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Advocacy for Digital Health in Nigeria: Is AI and Telemedicine Bridging the Gap in Healthcare Access?
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by
Victory Emilomo Oaikhena (Miss) and Chinedu Joseph Okoye (Mr.)
Nigeria’s healthcare system faces significant challenges, including a severe shortage of healthcare professionals, poor healthcare infrastructure, and limited access to quality medical services, especially in rural and underserved areas. However, advancements in digital health technologies, particularly telemedicine and e-pharmacy and the integration of artificial intelligence into these platforms have emerged as a potential game changer in bridging the healthcare gap.
The key question, however, is whether these innovations are truly available and accessible to the people who need them most. This article explores how AI and digital health technologies (telemedicine and e-pharmacy) are transforming healthcare in Nigeria, the challenges limiting its effectiveness, and the necessary advocacy efforts required to ensure equitable access.
The Promise of AI and Digital Technologies in Healthcare
1. Addressing the HealthCare Workers-Patient Ratio Gap
I leave to your imagination the number of actively licensed physicians and other healthcare workers in Nigeria relative to those registered to practice. For Physicans, available data places it around 24,000[1] giving a horrible true ratio of approximately 1:10,000. This ratio of 1:10,000 is a national average but in most states, the situation is palpably worse. Only one doctor is incredibly available to treat 30, 000 patients in some states in the south, while states in the North are as bad as one doctor to 45,000 patients. In some rural areas, patients must travel more than 30 kilometers from their abodes to get medical attention where available, thus making access to healthcare a rarity. This shortage has led to long wait times, overcrowded hospitals, and delayed medical interventions, particularly in rural areas. The dashboard below obtained from WHO further revealed that in 2022, the density of doctors, nurses, dentists and Pharmacists per 10,000 population are 3.94, 16.8, 0.23 and 0.84 respectively significantly lower than the 36.1, 118.8, 6 and 9.6 seen in the United States dashboard for the same healthcare professionals and period.
Telemedicine platforms such as Accesscare and e-Pharmacy solutions such as the HealthPlus e-pharmacy platform have emerged to address this challenge. These digital solutions enable patients to consult with healthcare workers remotely via smartphones, reducing the burden on healthcare facilities and providing quicker access to medical advice.
[1]Dr. Ojinmah Uche, Past President, Nigeria Medical Association https://punchng.com/nigeria-has-one-doctor-to-10000-patients-nma/
1. AI-Driven Diagnostics and Predictive Analytics
AI-powered healthcare tools are revolutionising early disease detection and diagnosis. Some of the notable AI applications in Nigerian healthcare include:
- Medical Imaging & Radiology: AI algorithms assist in analysing X-rays, MRIs, and CT scans, helping doctors detect conditions such as tuberculosis and cancer at an early stage.
- Chatbots and Virtual Health Assistants: AI-powered chatbots on digital healthcare platforms provide initial consultations and guide patients on symptoms, treatment options, and whether they need to seek in-person care.
2. AI for Maternal and Child Health
Maternal and child mortality rates in Nigeria remain among the highest in the world. AI-powered solutions are addressing these challenges through innovations that provides virtual coaching for pregnant women, helping them monitor their health and access professional medical advice and AI-based tool that detects birth asphyxia (one of the leading causes of neonatal mortality) by analysing a newborn’s cry, allowing for early intervention.
3. AI and Telemedicine in Rural Areas
The deployment of mobile health (mHealth) has helped rural communities access medical services that would otherwise be unavailable. With increasing mobile phone and internet penetration, mobile applications and equity model platforms (USSD and IVR) allow individuals to consult with doctors, receive prescriptions, and even schedule lab tests without visiting a hospital.
Challenges Hindering AI and Telemedicine Adoption in Nigeria
Despite the immense potential of AI and telemedicine in transforming healthcare access, several barriers hinder their widespread adoption in Nigeria:
1. Digital Divide and Internet Penetration
Many rural areas in Nigeria lack stable internet connectivity and electricity, making it difficult for residents to access telemedicine services. Recent data indicates that Nigeria’s internet penetration rate was approximately 45.5% in early 2024, with about 103 million internet users. This figure represents a decrease from the 55.4% penetration rate reported in early 2023. Therefore, as of 2024, more than half of Nigeria’s
population remains offline.[1]
2. Affordability and Financial Constraints
Most AI-powered
healthcare services and telemedicine consultations are costly, limiting access
for low-income populations. Additionally, a poll conducted in November 2024
revealed that 19% of adult Nigerians now have health insurance[2]
indicating an increase from the 5% of Nigeria’s 208 million population that
were enrolled in the national health insurance scheme in 2022.[3]
Despite these improvements, a significant portion of the Nigerian population
remains without health insurance, leading to high out-of-pocket healthcare
expenditures.
