthcare provider without moving physically. Second, the increasing usage and adoption of digital health technologies by healthcare providers as well as end users (patients) in Pakistan [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. There has been an encouraging change in stance by health systems, which now understand that digital technology can improve patient quality throughout the patient journey. Similarly, patients are increasingly willing to employ digital health tools as they become increasingly accustomed to technology, among other potential advantages [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e "},{"header":"Methodology","content":"\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003cp\u003eThis research aimed to investigate problems with the accessibility and adoption of health technology in Pakistan by concentrating more on diabetic patients. Pakistan has a large population of diabetic patients and has proven to be an ideal place for investigating the role of health technology in bridging the digital divide; thus, it was selected as our study area. For data collection, we employed both primary resources such as questionnaires and personal interviews with diabetic patients. This method was selected to allow for individual and in-depth thoughts of participants on how they live health technologies. Data sampling was performed via a random technique to guarantee that the data obtained a fair stay. This technique helps with participant selection from all over Pakistan, i.e., Khyber Pakhtunkhwa (KPK), Punjab, Gilgit-Baltistan, Baluchistan and Sindh. This approach was selected to ensure that access to and adoption of health technology across regions in the country were truly diverse. The sample size of this study consisted of 600 diabetes patients. A descriptive analysis method was used as the primary approach to look at and interpret the data. The analytical approach in this case involves summarizing and organizing the key features of the dataset in question. Descriptive analysis is an important component of the data analytic approach and includes grouping into observations, patterns, trends, or key insights into health technology use and affordability among diabetic patients. The analysis was carried out via the use of statistical software, i.e., SPSS 23 and Excel 16.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable/Characteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (6.66%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (13.33%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e41\u0026ndash;50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e210 (35%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e51\u0026ndash;60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e180 (30%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e61 and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e350 (58.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e250 (41.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital-status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e560 (93.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnmarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (6.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eJob-Status\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e350 (58.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e250 (41.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMatric\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIntermediate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (20%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBachelors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMasters\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140 (23.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIlliterate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMonthly Income\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;37 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e156 (26%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e37 to 120 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e331 (55.16%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;120 thousand\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e113 (18.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFamily Members\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (11.66%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e300 (50%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eResidence\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e360 (60%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e240 (40%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs summarized in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the comprehensive data include demographic characteristics such as age, gender, marital status, employment, education, income levels, family size, and residential distribution. This multifaceted breakdown allows us to explore the socioeconomic status and lifestyle of the target audience, revealing its demographic characteristics from different angles.\u003c/p\u003e \u003cp\u003eAge distribution is another demographic characteristic whereby a noticeable majority of the population sample is in the 41\u0026ndash;50 and 51\u0026ndash;60 age categories. Specifically, 35% of the population belongs to the 41\u0026ndash;50 age group, and 30% of the population falls within the 51\u0026ndash;60 age range. Fifteen percent of the individuals belong to the 61 years and above age category, indicating the presence of the older generation. Young adults comprising 20\u0026ndash;30 and 31\u0026ndash;40 categories constitute 6.66% and 13.33% of the sample, respectively. The second demographic characteristic evident from the sampled population is the gender distribution between male and female individuals, where there are 58.3% and 41.7% males and females, respectively. This is an indication of a male-dominated population, with the male population making up a greater percentage of the sample population than female members do. Another central demographic characteristic presented in the data is the marital status of the population; 93.3% of the people are married, and only 6.7% of the people are unmarried. Employment and unemployed status among the population sample are estimated at 58.3% who are employed and 41.7% unemployed. The educational status of the sample population varies in that 23.3% of the population have a master\u0026rsquo;s degree, 20% have intermediate education, and 15% have primary and matric levels. Similarly, 15% have a bachelor\u0026rsquo;s degree, 13.3% are illiterate, and 13.3% are estimated to have a primary income. The family size among the population presents varied responses, whereby 50% of people have a family size of 4\u0026ndash;6 members, 33.3% have a family size of 7\u0026ndash;9 members, and 11.66% and 5% have a family size of 0\u0026ndash;3 and 10\u0026ndash;12 members, respectively. With respect to family size, while 60% of the population resides in a rural setting, 40% lives in an urban setting. This rural\u0026ndash;urban split highlights the demographic and geographic diversity within the population, suggesting different lifestyle patterns, access to resources, and socioeconomic conditions between rural and urban dwellers.