Equity effects of digital primary care interventions in low-and middle-income countries: A systematic review using the PROGRESS-Plus framework

Indrawan, Doby ORCID: https://orcid.org/0009-0008-4074-1942 (2026) Equity effects of digital primary care interventions in low-and middle-income countries: A systematic review using the PROGRESS-Plus framework. International Journal of Global Sustainable Research, 4 (10). pp. 1301-1326. ISSN 3026-4677

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Abstract

Purpose: Digital primary care is increasingly promoted as a strategy to overcome barriers in lowand middle-income countries (LMICs). However, whether these interventions reduce health inequities remains uncertain. This systematic review examined equity effects across disadvantaged populations using PROGRESS-Plus. Methods: Following PRISMA 2020, peer-reviewed primary empirical studies published between January 2020 and September 2026 were identified through bibliographic databases and citation searching. Twenty-six studies evaluating digital primary care interventions in LMICs were included in a structured narrative synthesis. Equity evidence was mapped across PROGRESS-Plus dimensions. Main Findings: Digital primary care generally improved healthcare access, continuity, referral completion, service utilization, and selected clinical outcomes among rural, remote, low-resource, maternal, refugee, and underserved populations. However, equity gains depended on education, digital and health literacy, socioeconomic resources, connectivity, device access, gender, autonomy, and health-system readiness. Human-supported models involving community health workers and frontline providers appeared more equity-sensitive than technology-only approaches. Most studies demonstrated improved access among disadvantaged populations rather than directly measuring reductions in inequalities between advantaged and disadvantaged groups

Item Type:	Journal Article
Keywords:	Digital Primary Care, Mhealth, PROGRESSPlus, Primary Healthcare, Low- and Middle-Income Countries
Subjects:	11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111708 Health and Community Services 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care
Divisions:	Faculty of Medical and Health Sciences > Department of Medical Education
Depositing User:	Doby Indrawan
Date Deposited:	26 Oct 2026 15:47

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