Strengthening Health System Resilience through Digital Health: Challenges and Prospects in Indonesia's Rural and Remote Regions - A Scoping Review Protocol

Digital health has emerged as a critical tool for enhancing health system resilience, particularly in countries with substantial geographical disparities, such as Indonesia. Persistent barriers in rural and remote areas—limited internet access, inadequate infrastructure, and low digital literacy—continue to hinder the adoption of digital health initiatives. This scoping review aims to systematically map Digital Health Interventions (DHIs) implemented in rural Indonesia, identify key barriers and facilitators, and generate evidence-based recommendations for strengthening equitable healthcare delivery.

This study follows the Arksey and O’Malley framework and adheres to the PRISMA-ScR guidelines. A comprehensive search was conducted across PubMed, Scopus, Web of Science, Google Scholar, and Neliti.com for articles published between 2010 and 2024 in English or Bahasa Indonesia. Two independent reviewers conducted the screening, data extraction, and risk of bias assessment to enhance the quality and interpretation of findings.

A total of 17,858 records were identified, and after screening and eligibility assessment, 20 studies were included. The studies reported various DHIs, including telemedicine services, mHealth applications, SMS-based platforms, and electronic health information systems deployed in rural and remote settings.

Challenges to the implementation of DHI include infrastructural limitations, variations in digital literacy, and sociocultural barriers. Key enabling factors, such as supportive policies, sustainable funding, and community participation, have been identified as crucial for success.

The review offers a synthesis of digital health implementation experiences in underserved Indonesian regions, providing insights to inform future policies and initiatives aimed at building a resilient and inclusive health system.