Can Digital Health Reduce Inequities? A Scoping Review of Implementation Evidence from Low-Resource Settings

Abstract

Digital health is increasingly used to extend care in low-resource settings, yet improved access, feasibility, or acceptability does not necessarily demonstrate reduced health inequities. This scoping review mapped evidence on digital health and health equity in low-resource settings. Following the PRISMA extension for Scoping Reviews (PRISMA-ScR) and Joanna Briggs Institute (JBI) guidance, Scopus, Web of Science, and PubMed were searched on 20 May 2026 for English-language studies published between 2021 and 2026. After eligibility screening, two reviewers independently applied a review-specific seven-criterion cross-design rubric before thematic synthesis. Sixty-nine studies were included; all met the review-defined 19/21 threshold for sufficient reporting and relevance to synthesis. Evidence comprised implemented or evaluated interventions and services (n = 34), implementation, adoption, or contextual studies (n = 24), and protocols, development studies, or requirements analyses (n = 11). mobile health (mHealth) applications (n = 39) and telemedicine/telehealth (n = 32) predominated. Leading barriers involved connectivity, infrastructure, or device access (n = 31), digital literacy or usability (n = 22), and affordability or resource constraints (n = 20). Direct evidence of narrowed disparities remained limited. Digital health can support equity when it addresses defined access barriers and is affordable, usable, culturally responsive, locally supported, privacy-conscious, and integrated into actionable care pathways.