This study aimed to identify the critical success factors (CSFs) for implementing effective Electronic Health Record Systems (EHRS) in Tanzania's public healthcare system. Through a systematic literature review, the study analyzed various articles published between 2012 and 2022, focusing on social, technical, and environmental factors specific to developing countries. The modified sociotechnical theory provided the theoretical framework, and the reciprocal translation method synthesized the findings. The study identified barriers to EHRS implementation, including political pressures, societal considerations, and a need for more training and dedication among healthcare professionals. Technical factors were also identified, such as inadequate IT infrastructure and high implementation costs. Environmental factors, including policies, strategies, laws, and regulations, impacted EHRS adoption. Based on the analysis, the study suggests several CSFs for successful EHRS implementation. These include recognizing and rewarding the health informatics profession, developing scalable and interoperable EHRs, promoting EHR acceptability among healthcare professionals, and addressing moral and legal issues surrounding EHRS. The findings of this study contribute valuable insights into the environmental, social, and technical factors that hinder the effective adoption of EHRS in underdeveloped nations. By identifying the CSFs and offering potential solutions to the identified challenges, this study guides public health stakeholders and policymakers to develop strategies and plans to overcome obstacles and facilitate the successful implementation of EHRS in Tanzania's public healthcare system and similar contexts.