Health System Factors Influencing the Effectiveness of Mobile Phone Platforms in Promoting Treatment Compliance among Patients with Non-Communicable Diseases in LMICs: A Systematic Review

Non- Communicable Diseases (NCDs) such as hypertension and diabetes have continued to impose a significant health burden in Low and Middle-Income Countries (LMICs), where treatment compliance remains critically low. Systemic barriers including limited healthcare infrastructure, inadequate follow-up mechanisms, and sociocultural factors have impeded patients’ ability to adhere to long-term treatment regimens. While mobile health (mHealth) and digital interventions have emerged as potential tools to enhance medication adherence, their effectiveness in LMICs remains uneven and context-dependent. This study aimed to assess the role of health system factors in promoting treatment compliance among patients with NCDs through mobile platforms in LMICs, with a particular focus on Kenya. A qualitative literature review was conducted using purposive sampling of 20 peer-reviewed articles published between 2020 and 2025. The studies were selected based on their focus on health system factors, treatment compliance, and digital or mobile health interventions in LMICs. Data were extracted and analyzed thematically to identify patterns across health system components, digital health strategies, and patient adherence outcomes. The review revealed that systemic barriers including shortages of healthcare personnel, poor digital infrastructure, low health literacy, and financial constraints consistently undermined treatment compliance in LMICs. However, digital tools such as SMS reminders, mHealth apps, and teleconsultations demonstrated improved patient adherence, especially when culturally adapted and integrated into community health frameworks. In Kenya and similar settings, mobile interventions linked with community health workers showed greater success in sustaining long-term engagement. Nonetheless, disparities persisted in digital access, gender equity, and scalability due to infrastructural limitations and weak policy integration. Mobile and digital health platforms offered a promising avenue for improving treatment compliance among NCD patients in LMICs. Their effectiveness was significantly influenced by the readiness of local health systems, sociocultural adaptability, and the extent of integration with human health resources. Despite their potential, many digital interventions remained fragmented, donor-driven, and unsustainable without supportive infrastructure and policy frameworks. To optimize the impact of mobile health (mHealth) interventions, policymakers should invest in digital infrastructure, integrate mHealth into national health systems, and prioritize the training and deployment of community health workers. Future research should include longitudinal and experimental designs to assess long-term outcomes and cost-effectiveness, and emphasize inclusive, culturally tailored approaches to improve equitable access to care.