3. Limited Digital Literacy
A significant proportion of the population, especially in rural areas, lacks the digital skills necessary to use telemedicine applications effectively. Without proper education and awareness, many Nigerians are unable to take advantage of these healthcare innovations.
4. Regulatory and Data Privacy Concerns
AI powered digital healthcare solutions require clear regulations on data protection, ethical AI use, and medical liability. Nigeria is still developing its digital health policies, and concerns about patient data privacy and security remain unresolved. In March 2024, the Federal Government inaugurated a 20-member committee dedicated to implementing the Nigeria Digital in Health Initiative (NDHI). This initiative aims to transform the national digital healthcare architecture, enhancing data management and healthcare delivery across the country. To contribute to this health sector digitisation initiative being rolled out by the Federal Government, the Society for Family Health is implementing the ePharmacy for Family Planning project. The project, which is a 4-year investment of the Bill and Melinda Gates Foundation, has the building of an enabling policy environment for the provision of information, products, and services through e-pharmacy as a key outcome. In June 2024, the project participated in the inauguration of the National Steering Committee tasked with the responsibility of developing the Nigeria National Prescription Policy, which aims to ensure that healthcare workers across Nigeria adhere to rational prescribing and dispensing practices regardless of the platform of operation. The project has since supported the follow-up engagement processes by the committee towards the development of the policy. The project is also supported by the Government of Nigeria to develop the draft electronic pharmacy regulation and is currently providing support for the development of the national electronic pharmacy policy and the national telemedicine guideline.
As Nigeria continues to make strides in developing her digital health policies through these, key cross-cutting themes across stakeholders remain issues around interoperability, data protection, and data privacy.
Advocacy for Digital Health in Nigeria
To ensure that AI and telemedicine truly bridge the healthcare gap, concerted efforts must be made to advocate for equitable digital health policies, improved infrastructure, and public-private partnerships. The following advocacy strategies are crucial:
ü Expansion of Digital Infrastructure
The Nigerian government, in collaboration with the private sector, must invest in expanding broadband internet access and improving electricity supply in underserved areas. Initiatives like the National Broadband Plan 2020–2025 should be accelerated to ensure digital health services reach remote regions.
ü Subsidised and Affordable HealthTech Solutions
To make AI and digital health services accessible to low-income Nigerians, healthcare startups and the government should offer subsidised telemedicine consultations and expand health insurance coverage to include non-internet-based digital health services (Integrating low-tech high-fidelity equity models like USSD and IVR). Public-private partnerships in this regard can facilitate the provision of affordable mobile health solutions.
ü Digital Literacy and Public Awareness Campaigns
Educating Nigerians on the benefits and use of telemedicine and AI-powered healthcare tools is essential. Community-based training programmes should be introduced to help individuals, especially in rural areas, understand how to navigate digital health platforms. Digital health platform information products and services should also be available in local languages including Nigerian Pidgin English, Igbo, Hausa and Yoruba, to boost acceptance and uptake.
ü Stronger Policies and Investment in AI Regulation
Nigeria needs clear guidelines on AI ethics, data security, and telemedicine regulation to encourage healthcare providers to integrate AI solutions safely. The government must collaborate with stakeholders, including the Nigerian Medical Association (NMA), the Ministry of Health, development organisations, and HealthTech companies, to draft and implement comprehensive digital health policies.
ü Support for Local HealthTech Startups
Homegrown AI and telemedicine startups need funding, policy support, and strategic directions to scale their services. Encouraging local innovation ensures that solutions are tailored to Nigeria’s specific healthcare challenges, making them more effective in addressing the needs of underserved populationss
The Future of AI and Digital Health Services in Nigeria
AI and Digital Health Services have immense potential to transform Nigeria’s healthcare landscape, but without addressing key barriers such as affordability, digital literacy, infrastructure, and policy gaps, the most vulnerable populations may remain excluded.
Advocacy efforts should focus on ensuring that no one is left behind in the digital health revolution. Through prioritising equitable healthcare policies, expanding digital access, and fostering collaboration between the public and private sectors, Nigeria can harness the full potential of AI and digital healthcare services to achieve universal health coverage (UHC) and improved healthcare outcomes for all.
The future of digital health in Nigeria is promising but only if the right steps are taken now to ensure that these innovations are accessible to those who need them most.
[1] Leadership News https://leadership.ng/internet-penetration-rate-rises-to-45/
[1] 26th November 2024 – A new public opinion poll conducted by NOIPolls https://www.noi-polls.com/post/only-19-nigerians-have-health-insurance-new-poll-reveals
[1] Lead Researcher, Dr Terrence Kairiza from African Economic Research Consortium AERC in the report titled “Leveraging Economic Development through Human Capital in Nigeria: The Roles of Foreign Direct Investment and Health” October 10, 2024 https://www.vanguardngr.com/2024/10/report-reveals-nigerias-low-health-insurance-coverage/
