Is telehealth the way forward in Nigeria?

Can you remember when, if ever, Nigeria’s healthcare system was not in a “state of crisis?”

I know you have been reading about this issue in the national dailies long before I started writing about it today and the stories I write will sound very similar to those you read 20 to 30 years ago. Sadly, year after year, decade after decade, not much has changed; it is almost as if we are still stuck in a loop.

9ja—a country with a population of more than 218 million people—spent N1.34 trillion on health in the 2024 fiscal year budget of N28.78 trillion, accounting for 4.64 per cent of the budget.

But let’s break that down: N771.56 billion is for personnel expenditure, N121.76 billion for overhead costs, and N542.95 billion for capital projects. If you divide this total healthcare budget evenly among all Nigerians, each person gets N6,288.97 for the entire year—just N524 per month.

N524 a month? Think about that for a second—N524 per month for your health. That’s less than $1—exactly $0.68—a month per person. This amount isn’t enough to cover basic consultation fees, let alone treatment or medication., let alone buy a loaf of bread. This paltry allocation is even more troubling when you consider that 70% of Nigerians must pay out of pocket for their healthcare. This isn’t just about numbers—it’s about real people, real lives. A simple doctor’s visit could drain your savings or force you to choose between medicine and food. Families are pushed into poverty just trying to stay alive.

Despite Nigeria’s 2001 commitment to the Abuja Declaration, which promised to allocate 15% of the national budget to healthcare, twenty-three years later, we’ve yet to see that pledge fulfilled. We’re miles away from where we should be. The result? A healthcare system that is, quite literally, on life support.

Things Fall Apart

The symptoms of a broken Nigerian healthcare system are everywhere cropping up across the country from the ridiculously high out-of-pocket costs—86 per cent of Nigerians cover their own medical expenses. Meanwhile, healthcare infrastructure continues to deteriorate. The tragic death of Dr. Vwaere Diaso, a young doctor doing her housemanship at the General Hospital in Lagos, serves as a painful reminder of this decay. Dr. Diaso fell to her death when the hospital’s elevator malfunctioned—an incident that speaks for itself about the systemic failures in Nigeria’s healthcare sector.

Or do I still need to remind you that Nigeria continues to battle preventable diseases such as malaria, polio, cholera, tuberculosis, and measles? Epidemics like Lassa fever resurface regularly, and millions suffer from malnutrition.

Even more alarming, a 2020 study by The Lancet found that 123,000 Nigerians die each year from poor-quality healthcare, while another 253,000 die because they can’t access healthcare at all. That’s over 376,000 people whose deaths could have been prevented with basic medical attention. As a nation, we’re not just failing; we’re losing lives unnecessarily.

Primary Healthcare Centres (PHCs), meant to serve as the first point of contact for millions, are barely functioning. According to the National Primary Healthcare Development Agency, fewer than 6,000 out of 30,000 PHCs can provide basic services. Worse, 70% of these centers lack essential drugs or staff. The healthcare system is collapsing under its own weight.

Former Vice President Yemi Osinbajo noted this brutal reality ”Our country loses 2,500 children under the age of five every day due to largely preventable causes, including the lack of services that skilled birth attendants could provide. It is of interest that 80 per cent of these death burdens occur at the primary health care and community levels.”

That’s 2,500 families losing a child every single day—losses that could be avoided if the healthcare system were functional.

Our country loses 2,500 children under the age of five every day due to largely preventable causes, including the lack of services that skilled birth attendants could provide. It is of interest that 80 per cent of these death burdens occur in the primary health care and community levels,”

The Doctors Are Gone

Then there’s the issue of massive brain drain—a major headline—with more than 80,000 Nigerian doctors now working abroad, the country is now left with less than one doctor for every 5,000 people—well, this is below the World Health Organisation’s recommended ratio of one doctor per 600 patients.

Think about what this means for the average Nigerian patient. In Lagos State University Teaching Hospital (LASUTH), for example, patients report waiting over eight hours just to see a doctor. One woman shared how she arrived at the hospital at 6 a.m. but wasn’t seen until 2:30 p.m., losing a full day of work in the process.

Another woman, 65 years old, left her home in Ogun State at 5:30 a.m. to see a doctor for her swollen feet. When she got to the hospital, the nurse told her she was too late to be seen and should come back the next day. She couldn’t afford to leave and return, so she begged the nurses to attend to her. But they didn’t. After waiting until 3 p.m. with no help, she left in tears, having wasted an entire day.