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eData on Affordability and Adaptability of DHT\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariable n (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAwareness Of DHT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e390 (65%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e210 (35%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUsing DHT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e350 (58%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e250 (42%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eType of DHT used\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInsulin Pens\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (20%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCGM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGlucose Meter\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160 (26.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAll of the above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (11.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone of the above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFrequency of Usage\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDaily\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70 (11.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeekly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e150 (25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMonthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100 (16.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccasionally\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e120 (20%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRarely or Never\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e160 (26.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHealth Insurance\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e217 (36.1%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e383 (63.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDigital Literacy\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e498 (83%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e102 (17%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eInternet Accessibility\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e552 (92%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48 (8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eReason For Using DHT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTo Monitor health status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e370 (61.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTo track fitness goal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 (8.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTo receive medical advice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e180 (30.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eChallenges Faced\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCost (Non-affordable)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e360 (60%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTechnical difficulties\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e150 (25%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLack of information\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90 (15%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAffordable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e250 (41.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e350 (58.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eIncurred Cost\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1000\u0026ndash;4000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e383 (63.8%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4000\u0026ndash;8000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e198 (33%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMore than 8000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19 (3.16%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBenefits of DHT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eImproved access to healthcare service\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200 (33.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBetter quality of healthcare service\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e260 (43.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnhanced healthcare efficiency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e110 (18.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePublic health surveillance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 (5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePerceived Health Improvement due to DHT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e390 (65%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130 (21.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot Sure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eConcerned about cost\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes very Concerned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e330 (55%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomewhat concerned\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e130 (21.6%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot concerned at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e140 (23.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCultural Resistance to Adoption\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69 (11.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e531 (88.