Public policies and digital infrastructure in the health sector: A structured narrative review
DOI:
https://doi.org/10.5281/zenodo.21893826Keywords:
public policy, digital infrastructure, digital healthAbstract
The digital transformation of healthcare systems has become a strategic priority for improving the efficiency, accessibility, and sustainability of health services. In this context, the present study aimed to analyze the available evidence on public policies and digital infrastructure in the health sector through a structured narrative review. The methodology involved the identification, selection, and analysis of 30 academic and technical-scientific publications, primarily published between 2019 and 2025, including research articles, review papers, editorials, and specialized documents addressing digital governance, digital infrastructure, information and communication technologies, interoperability, and digital health. The literature search was conducted in the Scopus, Web of Science, and SciELO databases. The evidence was synthesized through thematic analysis organized into five dimensions: social impact and public policies, digital infrastructure, information and communication technologies, governance and regulation, and implementation challenges. The findings indicate that strengthening digital infrastructure is a key strategic factor for expanding equitable access to healthcare services, improving the interoperability of health information systems, supporting evidence-based decision-making, and enhancing continuity of care. Nevertheless, important challenges remain, including connectivity gaps, insufficient technological investment, cybersecurity concerns, limited workforce training, and the absence of comprehensive regulatory frameworks. It is concluded that advancing digital transformation in healthcare requires robust governance, sustainable investment, and effective interinstitutional coordination to ensure the equitable and successful implementation of digital health strategies.
Downloads
References
Ahmed, M. M., Okesanya, O. J., Olaleke, N. O., Adigun, O. A., Adebayo, U. O., Oso, T. A., Eshun, G., & Lucero-Prisno, D. E., III. (2025). Integrating digital health innovations to achieve universal health coverage: Promoting health outcomes and quality through global public health equity. Healthcare, 13(9), 1060. https://doi.org/10.3390/healthcare13091060
Al Knawy, B., McKillop, M. M., Abduljawad, J., Tarkoma, S., Adil, M., Schaper, L., Chee, A., Bates, D. W., Klag, M., Lee, U., Kozlakidis, Z., Crooks, G., & Rhee, K. (2022). Successfully implementing digital health to ensure future global health security during pandemics: A consensus statement. JAMA Network Open, 5(2), e220214. https://doi.org/10.1001/jamanetworkopen.2022.0214
Al Meslamani, A. Z. (2023). Technical and regulatory challenges of digital health implementation in developing countries. Journal of Medical Economics, 26(1), 1057–1060. https://doi.org/10.1080/13696998.2023.2249757
Alunyu Egwar, A., Amiyo, M. R., & Nabukenya, J. (2024). Framework for standardizing digital health in resource-constrained settings: A case study of Uganda's digital health communication infrastructure. Oxford Open Digital Health, 2, oqae018. https://doi.org/10.1093/oodh/oqae018
Alvarado, A. D. (2025). Desafíos estructurales en la transformación digital de los servicios públicos en el sector salud: Una revisión de literatura. Revista Espacios, 46(3), 449–460. https://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0798-10152025000300453
Álvarez Herrera, V. O. (2025). La brecha de conectividad ante los avances de la política pública de infraestructura de telecomunicaciones para banda ancha (Tesis de maestría, Pontificia Universidad Católica del Perú). Repositorio Institucional PUCP. https://tesis.pucp.edu.pe/items/60b3c7db-9360-495d-9344-604028d1cff4
Awosiku, O. V., Gbemisola, I. N., Oyediran, O. T., Egbewande, O. M., Lami, J. H., Afolabi, D., Okereke, M., & Effiong, F. (2025). Role of digital health technologies in improving health financing and universal health coverage in Sub-Saharan Africa: A comprehensive narrative review. Frontiers in Digital Health, 7, 1391500. https://doi.org/10.3389/fdgth.2025.1391500
