Why personalised health is the missing link in health ownership
South Africans have a health information problem – not a shortage of it, but an excess of it that has changed almost nothing1 .
Most people already know what better health looks like. The real challenge is turning intention into action in the midst of work pressure, caregiving, financial strain, emotional fatigue and limited time. In that context, even sound advice can feel disconnected from daily life.
The World Health Organization2 says non-communicable diseases are now responsible for more deaths and disability in South Africa than HIV and AIDS or tuberculosis. The same WHO feature notes that more than half of South African adults, including more than two thirds of women, are overweight or obese.
Against that backdrop, the stakes of getting this right are clear. Information alone is not enough – it never has been.
Ownership needs support, not pressure
Health ownership is not about placing more pressure on people. It’s about building the knowledge, confidence and practical routines that make healthier choices feel possible and sustainable.
Patient activation research3 supports this. People with stronger knowledge, skills and confidence are more likely to engage in healthier behaviours and experience better outcomes. In other words, health ownership is not about perfection. It’s about enablement. This is why personalisation matters.
Habit formation is often spoken about as if motivation is the only ingredient. But the science tells a more realistic story. A recent systematic review4 describes habit formation as starting with an intention, repeating the behaviour, and eventually doing it automatically when it happens in a stable context. That same review found that the time needed to form health habits varies widely, with reported medians ranging from 59 to 66 days, alongside substantial variation between individuals.
That tells us something important. Sustainable behaviour change is rarely instant, and it’s almost never universal. People need support that takes their own circumstances seriously.
What the best health ecosystems understand
Omada Health’s two-year study5 of a web-based diabetes prevention programme found that participants maintained average reductions in body weight and A1c over two years, a measure of average blood sugar levels that can indicate diabetes risk. What stands out is not just the result – it’s the design behind it: connected tools, coaching, feedback and ongoing support that help people stay engaged beyond the first burst of motivation.
A second example comes from Canada’s Carrot Rewards app. A 12-month quasi-experimental study6 involving 39 113 participants found that a programme using small, immediate digital incentives for personalised step goals was associated with increased step counts, with the biggest gains seen among physically inactive and more engaged users. Again, the lesson is not that rewards alone change behaviour. It’s that people are more likely to follow through when the action feels realistic, the feedback is immediate and the habit fits into daily life.
This is the case for personalisation. People are far more likely to sustain a habit when it feels relevant to their own life, rather than imposed from the outside. A routine that works for one person may be unrealistic for another, and a starting point that feels manageable for one person may feel overwhelming to someone else.
If we’re serious about health ownership, we need to stop treating health as a standardised checklist and start seeing it for what it is: deeply personal, shaped by context, mindset and daily reality. I have seen this pattern consistently in my own work when people are given a starting point that feels achievable, rather than aspirational. It changes the conversation about health entirely.
The mind shapes the routine
It’s also why I believe mental wellbeing must be part of the habit conversation.
At Momentum Multiply we believe that true health is more than the absence of disease and that mental wellbeing is foundational to lasting health. In my experience, healthy routines are often hardest to maintain when people are mentally stretched. Small, consistent mental practices matter, because they create the steadiness people need to return to healthier behaviours – not through willpower, but through self-awareness in a way that feels realistic and sustainable.
It’s not about chasing perfect balance. It’s about recognising that the mind and body do not operate separately. When people feel overwhelmed, depleted or emotionally overloaded, healthy routines are often the first things to slip. Any meaningful conversation about behaviour change has to start there.
That is the thinking behind our partnership with Dr Caroline Leaf’s Neurocycle app. Her approach is built around a structured five-step process that helps people recognise and rework unhelpful thinking patterns over time, underscoring a broader truth: lasting behaviour change is more likely when it’s rooted in self-awareness and consistent practice, rather than willpower alone.
The shift we need now
If we want more South Africans to take ownership of their health, we need to stop confusing information with enablement – the real opportunity in front of us. We don’t need a louder version of the same health advice. We need a more human one. One that recognises that lasting habits are built gradually, that health ownership has to be supported, and that personalisation is not a luxury. It is what makes change possible.
Maria Carpenter is Head of Momentum Multiply, Momentum Health’s complete wellness rewards programme, and a transformation strategist who has designed digital health solutions used by millions.
(1) https://www.statssa.gov.za/?p=16729
(2) https://www.who.int/news-room/feature-stories/detail/south-africa-applying-the-lessons-learned-from-tackling-hiv-to-accelerate-action-on-obesity
(3) https://link.springer.com/article/10.1007/s11606-013-2647-2
(4) https://pmc.ncbi.nlm.nih.gov/articles/PMC11641623/
(5) https://www.omadahealth.com/resource-center/long-term-outcomes-of-a-web-based-diabetes-prevention-program-2-year-results-of-a-single-arm-longitudinal-study
(6) https://pmc.ncbi.nlm.nih.gov/articles/PMC7043029/
