Amid inadequate funding to scale up current efforts, the Lagos State Primary Healthcare Board (LSPHCB) has called for sustainable financing to expand the digital referral system across primary healthcare (PHC) facilities in Lagos.

Speaking on the integration of technology into the state’s referral framework, the Permanent Secretary of the board, Dr Ibrahim Mustafa, said that although Lagos has made notable progress in deploying digital platforms and electronic health information systems, expansion beyond the current level has been constrained by financial limitations.

Mustafa noted that pooled funding from public agencies had sustained the health information management platform over the past three to four years. However, he explained that broader roll-out across all PHC centres has remained difficult due to funding gaps.

He stressed that before further expansion, clear and reliable funding sources must be identified, whether through increased state budget allocations, development partner support or patient contributions. According to him, financing remains central to institutionalising and sustaining the digital referral initiative.

The Permanent Secretary emphasised the importance of carefully introducing technology into the health system, noting that stakeholders must first understand and be convinced of the platform’s value before full-scale deployment. Innovation, he said, must clearly demonstrate how it will strengthen service delivery within the PHC system.

Mustafa added that successful implementation would require co-creation with stakeholders to ensure strong buy-in. When healthcare workers and partners perceive the system as collectively owned, he noted, they are more likely to take responsibility for its success and defend it against setbacks.

He also underscored the role of supportive supervision focused on mentoring and capacity building rather than fault-finding. Instead of penalising facilities or personnel that have not adopted the system, he said the board intends to provide guidance and support to help staff integrate the digital referral platform into routine practice.

According to him, recognising early adopters and leveraging them as champions could encourage wider acceptance among other healthcare workers. He identified internet connectivity issues and inadequate hardware as major barriers to adoption, stressing that the timely resolution of such technical challenges would significantly improve uptake.

Mustafa further called for stronger alignment among partners on a unified digital platform to avoid fragmentation and duplication of efforts. He warned that weak governance structures could undermine the initiative, stressing the need to institutionalise a clear governance framework and formally integrate the digital platform into the existing referral policy.

Describing the current two-way referral system as incomplete and often disjointed, he explained that once patients are referred from primary to secondary healthcare facilities, follow-up is frequently lost.

With digital integration, healthcare providers would be able to track patients’ progress, monitor referral outcomes and ensure treated patients are referred back appropriately within a functional two-way system.

Mustafa maintained that strong governance, effective partnerships, adequate investment and continuous monitoring and evaluation must be embedded in the reform process. He warned that insufficient funding and weak evaluation mechanisms have undermined many government initiatives in the past, adding that these gaps must be addressed if the PHC digital referral system is to succeed across Lagos State.