Discover Public Health, vol.23 no.499. Low- and middle-income countries (LMICs) face significant challenges in implementing digital health interventions due to a complex interplay of organizational, ethical, and human-centric barriers that hinder their adoption and sustainability. This review synthesizes evidence on these barriers and highlights the importance of integrated strategies that align digital health initiatives with local health system capacities, governance structures, and user needs to achieve sustainable and equitable health outcomes.