Telehealth in Low-Income Countries: A Systematic Review of Health Outcomes, Access, Equity, and Policy Implications

Thirty studies involving 45,600 participants were included: 12 randomized controlled trials, eight quasi-experimental, and 10 observational. Risk of bias was assessed with RoB 2 and ROBINS-I, while certainty of evidence was appraised using GRADE. Findings showed that telehealth significantly improved chronic disease outcomes (diabetes, hypertension), maternal-child health utilization, HIV adherence, and adolescent mental health.

Interventions reduced travel costs and improved rural access but equity gaps persisted, particularly for women and low-literacy populations. Barriers included unreliable electricity, poor connectivity, weak regulation, and donor dependence, while facilitators included community health worker involvement, NGO partnerships, and mobile phone penetration. The authors conclude that telehealth in LICs is effective and aligns with Sustainable Development Goals 3, 5, and 10.

However, sustainability requires infrastructure investment, robust policy frameworks, and equity-sensitive design. Telehealth must be institutionalized within universal health coverage strategies to evolve from short-term pilots into transformative health system reforms.