I think it depends on where you are going, and who you are going to be with..
For example.. the place I routinely hunt in South Africa is only a 35 minute drive to a reasonable hospital, in a fairly large town / small city.. cell coverage is good most everywhere, and there are good facilities/amenities very nearby.. I don't see a need for inreach or any sort of back up communication system.. between my US cell carrier, my PH's local cell carrier, my wifes cell carrier (different than mine), etc.. whatsapp, texting, making calls, using the cell GPS, etc is all easy to do and we're all connected pretty much all the time.. my PH also has a solid radio network and can easily communicate with the other PH's, the skinners, the trackers, the lodge staff, etc.. at the push of a button..
If I were chasing Bongo in the Congo however.. things would be very different.. not only is there much less cell connectivity, medical threats and physical threats are also very different...
Parts of Africa I don't mind traveling to with just a cell phone.. other parts Im going to have an inreach device on me.. others still Im taking my starlink mini with me..
It just depends..