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGovernment Support\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80 (13.3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e520 (86.7%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHospital Access\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e400 (66%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e200 (34%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWillingness to Adopt to DHT\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e582 (97%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18 (3%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe critical findings of this research are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. The presented data shed light on all possible corners of the DHT landscape in Pakistan, from awareness, usage, and challenges to factors that impact this adoption. A closer look at these data reveals a more nuanced view of digital health technologies and their role in a country with a changing healthcare landscape.\u003c/p\u003e \u003cp\u003eFirst, DHT awareness is relatively common, with 65% of respondents (390 people) reporting being aware of digital health technologies. That said, 35 percent\u0026mdash;or slightly more than two hundred people\u0026mdash;have never even heard of these technologies, suggesting an opportunity to increase awareness through campaigns that are specifically targeted at minority business owners. Although there is widespread awareness and knowledge of DHTs, the practice among survey respondents was slightly lower, with 58% (those individuals using) of this technology contrasting with the majority not doing so; on an individual basis, the remainder percentage was reported as 42% (individuals without such use). The difference between awareness and the usage gap indicates that factors other than awareness (such as affordability, accessibility, or perceived usefulness) are important in the decision to subscribe to digital solutions for health intervention. The types of DHT used are as expected all over the place in regard to the overall and specific taste of what tenants deploy. The most commonly used equipment was a glucose meter (26.7%, n\u0026thinsp;=\u0026thinsp;160), followed by an insulin pen (120, 20%). A small subset of individuals (50) use continuous glucose monitors (CGMs), and only 11.7% (n\u0026thinsp;=\u0026thinsp;70) of users use all three device types. Most notably, more than a third of these people (200 individuals) do not have even one device. The usage frequency data highlight the degree of engagement presented to a DHT. A small percentage of these technologies are used daily (11.7%, 70 individuals). The most common form of use was weekly (25%; 150 subjects), followed by monthly (16.7%; 100 subjects). Occasional users were 20% (120 persons) and rarely/never used them; it is also important to show that many users cannot rely too much on those technologies, i.e., 160 (26.7%). Only 36.1% (217 persons) of respondents have health insurance, which could dramatically affect the price they pay for DHT; the vast majority \u0026mdash; 63.8% (383 individuals) do not have health insurance. This uniquely widened distribution gap supports the likelihood that financial difficulty is likely a considerable limitation to narrower uptake and maintenance of DHT, particularly among those without insurance. Another important precursor to technology absorption is digital literacy, and in this category, 83% (498 individuals) claim that they are digitally literate. In comparison, 102 (17% of the overall sample) are digitally illiterate, which may hinder their use of DHT. Internet accessibility is a necessary component of many digital health tools and should be prioritized with additional investment in digital literacy. People in this region have high internet availability, as 92% (552) have internet access, and the remaining 48 (8%) do not. While wide internet access is promising for the potential large-scale adoption of DHT, it must also go hand in hand with digital literacy and affordability if one does not wish to become trapped in locked-in services. On the other hand, many problems prevent DHT from being used more often. The cost is the most common barrier, with 60% (360 people) being unable to afford this. A quarter of the participants (150) faced tech challenges, and 15% (90) reported a lack of information as a barrier. Affordability concerns understandably, as only 250 individuals (41.7%) say DHT is affordable, and a majority of 350 persons (58.3%) do not think it is affordable. This was supported by the data on incurred costs, with most users (63.8%, 383 individuals) spending between 1,000 and 4,000 PKRs on DHT, 33% (198 individuals) spending between 4,000 and 8,000 PKRs, and a small fraction (3.16%, 19 individuals) spending more than 8,000 PKRs. These numbers underscore the economic hardship that DHTs can impose, especially on individuals who do not have health insurance or for whom this financial outlay would constitute a substantial portion of income.\u003c/p\u003e \u003cp\u003eNonetheless, some people see the advantages of DHT. The quality of health care services improved, as observed by 43.3% (260 respondents), whereas 33.3% (200 respondents) reported that access to health care services improved. Enhanced healthcare efficiency was reported by 18.3% (110 respondents), whereas 5% (30 respondents) noted the usefulness of DHT in public health activities. Reported health improvements due to DHT are enjoyed by 65% (390 respondents), suggesting that a portion of the users seem to receive actual benefits from the usage of such applications. On the other hand, 21.7% (130 respondents) do not feel such improvements, whereas 13.3% (80 respondents) indicate that they are not sure of such improvements more than how they appear to the public, which is unfavorable for DHT. Concerned that costs continue to be a popular factor, with 55% (330 respondents) being very concerned about DHT-related costs, 21.6% (130 respondents) being somewhat concerned and 23.3% (140 respondents) not concerned at all. Cultural resistance to DHT adoption does not seem to be a serious problem, as only 11.5% (69 individuals) reported resistance, whereas 88.5% (531 individuals) did not face cultural barriers. This is a good finding, as it implies that cultural issues do not act as barriers to DHT taking root within Pakistan. Government support, or lack of support, is also a major issue that affects DHT adoption. Only 13.3% (80 individuals) claim that they have ever been supported by the government, in contrast to 86.7% (520 individuals) who do not. Sixty-six percent (400 individuals) have access to hospitals, whereas 34% (200 individuals) do not have access to hospitals.