Impact of health policy reforms on telemedicine and AI integration for early cancer detection among low-income populations in South Asia: A comparative policy analysis.

Early cancer detection remains a major challenge in low- and middle-income countries (LMICs), where late diagnoses and unequal healthcare access are widespread. While digital innovations such as telemedicine and artificial intelligence (AI) offer significant promise, their successful adoption depends on enabling policy environments. This study investigates how health policy reforms influence the integration of telemedicine and AI tools for early cancer detection in four South Asian LMICs: India, Pakistan, Bangladesh, and Nepal. Employing a qualitative comparative case study design and guided by Walt and Gilson's Policy Triangle Framework, the research analyzes national health strategies, policy documents, and global development reports from 2010 to 2023. The analysis focuses on five thematic domains: policy integration, technological readiness, institutional capacity, regulatory frameworks, and health equity. India demonstrates the most comprehensive digital health alignment through centralized governance and public-sector AI pilots, while Pakistan shows moderate progress via public-private initiatives. Bangladesh and Nepal lag behind due to fragmented systems and infrastructural deficits. Common barriers include poor regulation, limited digital literacy, and socio economic disparities. The findings underscore the need for inclusive, equity-driven reforms and regional cooperation to scale digital health innovations sustainably across LMICs and strengthen cancer detection frameworks.