Accessibility of Digital Financial Applications for People With Visual Impairment: Scoping Review
Clinical Snapshot
PICO Framework
| P — Population | People living with visual impairment (VI), including those with low vision and blindness, across all age groups and geographic settings |
| I — Intervention | Digital financial services and applications (mobile banking, payment platforms, fintech apps) across Android, iOS, and web platforms |
| C — Comparator | No formal comparator; the review maps the landscape of accessibility barriers and facilitators rather than comparing interventions head-to-head |
| O — Outcomes | Accessibility barriers and facilitators to digital financial service use; platform-specific usability issues; authentication challenges; screen reader compatibility; independence in financial management; implications for health equity as a digital determinant of health |
Bottom Line
This scoping review provides the first systematic map of evidence on digital financial service accessibility for people with visual impairment, framed as a digital determinant of health. Across 23 studies from 12 countries, authentication barriers and screen reader incompatibility emerged as the most pervasive cross-platform challenges, affecting independence, privacy, and financial participation. The evidence base is, however, methodologically limited: most studies involved very small samples (4–36 participants), no longitudinal or intervention studies were identified, and formal quality appraisal was not conducted. The geographic concentration of studies in South and Southeast Asia limits direct applicability to Australian and other high-income settings. The review's primary value lies in gap identification rather than practice-changing evidence synthesis. For Australian clinicians, the key takeaway is that digital financial inaccessibility is a documented, cross-platform problem for patients with VI that may compound social disadvantage and health inequity — consistent with the RACGP's social determinants framework. Clinicians should consider financial digital literacy and assistive technology access as part of holistic care for patients with VI. Policymakers and fintech developers should treat these findings as a call for co-designed, accessibility-first development and rigorous intervention evaluation.
Key Findings
Effect Size: Not applicable — scoping review with descriptive/thematic synthesis; no pooled effect sizes calculated
Primary Outcome: Authentication-related barriers were the most frequently reported accessibility challenge, identified in 18 of 23 included studies (78%). Screen reader incompatibility was reported in 17 of 23 studies (74%). Barriers were consistent across Android, iOS, and web platforms.
Nnt Or Sensitivity: Not applicable — no diagnostic, therapeutic, or prognostic effect measures reported. The single large population survey included n=19,136 participants; all other studies with human participants had n=4 to n=36.
Confidence Interval: Not applicable — no quantitative meta-analysis conducted
Clinical Application
The review does not evaluate specific interventions, so direct clinical implementation guidance is limited. Clinicians working with patients with VI should be aware that digital financial inaccessibility is a documented barrier to financial independence and may contribute to social disadvantage and health inequity. Referral to assistive technology specialists and financial counsellors with VI expertise is appropriate. Advocacy for accessible design in fintech platforms aligns with occupational therapy and rehabilitation goals. This review has direct relevance to Australian healthcare and policy contexts. Australia's Disability Discrimination Act 1992 and the Australian Human Rights Commission's web accessibility guidance require digital services to meet WCAG 2.1 AA standards, including financial platforms. The Australian Banking Association's accessibility commitments and the Australian Prudential Regulation Authority (APRA) oversight of digital banking create a regulatory environment where these findings can inform compliance advocacy. Vision Australia and the Royal Society for the Blind provide assistive technology support services relevant to the barriers identified. The RACGP's emphasis on social determinants of health in general practice (Standards for General Practices, 5th edition) supports clinician awareness of digital financial exclusion as a health-relevant social factor. PBS and TGA considerations are not directly applicable to this non-pharmacological, non-device review. The Monash University and Swinburne University authorship team situates this work within the Australian academic and policy context, enhancing local relevance. Adults and older adults with visual impairment (including low vision and blindness) who use or are expected to use digital financial services for routine transactions, banking, payments, and financial management. Particularly relevant for rehabilitation medicine, ophthalmology, occupational therapy, and social prescribing contexts where financial independence is a functional outcome.
Abstract
BACKGROUND: Routine financial activities are now conducted primarily through digital channels. Many such systems remain inaccessible to more than 2.2 billion people globally living with vision impairment, limiting independent financial management. Constrained access can create financial strain and social disadvantage, reducing access to health-enabling resources, and contributing to avoidable health inequities. OBJECTIVE: This scoping review maps evidence on the accessibility of digital financial services for individuals with visual impairment (VI) as a digital determinant of health. We synthesized barriers and facilitators, characterized study designs, settings, and populations, and identified evidence gaps to inform inclusive design, digital health research priorities, and policy. METHODS: A scoping review was conducted using the Joanna Briggs Institute framework and reported in line with PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eight databases (PubMed, MEDLINE, CINAHL, Scopus, Web of Science, Business Source Complete, ProQuest, and IEEE Xplore) were searched for peer-reviewed papers in English published between 1995 and 2026. Searches featured controlled vocabulary and free-text terms structured in 3 conceptual blocks (VI, digital financial services, and accessibility or usability). A random sample of 20% of titles, abstracts, full texts, and included studies was independently screened or charted by 2 reviewers to calibrate decisions; the remainder were screened and charted by a single reviewer. Data were charted using a standardized extraction form, and results were synthesized descriptively and thematically. RESULTS: Twenty-three studies met the inclusion criteria. Studies were conducted across 12 countries, with the largest number from India (n=7), Indonesia (n=2), Thailand (n=2), and the United States (n=2). Study designs included qualitative studies (n=6), mixed methods studies (n=1), cross-sectional studies (n=4), nonrandomized experimental studies (n=2), and technical or design-focused evaluations (n=6). One study was a large population survey (n=19,136), and the remaining studies with human participants had sample sizes ranging from 4 to 36 participants. Accessibility barriers were reported across all platform types, with authentication-related barriers described in 18 studies and screen reader incompatibility in 17 studies. Reported barriers included reliance on sighted assistance for tasks such as login, verification, and payments, compromising privacy and independence. Facilitators included assistive technology support, logical navigation order, nonvisual feedback mechanisms, and accessible authentication alternatives. Evidence mapping revealed recurrent barrier patterns across Android, iOS, and web platforms. No longitudinal or intervention-based evaluations were identified. CONCLUSIONS: This review provides a focused synthesis of accessibility evidence at the intersection of digital financial services and VI, a domain addressed by neither prior digital accessibility reviews nor financial inclusion for people with disabilities. Authentication methods, interface labeling, and navigation were identified as persistent cross-platform accessibility barriers. The findings carry implications for financial technology developers, accessibility auditors, and policymakers implementing accessibility legislation and extend the digital determinants of health framework by demonstrating how inaccessible financial technology may compound health inequities.
References
- 1.Puli, L., Kooijman, L., Kanij, T., Hartel, C., Shahriar, A. Z. M., & Rotaru, K. (2026). Accessibility of digital financial applications for people with visual impairment: Scoping review. Journal of Medical Internet Research. https://doi.org/10.2196/82315
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