\u003c/p\u003e \u003cp\u003eMost importantly, the acceptability of DHT is overwhelmingly high; 582 (97%) are willing to use these technologies, with only eighteen (3%) showing unwillingness. This high desire to take up DHT despite these barriers means that there is much potential for excellent utilization of this technology in Pakistan, given that paradoxical bottlenecks are mitigated.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eResearch on Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan\u0026rsquo;s Evolving Healthcare Landscape has provided valuable insights into the current level of digital health technology (DHT) adaptation among various demographics across verticals within the country. The large percentage of the population in the middle-aged groups, along with a significant proportion of elderly people, signals an acute requirement for health technologies that pertain to diseases at chronic levels, which are common among these age categories. The difference in gender distribution points toward potential sociocultural mechanisms that could affect engagement with DHT and uptake. The high proportion of married participants and heterogeneity regarding educational level and income provide further evidence for how socioeconomic determinants affect DHT adoption. This gap \u0026mdash; between high awareness of DHT and its actual use \u0026mdash; suggests that barriers are deeper than simple knowledge. On the other hand, only 65 percent of the respondents said that they are aware of DHT; furthermore, only 58 percent reported using these technologies, which demonstrates that becoming irrelevant, as awareness does not correlate with usage. This discrepancy highlights the need to work on affordability and accessibility as well as the perceived usefulness of these technologies. The data support this claim; financial constraints are a major barrier\u0026mdash;60% of participants identified cost as their greatest issue. Those who are uninsured have these concerns amplified because they now lack the means to attempt a trial of DHT. The variety in the types of DHT used, most notably glucose meters and insulin pens, indicates that the technologies being adapted for specific health needs more than anything else regarding managing diabetes. The different usage patterns (daily, weekly, or occasional) used by the users reveal varying depths of engagement and perhaps levels of need perceived in terms of necessity. The high rates of digital literacy and internet availability suggest a promising terrain for the uptake of DHT, provided that this corresponds to accessibility and affordability. The financial burden can be seen from the spending data, where most users are found to spend between 1,000\u0026ndash;4,000 PKR, while a very small fraction spends even more; this highlights the economic strain associated with DHT. This is coupled with technical difficulties and a lack of information, which reinforces the fact that support systems should be upgraded to promote adoption and use. Despite these hurdles, 97% of the participants were willing to use DHT. This willingness implies high growth potential for DHT adoption, provided that the single most commonly cited barrier is addressed. There is low cultural resistance toward the use of DHT, which bodes well for the integration of these technologies into routine practices influenced by culture. A major problem that needs to be resolved is that there has been no government assistance given for DHTs. Since only 13.3% reported receiving support at all of the sample sizes, an obvious conclusion is that public policies and efforts should have a more comprehensive nature through active cooperation with digital health tools. Owing to the clear disparity in hospital access, DHT can play a greater role in increasing healthcare accessibility for those presented with geographic and logistical challenges.\u003c/p\u003e \u003cp\u003eAlthough there is a high willingness for and possibility of DHT among participants in Pakistan, corresponding barriers such as cost, accessibility, and support need to be rigorously mitigated. Bridging the digital divide involves not only challenging awareness and literacy but also affordability problems that mimic sustainability challenges as well as support mechanisms. This will address primary healthcare challenges and further contribute significantly to enhancing the overall reach and quality \u0026mdash; making a significant portion of health service provision in Pakistan more accessible, efficient and equitable.\u003c/p\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eRecommendations\u003c/h2\u003e \u003cp\u003eThe government needs to include DHT in policies of financial support for low-income countries and as a category eligible under economic aid or insurance amelioration. This might involve producer or health tech partnerships to reduce costs and provide flexible payment plans. Create government-backed programs that target DHT adoption. This includes funding for research, public awareness campaigns, and programs that provide technical support to users. Awareness is elevated among the population, but efforts need to be concentrated on these 35%, as they are unaware of DHT. These campaigns need to explain the advantages and where to obtain DHT, if it can be integrated into our daily health management, etc., and make digital health tools accessible to all, including remote and rural areas. Purpose: To enhance local infrastructure, offer regional education and support\u0026thinsp;+\u0026thinsp;obtain DHT in multiple languages/formats, develop friendly tools \u0026amp; support assisting users in overcoming the pain associated with using DHT. This may involve producing tutorials, providing customer support services and designing tech that is user friendly and intuitive. Keep funding digital literacy programs so that people who need to use DHT can. On the one hand, training programs should be conducted to improve digital skills and guide users in drawing and addressing health technologies. Set up feedback mechanisms: repeat, include other people in your user base on the experience that DHT. This enables one to more easily identify things that are preventing usage and where improvements can be made. Surveys, focus groups, and user reviews help in collecting feedback. Keep researching the ways that DHT works in your body. This research must seek to understand the different needs and barriers for various population segments as well as evaluate the outcomes of DHT adoption.