Why digital accessibility and app usability should matter to tech leaders

Learn how co-creation, usability and digital accessibility have helped develop C-Vive, a healthtech app tackling stigma and improving outcomes in South Africa.

Context and accessibility are vital if a software application is to deliver the expected outcome. With cervical cancer remaining one of the leading causes of cancer-related deaths in South Africa, a mobile application to help South Africans dealing with the disease has to reflect the needs of its audience. Fortunately, the development of just such an app, C-Vive, was led by an accessibility expert in distinguished professor, Darelle Van Greunen. 

C-Vive is a story of tech for good. But technology can only deliver positive outcomes if it is developed with a good understanding of the user’s needs, a lesson for any CIO or CTO.

Digital accessibility: Overview

• Technology co-creation to reflect local culture
• Starting with app usability and user-centred digital strategy
• Digital accessibility and inclusion become business imperatives
• Key takeaways on digital accessibility: What tech leaders can learn from C-Vive

The fear of stigmatisation is a real issue in South Africa, leading to an avoidance of medical treatment. To break down that stigma, there was a push to increase the public’s knowledge of cancer. 

In 2022, the Center for Community Technologies (CCT), a body within the Nelson Mandela University, worked with NTT Data to launch C-Vive, a mobile application designed to increase awareness within rural South-African communities. 

The CCT analyses and leads the use of technology to solve societal issues. 

"We don't have technology solutions and then find a place to implement them,” says Van Greunen. “Instead, we are speaking to the people and understanding their challenges and seeing if some form of innovation can be used that will bring about change and solve those challenges." 

The CCT consists of academics, practitioners and technologists, who Van Greunen says are all motivated by making a difference. It was this ethos that led to CCT realising that technology could tackle South Africa's cancer stigma and awareness problems. 

"When you hear the diagnosis of cancer, it is like somebody has pulled the rug from under your feet. Speaking to people in rural areas, we came to realise that they don't know about cancer, and oncologists told us there is a lot of fear, so when they do go for tests, it is too late,” says Van Greunen. 

"We decided to do a landscape scan of what was available from a South African context and found there was very, very little. There are thousands of apps and resources that have been developed in the USA or UK, but nothing uniquely African that speaks to the African context and culture." 

Without context, the stigma would continue, and as Van Greunen says, you only get one shot in the fight against cancer. She recalls her own personal story:

“I remember my own mother had breast cancer 40 years ago. She is in her 80s now, but I can vividly remember the day she was diagnosed, and back then, that was almost a death sentence. I am not saying that cancer is not a death sentence anymore, but there is hope, and that is what we are trying to instill in people through C-Vive." 

Technology co-creation to reflect local culture

The landscape scan and research revealed that South Africans needed their own app, one that reflected their local culture. This became one of the central pillars of developing C-Vive and was led by continuous co-creation of the app with citizens and oncologists who work on the ground.

Context shapes language and, ultimately, app usability. "People may not have the jargon. So when you talk about cancer as a disease, you cannot talk to them about lymph nodes. Also, culturally, there are topics that are not discussed in public, and at the moment, cervical cancer is not a conversation to be had; it is something that happens behind closed doors. Prostate cancer is also an absolute no among the traditional communities," the professor says.  

These cultural barriers lead people to trust local healers and avoid modern healthcare. "Using words like diagnosis may not sit well with people. You need to say 'how you detect'. Say it as it is," she says. 

Starting with app usability and user-centred digital strategy

As a published PhD in technology usability, inevitably, Van Greunen ensured there was a strong focus on app usability in the development of C-Vive. 

"To me, it's obvious that if the user can't use it, then it doesn't work," she says. To ensure good usability, Van Greunen used scenarios to make sure functions and content were relatable and accessible. 

"Technology is the glue that brings it all together. Through technology and innovation, we have the ability to create hope. If we do nothing else with technology, let us create hope and not see it as a threat." 

Van Greunen's ethics reflect those of former prisoner and then national leader Nelson Mandela and not the greed and right-wing avarice of the current crop of AI technology "leaders", but she has similar levels of hope for AI.  "In the AI age, people are worried that they will lose their jobs, so part of what we need to instill is that AI is a technology to create hope, with new innovations that are unknown to us at this point in time." 

C-Vive was first developed in 2022 using a five-week hackathon with technology partners OutSystems and NTT, as well as the Cancer Association of South Africa. She says the hackathon proved highly effective, in part because so many of the developers and organisations that got involved had experiences with cancer and wanted to make a difference. Initially, 14 teams began developing solutions before a final seven teams crafted the final C-Vive. 

Today, the multi-language C-Vive has good penetration across South Africa, Van Greunen says, with private and public oncologists using the tool as well as those suffering from cancer. A range of cancer networks have backed the tool and promoted it to their communities. 

Digital accessibility and inclusion become business imperatives

In June 2025, the EU Accessibility Act came into effect, in a move to improve digital accessibility for people with disabilities across the EU. As such, all organisations operating within the region will need to develop applications which promote usability and accessibility - not least as management consultants McKinsey estimates that poor digital accessibility accounts for $6.9 billion (£5.1 billion) in lost revenue.

This is a number that will grow, after all we are all getting older and our abilities decline with age. Thus our needs for better usability and accessibility increase. Back in 2022, the World Health Organisation (WHO) reported that there are two billion people worldwide with low vision or blindness. 

If a technology is difficult, or for those with neurodiversity or disabilities, impossible to use, then it is failing in its brief. This is important for consumers, staff and even AI. 

"Machines need to be able to access and parse through your information," says Suraj Kika, CEO of Jadu, a software firm that focuses on digital accessibility. As user behaviour changes and AI adoption increases, CIOs whose web estate is digitally accessible, usable and inclusive will benefit. This is both an internal and external usage consideration, considering employees and customers alike. 

In these difficult times it is important to coalesce around a positive story. South Africa’s C-Vive reminds us that technology can be a force for good.

Key takeaways on digital accessibility: What tech leaders can learn from C-Vive 

C-Vive’s story of usability and digital accessibility can inspire technology leaders facing their own challenges.

Accessibility and app usability are good business: Digital accessibility isn’t only the right thing to do, but a business opportunity to address missed or underserved communities. Accessible services will be more readily available to all, in-turn maximising revenue opportunities and reducing operational costs (as well as potential legal risks). Analysts at Forrester have previously found that every $1 invested in accessibility yields up to $100 in benefits.

Innovative modes to drive user engagement: C-Vive’s app leveraged illustrations and neutral colours to improve the user experience, but also in-app gamification to drive user consumption and progress through the app’s content.

As a community, we can develop technology that makes the world a better place: Technology leaders are well-positioned to drive digital equity beyond the four walls of their business. Purpose-driven leadership can ensure that accessibility becomes part of an organisation’s culture – and that of its wider tech ecosystem

AI requires accessibility: Artificial intelligence threatens to widen the digital divide, with many lacking the digital access, confidence and skills required for tools that evolve each passing day.

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