4 Lessons Learned From Global Digital Health AI Chatbot Failures

The Frontier Technologies Hub’s recent findings from health chatbot pilots in Peru, Kenya, and Nigeria offer important insights for digital health projects. Each year, numerous health chatbot initiatives in low- and middle-income countries fail, not due to AI limits, funding issues, or poor internet but because of flawed development approaches.

Key Pilot Insights

The pilots focused on areas such as vaccine uptake, sexual health education, chronic disease management, and post-surgical care. They revealed challenges including:

Unreliable chatbot performance
Mixed effects on existing workflows
Poor usability for target users
Insufficient adaptation to local contexts

Systems Approach Over Technology-First Mindset

The failure of many projects stems from starting with technology capabilities—like AI—rather than user needs and realities. The pilots showed even when users have phones and internet access, they often lack the digital skills to effectively engage with chatbots.

"This is where most projects go wrong from day one. We get excited about what ChatGPT can do and immediately start designing solutions around AI capabilities rather than user realities."

Four Critical Lessons from the Pilots

Prioritize understanding user digital literacy.
Design chatbot solutions grounded in local cultural and health contexts.
Evaluate how chatbots fit within existing health workflows.
Ensure reliability of chatbot interactions before scaling.

Success in chatbot innovation demands a comprehensive systems perspective, integrating technology with user-centered design and local context awareness.

Author's Summary

Effective digital health chatbots require focusing on users' skills and contexts rather than just AI capabilities, as technological excitement often leads to project failure.

ICTworks — 2025-11-05