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eUnderstanding the exploratory nature of this research is crucial, and while broadly thoughtfully done, there are caveats to my comprehensive study. The study had various limitations: it relied mostly on self-reported data gathered via questionnaires and interviews, which can introduce biases and inaccuracies. While the 600 samples are not small in number, they fail to capture fully our diverse population diversity seen in more remote or less served areas. The same is true for this study; it is no doubt interesting and important, but its localized interest does not do full justice to the spread of DHT adoption in all regions in Pakistan. For subsequent studies, it will be important to increase the sample size and include other regions as well as follow-up longitudinal studies to detect the dynamic implications of DHT adoption.\u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDHT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDigital health technology\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical Package for the Social Sciences\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGDP\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eGross domestic product\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCGM\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eContinuous glucose monitoring\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLMICs\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLow and Middle Income Countries\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003emHealth\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMobile health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eKPK\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eKhyber Pakhtunkhwa\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003ePKR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePakistani Rupee\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eERC\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eEthics and research committee\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe extend our heartfelt gratitude to everyone who made this research possible. We are indebted to the Honorable Management and Faculty of Government Postgraduate College Nowshera for extending their support in carrying out this research. We acknowledge our fellow researchers and coauthors, Laiba Khan, Ruqayya Begum, Wasiq Ahmad, Manzoor Ahmed, and Fatima Sana, for their valuable guidance in research. This research would not have been possible without their collaboration, insights, and dedication. The depth of their experience and dedication were immeasurably valuable to the study. Most importantly, we would like to thank the participants of our research study because without them, we never had these valuable data about their experiences and opinions about digital health technologies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research did not benefit from any specific grant from public, commercial, or not-for-profit funding organizations. The author of the study did not receive any funding for the research work to be done in the course of the study; hence, all the costs incurred were borne directly out of pocket by the authors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval and Consent to Participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics and Research Committee (ERC) at Government Postgraduate College Nowshera. It has sought ethical approval and rights for participation from the participants. Each participant was told the aim of the research, the processes that would be undertaken together with their right to refuse to continue participating at any time without any repercussions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests to report.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData is provided in the form of supplementary information files.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEthics statement Informed consent was obtained from all individual participants included in the study. Parents or legal guardians provided informed consent for participants younger than 18 years and children or adolescents themselves gave assent.\u003c/p\u003e\n\u003cp\u003eThis statement signifies that all required consents from adults and parents (guardians) for minors were achieved in accordance with ethical standards on research of human subjects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMuhammad Fayez\u003c/strong\u003e: Muhammad Fayez, who is the main author and corresponding author for this paper, has an excellent role in study design as well. He designed this study, coordinated with the coauthors, and prepared the first draft of the manuscript and associated correspondence. He was also responsible for ultimately curating the content, integrating feedback, and ensuring that the paper was of high quality with good flow.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRuqayya Begum\u003c/strong\u003e: A literature review and formulation of the theoretical framework were accomplished by Ruqayya Begum. She conducted an extensive literature search and shared an understanding of the current theories of the problem.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLaiba Khan\u003c/strong\u003e: From a human resource perspective, Laiba Khan also contributed greatly to the data collection and analysis. She was in charge of data collection, data quality assurance, and initial data processing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eManzoor Ahmad\u003c/strong\u003e: Manzoor Ahmad helped with the statistical analysis and data presentation. He underwent various statistical examinations and passed the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWasiq Ahmad\u003c/strong\u003e: The methodology and data interpretation were performed by Wasiq Ahmad. He led the study design, designed the analytic approach, and interpreted the results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFatima Sana\u003c/strong\u003e: Fatima Sana provided input in the writing of the introduction and discussion parts of the research. She developed the story that is used in guiding this study, and she also deliberated on the consequences of the research outcomes.