Between hype and harm: Does Artificial Intelligence in health offer solace or further exclusion for Africa’s marginalised? A scoping review

This protocol outlines a scoping review that will examine whether artificial intelligence (AI) in healthcare improves equity or deepens exclusion among marginalised populations in Sub-Saharan Africa. Although AI has shown potential to improve diagnostics, decision-making, and health service efficiency, most AI systems are trained on datasets from high-income countries and governed by frameworks developed in Western contexts, which may limit their relevance and fairness in African health systems. As a result, there are growing concerns that AI could reinforce existing inequities, bias, and forms of “digital colonialism,” particularly for populations already disadvantaged by poverty, geography, gender, displacement, disability, or stigma. Using the PRISMA-ScR framework and the Arksey and O’Malley scoping review methodology, the study will systematically search databases such as PubMed and Google Scholar, alongside relevant grey literature, to identify empirical studies on AI-enabled health interventions implemented in Sub-Saharan Africa. The review will synthesise qualitative and quantitative evidence to assess how these technologies influence equity, access to care, and health outcomes among marginalised groups, while also identifying reported ethical, governance, regulatory, and implementation challenges affecting equitable deployment. Findings will be analysed thematically and interpreted through the PROGRESS-Plus equity framework, with the aim of clarifying whether AI offers meaningful benefits for underserved populations or risks further exclusion within African health systems.