The Effectiveness and Feasibility of Virtual Reality and Augmented Reality Interventions for the Prevention of Non-Communicable Diseases in Low- and Middle-Income Countries: A Systematic Review

Abstract

Background: Non-communicable diseases (NCDs) account for approximately 41 million deaths annually, with over 85% of premature NCD deaths occurring in low- and middle-income countries (LMICs). Virtual reality (VR) and augmented reality (AR) technologies have emerged as innovative tools for health promotion and disease prevention, yet their application in LMIC settings remains poorly characterized. Objective: This systematic review synthesizes current evidence on the effectiveness and feasibility of VR and AR interventions for NCD prevention in LMICs. Methods: Following PRISMA guidelines, we searched PubMed, Scopus, and Web of Science databases for peer-reviewed studies published between January 2010 and May 2026. Studies were included if they evaluated VR or AR interventions targeting NCD prevention (primary, secondary, or tertiary) in LMIC settings or with clear LMIC applicability. Outcomes assessed included effectiveness measures (clinical, behavioral, educational) and feasibility metrics (acceptability, cost, implementation challenges). Results: From 412 initial records, 24 studies met inclusion criteria. Evidence demonstrated that VR/AR interventions are effective for cardiovascular rehabilitation (improved exercise capacity: MD 53.26, 95% CI 45.14–61.37; reduced anxiety: SMD −0.39, 95% CI −0.69 to −0.08), stroke rehabilitation (upper limb function improvement), medical education (superior to traditional methods for anatomy knowledge: SMD 0.40, 95% CI 0.15–0.65), and health professional training for NCD management. Feasibility assessments identified key barriers including infrastructure limitations (reported in 6 studies), high initial costs, and lack of culturally adapted content. However, emerging low-cost, mobile-based solutions and participatory co-creation approaches show promise for overcoming these challenges. Conclusion: VR and AR interventions demonstrate significant potential for NCD prevention in LMICs, particularly for rehabilitation and health professional training. However, evidence remains limited in quantity and quality. Successful implementation requires context-specific adaptation, investment in infrastructure, and integration with existing health systems.