en Healthcare setting Healthcare setting كاربردي Applicable <div style="text-align: justify;"><span style="font-size:11.0pt"><span style="line-height:106%"><span new="" roman="" style="font-family:" times="">Telemedicine adoption in low-resource settings (LRS) has accelerated since the COVID-19 pandemic, accompanied by substantial investment in digital health infrastructure. However, persistent low uptake across sub-Saharan Africa, South and Southeast Asia, and rural middle-income regions suggests that connectivity and hardware access alone are insufficient. This letter argues that non-infrastructural barriers including digital health literacy deficits among patients and providers, cultural preferences for face-to-face care and mistrust of virtual consultations, regulatory and policy gaps around licensure, liability, and data privacy, and socioeconomic and gender-based inequities in technology access are critical and often overlooked determinants of telemedicine uptake. Addressing these barriers requires a multi-dimensional policy framework that integrates digital literacy training, culturally adapted platforms, national regulatory structures, and targeted financial support for underserved populations.</span></span></span></div> ,Telemedicine,Low-resource settings,Health equity,Digital health policy 45 47 http://jhsp.medilam.ac.ir/browse.php?a_code=A-10-75-1&slc_lang=en&sid=1 Alireza Pourrahim alirezapourrahim2003@gmail.com 1003194753284600512 0009000446694033 Yes Student Research Committee, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran