World Health Organization · 1st edition, 2024 · 35 pages
Practical guidance for governments, industry, health providers and civil society to implement the WHO-ITU Global Standard for accessible telehealth
- Issuer
- World Health Organization
- Edition
- 1st edition, 2024
- Audience
- Governments, policy-makers, telehealth manufacturers, public and private health service providers, civil society organizations, organizations of persons with disabilities
- Evidence
- Based on best available evidence, comprehensive consultation with civil society and industry, and international human rights treaties including UN Convention on the Rights of Persons with Disabilities
- Reviewed
- 23 Oct 2026 · GMJ
What this guideline says
GMJ summary
This toolkit provides a stepwise implementation framework for the WHO-ITU F.780.2 Global Standard for Accessibility of Telehealth Services, developed in response to widespread inaccessibility of telehealth platforms for persons with disabilities and other marginalized populations. The global standard comprises 25 technical requirements addressing the needs of persons with vision impairment and blindness, deaf and hard-of-hearing persons, persons with speech difficulties, mobility impairments, mental health conditions, developmental and intellectual disabilities, and learning disabilities.
The toolkit targets four key stakeholder groups with tailored implementation pathways: governments (who should integrate the standard into legislation, regulation and procurement policies), industry manufacturers (who should voluntarily or mandatorily adopt the 25 requirements), health service providers (who should purchase compliant platforms and ensure accessible service delivery), and civil society (who should advocate for adoption and monitor implementation).
Core principles emphasize meaningful participation of persons with disabilities throughout design, implementation and monitoring processes; universal design to benefit all users including older persons, migrants and those with low literacy; and integration of accessibility features from the outset rather than retrofitting. The toolkit includes situation assessment tools, stakeholder consultation formats, and a recognition that telehealth accessibility must be part of broader disability-inclusive health strategies to advance health equity and universal health coverage.
Key points
For clinicians — doses and thresholds as stated in the guideline
- The WHO-ITU Global Standard includes 25 technical requirements: compatibility with assistive devices, colour contrast and screen magnification, captioning and volume control, text messaging options, sign language interpretation, voice synthesizers, simplified user interfaces, easy-read formats, and multi-participant meeting capability
- Governments should integrate the standard into telehealth legislation and regulations, enforce compliance through government departments, and adopt procurement policies requiring all purchased telehealth platforms to align with the standard
- Manufacturers should implement all 25 requirements ideally, or prioritize features that can be integrated within a shorter time frame, and test platforms for compliance using ITU's conformance assessment plan (to be published late 2024)
- Health service providers must purchase telehealth platforms complying with the standard, ensure their websites and shared information are accessible (colour contrast, accessible formats, positive representation), and consult patients about technological barriers
- Video conferencing shall provide captioning, monitored chat box with volume control provisions, and separate windows; text messaging must be available when video/audio malfunction
- Telehealth platforms shall allow more than two meeting participants to enable personal support workers to attend consultations with persons with developmental and intellectual disabilities
- All implementation processes must meaningfully engage persons with disabilities and their representative organizations in design, testing and monitoring phases, with provisions for reasonable accommodations
- Platforms should avoid unexpected or inappropriate content that can trigger negative feelings in persons with mental health conditions, and explain privacy and security measures to reduce anxiety about data safety
Four stakeholder groups and core implementation actions
Table extracted from the guideline
| Stakeholder | Key actions | Tools provided |
|---|---|---|
| Governments | Integrate standard into legislation; enforce through regulation; adopt procurement policies; conduct awareness campaigns | Situation assessment tool; stakeholder planning meeting outline |
| Industry manufacturers | Implement 25 technical requirements; conduct participatory design with persons with disabilities; test for compliance; publicize accessibility features | WHO-ITU Global Standard (25 requirements); ITU conformance assessment plan |
| Health service providers | Purchase compliant platforms; ensure accessible websites and information; consult patients on barriers; provide information in accessible formats | Assessment of existing services; participatory planning process |
| Civil society | Advocate with governments for regulations; sensitize manufacturers; conduct awareness campaigns; monitor implementation | Advocacy strategies; stakeholder engagement frameworks |
Source: World Health Organization, Implementation toolkit for accessible telehealth services. Reproduced in summary form.
From the guideline
Verbatim
“Although governments are obligated to provide equitable telehealth services to every person, these services are very often not accessible, thus challenging the primary goal to expand and provide the means for health service provision for all people.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As Chair of the Public Health Institute of Georgia and WHO consultant, I recognize that this toolkit addresses a critical gap in Georgia's expanding digital health infrastructure. While we have made progress in telehealth adoption since COVID-19 and the Ministry of Labour, Health and Social Affairs has begun integrating digital solutions into state medical programmes, we must ensure these platforms serve all Georgians including the approximately 16% of our population with disabilities. The requirement for meaningful participation of persons with disabilities throughout design and implementation—not merely consultation—is the recommendation I would stress most, as our experience with inclusive health programmes shows that participatory approaches yield better uptake and outcomes. The realistic implementation caveat for Georgia is that many of the 25 technical requirements demand sustained investment and coordination between the Ministries of Health, Economy, and IDPs from Occupied Territories, Labour, Health and Social Affairs, and regulatory bodies, which will require dedicated budget allocation and cross-ministerial governance structures that currently remain underdeveloped in our context.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 23 Oct 2026
Applicability
Georgia and the South Caucasus
For Georgia and the South Caucasus, this toolkit is directly relevant given the region’s expanding telehealth infrastructure, particularly accelerated during COVID-19, and commitments under the UN Convention on the Rights of Persons with Disabilities (ratified by Georgia in 2014, Armenia in 2010, Azerbaijan in 2009). The Georgian Ministry of Labour, Health and Social Affairs should lead implementation by conducting the situation assessment to map existing telehealth accessibility regulations, engaging the Public Health Institute and the State Fund for Protection and Assistance of (Statutory) Victims of Human Trafficking in stakeholder consultations, and integrating the 25 requirements into national digital health strategies. Given that approximately 16% of the Georgian population has a disability, ensuring accessible telehealth is essential for achieving universal health coverage under Georgia’s state medical programmes. The toolkit’s emphasis on affordable Internet connectivity and device availability is particularly pertinent in rural mountainous regions of Georgia, Armenia and Azerbaijan where telehealth could bridge geographic barriers if accessibility and affordability challenges are addressed through coordinated policy.
