• Margot Rakers, Steven van de Vijver, Paz Bossio, Nic Moens, Michiel Rauws, Millicent Orera, Hongxia Shen, Cynthia Hallensleben, Evelyn Brakema, Nick Guldemond, Niels H Chavannes, and María Villalobos-Quesada.
• Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
• Eur J Gen Pract. 2023 Dec 1; 29 (1): 22419872241987.

BackgroundeHealth offers opportunities to improve health and healthcare systems and overcome primary care challenges in low-resource settings (LRS). LRS has been typically associated with low- and middle-income countries (LMIC), but they can be found in high-income countries (HIC) when human, physical or financial resources are constrained. Adopting a concept of LRS that applies to LMIC and HIC can facilitate knowledge interchange between eHealth initiatives while improving healthcare provision for socioeconomically disadvantaged groups across the globe.ObjectivesTo outline the contributions and challenges of eHealth in low-resource primary care settings.StrategyWe adopt a socio-ecological understanding of LRS, making LRS relevant to LMIC and HIC. To assess the potential of eHealth in primary care settings, we discuss four case studies according to the WHO 'building blocks for strengthening healthcare systems'.Results And DiscussionThe case studies illustrate eHealth's potential to improve the provision of healthcare by i) improving the delivery of healthcare (using AI-generated chats); ii) supporting the workforce (using telemedicine platforms); iii) strengthening the healthcare information system (through patient-centred healthcare information systems), and iv) improving system-related elements of healthcare (through a mobile health financing platform). Nevertheless, we found that development and implementation are hindered by user-related, technical, financial, regulatory and evaluation challenges. We formulated six recommendations to help anticipate or overcome these challenges: 1) evaluate eHealth's appropriateness, 2) know the end users, 3) establish evaluation methods, 4) prioritise the human component, 5) profit from collaborations, ensure sustainable financing and local ownership, 6) and contextualise and evaluate the implementation strategies.

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