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBergier, H., Duron, L., Sordet, C., Kawka, L., Schlencker, A., Chasset, F., \u0026amp; Arnaud, L. (2021). Digital health, big data and smart technologies for the care of patients with systemic autoimmune diseases: where do we stand? 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Annals of Medicine and Surgery, \u003cem\u003e81\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaeem, W., Nadeem, H. A., Javed, A., \u0026amp; Ahmed, W. (2022). Digital Health and Future of Healthcare in Pakistan. Annals of King Edward Medical University, \u003cem\u003e28\u003c/em\u003e(2), 268\u0026ndash;272.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilson, D., Sheikh, A., G\u0026ouml;rgens, M., Ward, K., \u0026amp; Bank, W. (2021). Technology and Universal Health Coverage: Examining the role of digital health. \u003cem\u003eJournal of Global Health\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuhammad, Q., Eiman, H., Fazal, F., Ibrahim, M., \u0026amp; Gondal, M. F. (2023). Healthcare in Pakistan: navigating challenges and building a brighter future. Cureus, \u003cem\u003e15\u003c/em\u003e(6).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKhan, S. J., Asif, M., Aslam, S., Khan, W. J., \u0026amp; Hamza, S. A. (2023). Pakistan\u0026rsquo;s healthcare system: a review of major challenges and the first comprehensive universal health coverage initiative. Cureus, \u003cem\u003e15\u003c/em\u003e(9).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFarooq, S., Ramzan, M., Ali, F. H., \u0026amp; Rashid, H. A. (2020). Analyzing the efficiency of health care in Pakistan: An application of data envelopment analysis to rural health centers in Punjab. Pakistan Vision, \u003cem\u003e21\u003c/em\u003e(2), 273.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-health-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dihs","sideBox":"Learn more about [Discover Health Systems](https://www.springer.com/44250)","snPcode":"44250","submissionUrl":"https://submission.nature.com/new-submission/44250/3","title":"Discover Health Systems","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Digital health technology (DHT), healthcare access, digital divide, diabetes management, Pakistan, affordability, adoption, healthcare disparities.","lastPublishedDoi":"10.21203/rs.3.rs-5138453/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5138453/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eDigital health technology (DHT) offers great promise for revolutionizing healthcare delivery in limited-resource settings such as Pakistan due to existing challenges, including low infrastructure, scarcity of resources, and digital partitioning. The purpose of this study was to explore the affordability and adoption status of health technology among diabetic patients in Pakistan.\u003c/p\u003e\u003ch2\u003eMethods:\u003c/h2\u003e \u003cp\u003eA descriptive approach was employed, and primary data were collected via questionnaires from 600 diabetes patients from different areas of Pakistan. The use of a random sampling technique enabled collection from different geographical areas, leading to the recruitment of a broad range among the diabetic population. The descriptive analysis was performed via SPSS 23, and Excel 16 was used to categorize the data into different patterns/trends concerning DHT awareness, usage, and affordability.\u003c/p\u003e\u003ch2\u003eResults:\u003c/h2\u003e \u003cp\u003eThe results reveal that 65% of the population is aware of DHT, and this high awareness has translated into practical usage at a rate of approximately 58%, illustrating additional barriers to adoption beyond simple knowledge, namely, costs and perceived utility. Additionally, 60% indicated that they could not afford DHT, and only 36.1% reported that they had health insurance. The study also noted variability in DHT use, with blood glucose meters and insulin pens being the most common devices used. There is a significant willingness to adopt DHT (97%), although this comes with a range of challenges.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eThis study underscores the need to address the digital divide in Pakistan by improving affordability, access, and support for DHT. Bridging these gaps could enhance healthcare access and quality, particularly for managing chronic conditions such as diabetes. Effective public policies and initiatives are crucial to promoting DHT adoption and ensuring equitable healthcare delivery across the country.\u003c/p\u003e","manuscriptTitle":"Bridging the Digital Divide: Affordability and Adoptability of Health Tech in Pakistan’s Evolving Healthcare Landscape","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-11-11 15:27:16","doi":"10.21203/rs.3.rs-5138453/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-10-21T19:01:36+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-21T01:48:35+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-10-19T06:21:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"212326514068847214875924327839668512753","date":"2024-10-18T19:48:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"237581964883736847201549947736222988590","date":"2024-10-17T04:43:26+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"282900729890891697322551498994831941143","date":"2024-10-16T21:05:24+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"12990581339651449482768299037228711994","date":"2024-10-16T20:45:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-10-09T20:33:21+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-10-04T19:30:11+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-09-30T10:03:32+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Health Systems","date":"2024-09-23T13:23:22+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-health-systems","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dihs","sideBox":"Learn more about [Discover Health Systems](https://www.springer.com/44250)","snPcode":"44250","submissionUrl":"https://submission.nature.com/new-submission/44250/3","title":"Discover Health Systems","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b7f1d9c7-fba4-4def-97c9-b8745b78a12c","owner":[],"postedDate":"November 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-04-01T04:53:27+00:00","versionOfRecord":[],"versionCreatedAt":"2024-11-11 15:27:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5138453","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5138453","identity":"rs-5138453","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}