Baque Pinargote, O. S., Asanza Chóez, J. A., Chiquito Manrique, C. D., & Caicedo Plúa, C. R. (2024). Políticas de seguridad en la infraestructura tecnológica de instituciones de salud mediante un appliance Fortinet 80E: Estudio de caso Hospital Básico Jipijapa. Revista Científica de Salud BIOSANA, 4(1), 115–138. https://doi.org/10.62305/biosana.v4i1.102
Cervera García, A., & Goussens, A. (2024). Ciberseguridad y uso de las TIC en el sector salud. Atención Primaria, 56(3), 102854. https://doi.org/10.1016/j.aprim.2023.102854
Cruz-Martínez, G. A. (2025). Gobernanza y transformación digital en el sector salud. Innovare Revista de ciencia y tecnología, 14(1), 1-7. https://revistas.unitec.edu/innovare/article/view/480
Curioso, W. H. (2019). Desarrollo de capacidades y capacitación en salud digital: Retos y oportunidades en América Latina. Revista Panamericana de Salud Pública, 43, e89. https://doi.org/10.26633/RPSP.2019.89
D'Agostino, M., Marti, M. C., Jaime, F., & García Saiso, S. (2022). Information systems for health: An analysis of design from a public policy perspective. Revista Panamericana de Salud Pública, 46, e35. https://doi.org/10.26633/RPSP.2022.35
D'Agostino, M., Marti, M., Medina Mejia, F., Malek, V., & García Saiso, S. (2021). Public health and digital interdependence: Technological evolution, technological sustainability and the user revolution. Revista Panamericana de Salud Pública, 45, e156. https://doi.org/10.26633/RPSP.2021.156
Escobar-Agreda, S., & Rojas-Mezarina, L. (2025). Evolución de la salud digital en el Perú: avances y retos en el sector público. Anales de la Facultad de Medicina, 86(1), 3–5. https://doi.org/10.15381/anales.v86i1.30223
Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230–235. https://doi.org/10.1179/2047480615Z.000000000329
Gadelha, C. A. G., Braga, P. S. D. C., Cohen, M. M., Araújo, A. L. F. D., & Montenegro, K. B. M. (2025). Complejo económico-industrial de la salud, salud digital en la APS y el riesgo de la vulnerabilidad 4.0. Saúde em Debate, 49, e10157. https://www.scielosp.org/article/sdeb/2025.v49nspe1/e10157/es/
Grande, D., Luna Marti, X., Feuerstein-Simon, R., Merchant, R. M., Asch, D. A., Lewson, A., & Cannuscio, C. C. (2020). Health Policy and Privacy Challenges Associated With Digital Technology. JAMA Network Open, 3(7), e208285. https://doi.org/10.1001/jamanetworkopen.2020.8285
Grant, M. J., & Booth, A. (2009). A typology of reviews: An analysis of 14 review types and associated methodologies. Health Information & Libraries Journal, 26(2), 91–108. https://doi.org/10.1111/j.1471-1842.2009.00848.x
Green, B. N., Johnson, C. D., & Adams, A. (2006). Writing narrative literature reviews for peer-reviewed journals: secrets of the trade. Journal of chiropractic medicine, 5(3), 101–117. https://doi.org/10.1016/S0899-3467(07)60142-6
Huaiquián Silva, J., Espinoza Venegas, M., & Ríos Bolaños, M. (2022). Salud digital en el control de pacientes crónicos durante la pandemia: La mirada del equipo de salud. Ciencia y Enfermería, 28, Artículo 32. https://doi.org/10.29393/CE28-32SDJM30032
Husain, L., Kitchens, K., Raja, S., & Memon, M. (2025). Bridging implementation gaps in digital health: A translational research imperative for equitable healthcare innovation. Clinical and Translational Science, 18(10), e70375. https://doi.org/10.1111/cts.70375
Jeilani, A., & Hussein, A. (2025). Impact of digital health technologies adoption on healthcare workers' performance and workload: Perspective with DOI and TOE models. BMC Health Services Research, 25, 271. https://doi.org/10.1186/s12913-025-12414-4
Jia, H. (2024). Impact of digital infrastructure construction on the migrants' utilization of basic public health services in China. BMC Health Services Research, 24, 761. https://doi.org/10.1186/s12913-024-11221-7
Labrique, A. (2025). From infrastructure to impact: Why foundations matter in digital health. Bulletin of the World Health Organization, 103(2), 83–83A. https://doi.org/10.2471/BLT.24.293085
Li, T., Wandella, A., Gomer, R., & Al-Mafazy, M. H. (2024). Operationalizing health data governance for AI innovation in low-resource government health systems: A practical implementation perspective from Zanzibar. Data & Policy, 6, e63. https://doi.org/10.1017/dap.2024.65
