Stakeholder perspectives on telemedicine acceptance and experiences in Uganda: A qualitative study

In Uganda and other low- and middle-income countries, access to healthcare is constrained by shortages of health workers, long travel distances, and inadequate infrastructure. Telemedicine offers a potential solution, but its effectiveness depends on how key stakeholders perceive, accept, and experience it. This study explored the acceptance and experiences of telemedicine by policymakers, healthcare providers, and service users in Kampala, Uganda. An exploratory qualitative study was conducted between November 2024 and February 2025 at four sites in Kampala: Rocket Health, Uganda Cancer Institute, Butabika National Referral Mental Hospital, and the Ministry of Health. Participants were purposively selected to ensure direct experience with telemedicine. Data was collected through 15 key informant interviews with policymakers and healthcare providers and three focus group discussions with service users (patients and caregivers) who had accessed telemedicine within the previous year. Interviews and discussions were conducted in English or Luganda, audio-recorded with consent, and transcribed verbatim. Data were analyzed thematically using Braun and Clarke's six-phase approach, supported by NVivo 12 software. Three main themes emerged: perceived benefits, perceived challenges, and recommendations for improving telemedicine. Participants described telemedicine as convenient, reducing travel and contributing to cost and time savings. It also enhanced continuity of care, flexibility, privacy, and autonomy. These benefits were particularly evident among people with disabilities and digitally literate urban users. However, challenges included poor internet connectivity, limited infrastructure, low digital literacy, concerns about diagnostic accuracy without physical examination, and variable levels of trust, with some participants preferring in-person interaction. Telemedicine was perceived as acceptable and useful. However, its broader adoption is limited by structural, technical, and trust-related barriers. Addressing these challenges will require investment in infrastructure, strengthened digital literacy, provider training, increased public awareness, and a robust national telemedicine policy to support equitable and sustainable integration into healthcare delivery in Uganda.