Purpose This study aims to identify the barriers that hinder the effective implementation of electronic health records (EHR) systems in developing countries while also uncovering the critical success factors (CSFs) that can facilitate their implementation. This study focused on the sociotechnical and environmental challenges that influenced the implementation of EHR systems. Design/methodology/approach This study used a systematic literature review methodology guided by the modified sociotechnical theory. It followed PRISMA guidelines to identify barriers and CSFs. This review included a comprehensive search of academic databases such as Taylor & Francis, Google Scholar, Emerald and PubMed, covering studies published between 2012 and mid-2024. The studies were screened and analysed using thematic analysis. Findings The review identified several barriers to EHR implementation, including a lack of information and communication technology infrastructure, inadequate training, and limited government support. It also highlighted CSFs such as enhancing training programmes, improving technical infrastructure, fostering government support and addressing privacy and security concerns. This study concluded that a holistic approach addressing technical, social and environmental factors was critical for the success of EHR systems in low-resource settings. Practical implications This study offered actionable recommendations for policymakers and health-care leaders in developing countries. These include strategies for enhancing user training, improving technical infrastructure, ensuring government support and addressing data privacy and security issues, which are crucial for successfully adopting EHR systems. Originality/value This research comprehensively examined the factors influencing EHR implementation in developing countries, offering a unique perspective by applying the modified sociotechnical theory. It bridged a significant gap in the literature by focusing on the specific challenges faced in resource-constrained environments.
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