Systematic review of frugal digital health innovations in low-resource settings

Frugal digital technologies are an emerging approach designed to be cheap, simple, and robust by prioritizing practical repurposing over novelty to improve healthcare outcomes, where the healthcare sector in low and middle-income countries faces many challenges in diagnosing, monitoring, and treating patients due to unreliable electricity, inadequate funding, the complexity of medical devices, and a lack of trained healthcare workers. We systematically searched PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar in accordance with PRISMA 2020 guidelines. From these studies searched, 172 eligible studies published between January 2000 and December 2025 were identified. Of these, the largest reported technologies (28%) are mobile health platforms, followed by handheld diagnostic devices (25%), physiological sensors (19%), and wearable monitoring systems (16%), with telehealth technologies (12%). Most innovations targeted diagnostics (20%), neonatal care (19%), physiological monitoring (19%), maternal health (18%), treatment-support technologies (16%), and telemedicine (8%). Digital frugal health technologies that reach low-resource settings tend to be affordable, functional, simple, easy to use, repairable, modular, and fit with local infrastructure. These characteristics of frugal innovation help to expand access to care, simplify clinical workflows, and support frontline workers. Most studies described prototypes and short pilots. Few have tested whether devices remain effective, scalable, and sustainable over time, or whether they fit routine healthcare systems.