Questions this guideline answers
Quick answers
What are the 25 technical requirements in the WHO-ITU Global Standard?
The requirements address seven user groups: (1) persons with vision impairment need compatibility with screen readers and Braille keyboards, colour contrast, screen magnification, and telephone accessibility; (2) deaf and hard-of-hearing persons need captioning, chat boxes, volume control, sign language interpretation, subtitles, and large screens for lipreading; (3) persons with speech difficulties need voice synthesizers and text-to-speech generators; (4) persons with mobility impairments need controls that don't require fine motor coordination, single rather than double clicking, and minimal scrolling; (5) persons with mental health conditions need platforms that avoid triggering content, explain privacy measures, use simple interfaces, minimize effortful tasks, and provide quality information; (6) persons with developmental and intellectual disabilities need easy-read formats, multi-participant meeting capability, and simple educational materials; and (7) persons with learning disabilities need accessible text layouts and sufficient time to read content.
How should governments enforce compliance with the standard?
Governments should: (1) conduct a situation assessment mapping existing telehealth services, legislation on ICT accessibility, current accessibility features, and needs of persons with disabilities; (2) organize a public consultation with all stakeholders to plan adaptation of existing legislation or development of new laws/policies; (3) establish a working group including Ministry of Health, Ministry of Telecommunications/ICT, industry and civil society to draft regulations; (4) define enforcement mechanisms specifying which government departments are responsible, what monitoring processes will be used, and budget allocation; (5) amend procurement policies so all government tenders require compliance with the standard; (6) organize sensitization workshops for manufacturers and health providers; and (7) monitor implementation through established regulatory mechanisms and periodic evaluation (e.g. every two years), creating a public reporting system to flag inaccessible services.
What should manufacturers do to voluntarily implement the standard?
Manufacturers should: (1) ensure staff working on accessibility and web developers read and understand the full WHO-ITU Global Standard and applicable references including Web Content Accessibility Guidelines; (2) conduct an internal assessment of current accessibility features across all platforms in different countries; (3) carry out a participatory design process through meaningful engagement of persons with disabilities and their representative organizations, using consultations, resource reviews, and validation workshops; (4) draft a costed implementation plan addressing gaps in the short, medium and long term; (5) implement the 25 requirements, prioritizing features that can be integrated quickly while planning others for future updates; (6) involve persons with disabilities to test whether platforms are truly accessible; (7) test platforms for compliance using ITU's conformance assessment plan (to be published late 2024); (8) raise awareness and publicize accessibility features to users and potential buyers; and (9) revise features periodically based on user feedback and keep updated with new versions of the standard.
Why is meaningful participation of persons with disabilities essential?
Meaningful participation ensures that accessibility features actually work for end-users rather than being designed based on assumptions. Evidence confirms that participatory design approaches foster access to digital health solutions and increase utilization. Examples from Sweden, Australia and Canada show that including marginalized groups as integral to policy drafting, design and implementation processes, and requiring their involvement at every stage of service implementation (as Canadian funding agencies do for digital health projects), creates more effective and accessible technology. During participation, provisions must ensure reasonable accommodations for persons with different impairments (e.g. accessible meeting venues, documents in Easy Read, Braille, diverse representation including gender balance). This applies to all implementation phases: government consultations, manufacturer product testing, health provider service design, and civil society advocacy and monitoring.
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- Issuer
- World Health Organization
- Type
- Toolkit
- Edition
- 1st edition, 2024
- Status
- Current
- Published
- 2024-09-09
- Languages
- English; translations planned
- Scope
- Global; applicable to all telehealth platforms regardless of health service provided
- Audience
- Governments, policy-makers, telehealth manufacturers, public and private health service providers, civil society organizations, organizations of persons with disabilities
- Pages
- 35
- Licence
- CC BY-NC-SA 3.0 IGO
- ISBN
- 978-92-4-009416-1
- Evidence
- Based on best available evidence, comprehensive consultation with civil society and industry, and international human rights treaties including UN Convention on the Rights of Persons with Disabilities
- Record history
- Created 23 Oct 2026 · updated 23 Oct 2026 · next check Apr 2027
World Health Organization, International Telecommunication Union. Implementation toolkit for accessible telehealth services. Geneva: World Health Organization and International Telecommunication Union; 2024. 35 p. ISBN 978-92-4-009416-1.GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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