Technological Determinants of Mobile Health Effectiveness in Improving Treatment Compliance in Patients with Non-Communicable Diseases in Low-Medium-Income Countries: A Systematic Review

Non-communicable diseases (NCDs) are responsible for 71% of global deaths, with 77% occurring in low- and middle-income countries (LMICs), where treatment compliance is hindered by limited healthcare access, low health literacy, and socioeconomic challenges. Mobile health (mHealth) interventions, including SMS reminders, apps, and teleconsultations, present a viable solution by delivering accessible health education and remote support. However, their effectiveness is heavily influenced by technological barriers such as network coverage, data and device costs, and privacy concerns, underscoring the need for a systematic evaluation tailored to LMIC settings. This review assesses how technological factors—network coverage, affordability, mobile penetration, security, trust, user experience, and usability—affect the efficacy of mHealth interventions in improving NCD treatment compliance in LMICs. It aims to identify key barriers and facilitators to guide the development of equitable and scalable solutions. Following PRISMA guidelines, the study analyzed relevant peer-reviewed articles from databases including Google Scholar, PubMed, Scopus and Web of Science. The focus was on Low-middle-income countries (LMICs) and mHealth interventions for non-communicable diseases (NCDs). While 41 references were included in the broader scope of this review, detailed synthesis and analysis were conducted on a subset of 23 studies. Data extraction and quality assessment were conducted using standardized tools, with findings synthesized narratively due to heterogeneous study designs. Results revealed that mHealth interventions achieved 70–85% adherence in urban LMICs like Bangladesh and India, where reliable connectivity and user-friendly designs improved compliance by 15–25%. In contrast, rural areas (e.g., Uganda, South Africa) saw lower adherence (50–60%) due to poor network coverage, high costs (reducing uptake by 20–30%), and low mobile penetration. Privacy concerns deterred 40% of users in Nepal and South Africa, while low trust in digital health reduced compliance by 20–30% in rural regions. Platforms perceived as easy to use and valuable significantly enhanced participation across NCDs. The review concludes that mHealth can effectively improve NCD treatment compliance in LMICs when technological barriers are addressed. However, rural disparities and psychosocial factors like distrust limit scalability. Policymakers should invest in rural infrastructure, subsidize costs, and enforce robust privacy measures. Developers are urged to prioritize user-centric, low-literacy-friendly designs, leveraging SMS in low-penetration areas. Future research should explore long-term impacts, standardize compliance metrics, and investigate trust-building strategies for sustainable solutions.