From Local Solutions to Global Impact: Navigating Legal Challenges and Policy Shifts of mHealth Applications from a Global Health Perspective (Preprint)

Abstract

BACKGROUND The widespread adoption of smartphones globally is reshaping healthcare access, with mobile health (mHealth) applications emerging as vital tools. These technologies leverage mobile devices to support a broad range of medical and public health practices, offering a cost-effective alternative to traditional healthcare methods. Their significance has grown in response to advancements in artificial intelligence, pandemic preparedness, and the need to address global health disparities. Despite their growing presence, the ethical, legal, and regulatory challenges associated with mHealth remain underexplored. OBJECTIVE This paper aims to examine the ethical and legal implications of mHealth applications, focusing on their role in fostering equitable access to healthcare, relevant legislation, and global health governance. METHODS A literature review was conducted to identify key themes in the discourse surrounding mHealth applications in the global health context. The analysis was structured around three critical themes: 1) equitable access to healthcare, 2) evolving legislation and regulation, and 3) global health policy and governance. Contemporary dilemmas and potential solutions were explored in each thematic area. RESULTS The review identified significant gaps in equitable access to mHealth solutions, particularly between low- and middle-income countries (LMICs) and high-income countries (HICs). In LMICs, mHealth applications have shown promise in reducing healthcare delivery costs and improving access, but regulatory frameworks remain insufficient. In HICs, while mHealth has improved patient monitoring and care quality, challenges related to data privacy, regulatory compliance, and global health governance persist. However, when mHealth deployment is informed by legal, ethical, and policy frameworks tailored to the socio-economic context of the region, whether LMIC or HIC, it can help reduce healthcare disparities. In LMICs, mHealth applications have the potential to bridge the healthcare access gap, provided there is a focus on enhancing infrastructure, provider training, and patient education. In HICs, efforts should prioritize integrating mHealth applications into existing healthcare systems and addressing issues of interoperability and data privacy. CONCLUSIONS While mHealth applications alone cannot resolve global healthcare inequities, they offer a powerful tool to address some of the biases and inequalities in healthcare access. The "points to consider" outlined in this study provide a strategic framework for stakeholders to adopt context-specific approaches, ensuring that mHealth applications can effectively meet global health objectives. In LMICs, a focus on user-centered design, provider training, and patient education will be essential for promoting equitable access. In HICs, integrating mHealth technologies into established healthcare systems and enhancing data governance will be key. By addressing these challenges and adopting targeted strategies, policymakers, developers, and stakeholders can contribute to bridging the digital divide and advancing healthcare equity on a global scale.