Aerial innovations in healthcare: A systematic review of drone-based logistics and regulatory barriers

This paper presents a PRISMA-guided systematic literature review synthesizing peer-reviewed evidence on the use of unmanned aerial vehicles (UAVs) in healthcare logistics, with emphasis on operational performance and regulatory barriers. The final corpus comprises 54 studies (53 published during 2018–2025 and one pre-2018 conceptual baseline retained solely for historical framing). Evidence is synthesized across four themes: UAV logistics applications, healthcare logistics use cases, emergency deployments, and regulatory/ethical constraints. Findings indicate that UAV-enabled delivery can improve timeliness and last-mile access for selected time-critical, lightweight medical payloads in infrastructure-constrained settings, provided that services are integrated into routine workflows and cold-chain handling is validated. Recurrent limitations include battery endurance and payload constraints, weather and connectivity sensitivity, cold-chain risk for temperature-sensitive products, fragmented BVLOS and airspace approval pathways, cybersecurity and privacy vulnerabilities, and unresolved liability and accountability arrangements. Emerging enablers—AI-assisted routing and dispatch, IoT-based condition monitoring, blockchain-supported traceability, and 5G-enabled communications—are frequently discussed as mitigations, but system-scale validation remains limited. Using TCMEOD-based evidence mapping, the literature is shown to focus on technological and operational dimensions, with comparatively weaker coverage of ethical and developmental readiness, indicating that governance and institutional capacity remain persistent bottlenecks to sustainable scale-up. The review concludes with implications for regulatory harmonization, privacy-preserving digital infrastructure, and interoperable operational standards to support equitable and resilient UAV adoption in healthcare supply chains.