Luna Solórzano, G. J., & Fernández Solís, M. A. (2025). Gobierno electrónico como herramienta de cohesión territorial en el sector salud: Evidencias desde el territorio ecuatoriano. ASCE Magazine, 4(3), 1581–1600. https://doi.org/10.70577/ASCE/1581.1600/2025
Mantri, M., Sunder, G., Kadam, S., & Abhyankar, A. (2024). A perspective on digital health platform design and its implementation at national level. Frontiers in Digital Health, 6, 1260855. https://doi.org/10.3389/fdgth.2024.1260855
Marwaha, J. S., Landman, A. B., Brat, G. A., Dunn, T., & Gordon, W. J. (2022). Deploying digital health tools within large, complex health systems: Key considerations for adoption and implementation. npj Digital Medicine, 5, Article 13. https://doi.org/10.1038/s41746-022-00557-1
Mesa del Olmo, A. (2019). Programas de salud y brecha digital. Estado, Gobierno y Gestión Pública, 17, 171–198. https://doi.org/10.5354/0717-8980.2019.65410
Ponce de León Sierra, J., & Merma Pillaca, A. (2024). Transformación digital en el sector salud peruano: retos y avances recientes. Revista Panamericana de Salud Pública, 48, e138. https://www.scielosp.org/article/rpsp/2024.v48/e138/
Rees, G. H., & Peralta, F. (2024). Telemedicine in Peru: origin, implementation, pandemic escalation, and prospects in the new normal. Oxford Open Digital Health, 2, oqae002. https://doi.org/10.1093/oodh/oqae002
Roveri, C. (2022). Artificial intelligence for well-being and healthy living in Latin America: Toward a responsible innovation ecosystem for digital health. Análisis Carolina, (21). https://doi.org/10.33960/AC_21.2022
Roy, S., Lartey, S. T., Durneva, P., Jha, N., Ofori, M. A., Zeba, Z., Dockery, S., Scarboro, N. S., Taylor, M., & Joshi, A. (2025). Digital health technology infrastructure challenges to support health equity in the United States: Scoping review. Journal of Medical Internet Research, 27, e70856. https://doi.org/10.2196/70856
Salazar-Villegas, B. (2024). Implementación de tecnologías de la información en la atención primaria de salud. Innova Science Journal, 2(2), 15–31. https://doi.org/10.63618/omd/isj/v2/n2/35
Suclly Amanqui, B. A. (2024). Derecho a la tecnología y gestión de políticas públicas en la reducción de la brecha digital- Comas 2022. Ciencia Latina Revista Científica Multidisciplinar, 8(2), 3560–3574. https://doi.org/10.37811/cl_rcm.v8i2.10778
Thakur, A., Bhageerathy, R., Mithra, P., Sekaran, V. C., & Kumar, S. (2025). From Peer Support to Program Supervision: Qualitative Insights on WhatsApp as Informal Digital Infrastructure for Community Health Workers and Public Health Officers in an Indian High-Priority Aspirational District. Healthcare, 13(17), 2223. https://doi.org/10.3390/healthcare13172223
Velasco Villafaña, B., Aguilera Correa, I., & Muñoz Moya, O. (2025). Gobernanza robusta en salud digital: El caso de telesalud en la atención primaria chilena [2020–2025]. Políticas Públicas, 18(1), 63–79. https://doi.org/10.35588/saq24602
Yew, S. Q., Trivedi, D., Adanan, N. I. H., & Chew, B. H. (2025). Facilitators and barriers to the implementation of digital health technologies in hospital settings in lower- and middle-income countries since the onset of the COVID-19 pandemic: Scoping review. Journal of Medical Internet Research, 27, e63482. https://doi.org/10.2196/63482
Zermeño-Flores, S. G., Zizaldra-Hernández, I., & Delgado-Guzmán, J. A. (2021). Creatividad e innovación en estrategias y políticas públicas para el desarrollo de destinos en turismo médico y de salud ante la pandemia. Cenário: Revista Interdisciplinar em Turismo e Território, 9(16), 9–27. https://doi.org/10.26512/revistacenario.v9i1.36221
Zhang, Y., Li, X., Wang, H., & Chen, J. (2025). How digital infrastructure development affects residents' health: A quasi-natural experiment based on the "Broadband China" strategy. Cities, 157, 105611. https://doi.org/10.1016/j.cities.2024.105611
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
The journal is licensed under the Attribution License (CC BY), allowing the possibility of copying, distributing, displaying, and producing derivative works, as long as the author is acknowledged and cited.
