By Mike Lawal (Lead Writer)
As countries undergo a demographic and epidemiological transition, the healthcare demands of the citizen change. These transitions are triggered by improvements in public health and medicine which has meant that some countries have an increasingly ageing population, as children are surviving into adulthood (thanks to improvements in public health). The epidemiological transition has seen a shift in the pattern of diseases from a high burden of infectious diseases to more degenerative non-communicable diseases. Nigeria faces a double burden of disease comprising protracted infectious diseases like HIV, Cholera and a rising number of non-communicable diseases (NCDs) like diabetes and hypertension.
The COVID-19 pandemic impacted access to healthcare services and healthcare delivery, highlighting the importance of digital innovation in healthcare. Globally, health systems worked to limit the spread of the pandemic and mitigate the economic and health impacts. They also scrambled to ensure that access to other healthcare services was not disrupted, and this triggered greater demand for digital health solutions.
Innovations in healthcare
The internet has democratised access to information, and the health tech industry is a fast-growing market worldwide. The health sector in Nigeria is seeing very gradual disruption in digital innovations, however not at the same pace as telecommunications or financial technology. The growth in innovations in the digital health industry can be seen by the recent success of DrugStoc, as the eHealth pharmaceutical distribution start-up was able to secure $4.4 million in Series A funding. Other examples include LifeBank, a blood products company founded by Temi Giwa-Tubosun, the pacesetting female founder. Her organisation has successfully secured funding from multiple investors and in 2021 launched the oxygen plant AirCo.
Currently, digital health exists in various categories, namely mhealth, telehealth, consumer health and wellness, wearables, electronic medical records (EMR), diagnostics, and provider tools. Technologies such as electronic medical records have been in existence for a while and an increasing number of hospitals in Nigeria can boast of functional electronic medical records. Globally, a growing trend of innovation in digital health is related to consumer health and wellness and, more recently, telehealth and mobile health. Telehealth, a technology-enabled remote healthcare service, is forecast to be a game-changer in digital health by 2025.
In 2018, the World Health Organisation estimated that there are 3.81 doctors per 10,000 population in Nigeria. This is more worrisome when extended to specialist doctors; for instance, there are only 250 practising psychiatrists in Nigeria. Telemedicine, when appropriately applied, can help address the perennial human resource shortage facing Nigeria’s health system.
Where telecoms exist, digital health thrives
Nigeria has a lot of potential and a massive opportunity for innovative disruptions that will help to improve its health outcomes. Digital health thrives on the availability of telecommunication and internet services and digital access will have an increasing impact on health and wellbeing outcomes. The Lancet and Financial Times Commission called for digital technologies to be recognised as a key determinant of health. According to the Nigeria Communications Commission, there were about 195 million active mobile (GSM) users in Nigeria in December 2021, implying that a growing proportion of the adult population has access to mobile phones. Also, mobile internet users are projected to reach 59.7% by 2026. Phone penetration and internet access are essential springboards for revolutionising digital health innovations in Nigeria.
However, the uptake of digital health in Nigeria’s public sector remains generally low. Before the pandemic, digital health was restricted to providing clinical and administrative tools for healthcare professionals and providers. Following the surge in COVID-19 cases, the restrictions and lockdowns led to an acceleration of digital trends and virtual health consultations for patients, especially those on routine health visits and those with non-emergency conditions, which enabled a continuum of care. This growth portends a bright future for digital health in Nigeria.
Consumerism is becoming a widespread phenomenon across every industry, and the healthcare industry is not an exception. In today’s digital era, patients are better informed, and they use the internet, social media, and other technological sources to get more information on their own. Digital innovation has enabled patients to have up-to-date health information, empowering them to demand better access to health services, based on a more informed understanding of improving health and wellbeing.
Boosting digital health through public and private sector involvement
The private sector is a leading provider of healthcare in Nigeria, supporting the efforts of the government. With the private sector accounting for a larger share of healthcare in Nigeria — over 62% — it has enabled the greater introduction of new technologies into the healthcare industry, such as electronic medical records and other e-health tools. The role of the private sector in health technology deployment was evident during the COVID-19 pandemic. The increased availability of COVID-19 diagnostics at the onset of the pandemic in 2020, in Nigeria, was enabled by private providers such as 54gene and Flying Doctors. However, the rate of uptake of new technologies is still low compared to the rising health needs of the population.
Nigeria is currently dealing with rising cases of NCDs. It is estimated that over five million Nigerians are living with either type 1 or type 2 diabetes. There is a National Policy for NCD prevention and control and incorporating digital health into this policy can help boost access to health services, especially in treating and preventing NCDs, in rural and hard-to-reach areas.
Nigeria’s health system is faced with a range of challenges, including but not limited to poor health infrastructure and inadequate health workers, harnessing the enormous opportunities for digital disruptions could help overcome some of these challenges. If enabled to thrive, technological disruption in healthcare will provide a more efficient and cost-effective service delivery that is urgently needed in Nigeria’s health system.
Mike Adeyemi Lawal is a medical doctor, Health coordinator and Global health advocate.