Integrated Health Information Systems in Conflict-Affected Developing Countries: A Narrative Review of Implementation Challenges and Solutions

Integrated Health Information Systems (IHIS) are pivotal to healthcare modernization in developing countries, yet their implementation in conflict-affected, resource-constrained settings remains poorly documented and weakly synthesized. This study applies a structured narrative review of 24 peer-reviewed studies, reports, and policy documents published between 2014 and 2025, retrieved from PubMed, Scopus, IEEE Xplore, Google Scholar, and WHO databases, and analyzed thematically across technical, organizational, and policy dimensions, with explicit inclusion and exclusion criteria and a PRISMA-style selection flow. Interoperability, data security, user adoption, governance, sustainable financing, and damaged or limited infrastructure emerge as the core determinants of implementation success across all developing-country contexts. A structured comparison of Sudan, Rwanda, and Kenya shows that Sudan confronts these shared technical and resource barriers alongside an additional, compounding burden of armed conflict and international sanctions—with up to 68% of hospitals in affected areas non-functional—which further constrains infrastructure, financing, and access to technology. The review contributes a comparative analytical framework and an evidence-based synthesis that explicitly links each implementation challenge to actionable, context-sensitive solutions, including offline-capable systems, open-source tools, and humanitarian licensing pathways for fragile settings. These findings yield specific policy recommendations and an implementation framework for policymakers, health administrators, and technology implementers operating under extreme resource and political constraints.