These stories are common across Nigerian hospitals. Patients flood the clinics, but with so few doctors available, many leave without being seen. However, the consequences of this broken system are tragic. A man in his late seventies remembered how he lost his so to malaria, a preventable and treatable disease. His son died at home because basic medical care was unavailable on the day he visited the hospital. The reality of staying alive in Nigeria today is that life and death are often determined by chance, not by the quality of care available.

As former VP Osinbajo noted, “there is no better way to tackle the challenges of health care delivery in Nigeria than to close the gaps in the equitable availability of skilled health workers in Nigeria’s PHC facilities.”

Is Telemedicine the Answer?

Can telemedicine close the gaps in Nigeria’s healthcare system? To understand how telemedicine can be a game-changer, I spoke with two Nigerian companies, WellaHealth and MobiHealth, who are leading the charge in the Nigeria telemedicine space.

Dr. Ikpeme Neto, the founder of WellaHealth, explains that telemedicine allows patients to access medical consultations via phone, SMS, email, or online platforms—making healthcare more affordable and accessible.

Similarly, Dr. Oluwalola Orioke, an assistant medical lead at MobiHealth, describes it as “the use of technology to provide remote clinical services to patients, bridging gaps in access by enabling consultations, diagnosis, and follow-up care through digital platforms.”

For Dr. Neto, WellaHealth was born out of firsthand seeing struggles that Nigerians face in accessing healthcare to provide affordable care: “We started to provide telemedicine when we saw the challenges people have around accessing care, such as having to travel long distances and the cost of presenting in person to a healthcare facility. And so we thought that we could provide telemedicine as a first point of access for people to receive healthcare. And it really is an innovative way to reduce cost, improve access, and really take care of where it’s needed.”

Dr. Orioke shares a similar vision for MobiHealth, which was founded with the goal of addressing healthcare inequities across Nigeria and other underserved regions. “MobiHealth was founded with the vision of addressing the inequities in healthcare delivery across Nigeria and other underserved regions. It was established to tackle challenges such as limited healthcare infrastructure, workforce shortages, and barriers to accessing quality care in remote areas.”

How do your services differ from traditional healthcare delivery methods, and what problems do they address?

Dr. Neto (WellaHealth): The key thing for WellaHealth is really providing mass-market health care. So we provide health care services and health care plans that start at less than 400 Naira a month. So that’s really our key focus: how can we deliver health care very cheaply? And so to do that, we leverage telemedicine and a network of community healthcare facilities. So from primary health care clinics to community pharmacies, we equip them with the tools to provide high-quality care supported by telemedicine. And so that’s the difference that we bring. And what we saw specifically is really just that affordability and access. So imagine paying less than 400 Naira a month and you can get care for things like malaria, typhoid, you know, et cetera, and very good quality care. So that’s what we bring.

Dr. Orioke (MobiHealth): MobiHealth differs from traditional healthcare delivery by eliminating the need for physical presence, making healthcare more accessible and convenient. Leveraging technology to connect patients with specialists regardless of location. Reducing costs associated with travel, accommodation, and long hospital queues. It addresses problems such as limited healthcare access in rural areas. Overcrowded urban hospitals.Delays in receiving timely medical care, especially for preventable or manageable conditions of health care providers.
What steps are required for an average patient to receive care through your platforms?

Dr. Neto (WellaHealth): To receive basic care via WellaHealth, the patient can access the service through various platforms, such as mobile networks, mobile money operators, or directly via our website. Let’s take the USSD channel as an example. The patient dials *347*96# on their phone, selects a plan, and gets a call from one of our customer service reps to complete registration and payment. After that, they can opt for a telemedicine consultation or a visit to a local community pharmacy for treatment. The process is designed to be simple and accessible, even for first-time users or those with limited digital literacy.

Dr. Orioke (MobiHealth): Patients register on our app or platform, provide basic health details, and book a consultation. After a video consultation, they receive prescriptions, referrals, or follow-up care as needed. Flexible payment options, including mobile money, make the process accessible.

How affordable are your telemedicine services for Nigerians?

Dr. Neto (WellaHealth): WellaHealth is focused on affordability, with plans starting as low as 300 Naira. This allows millions of Nigerians, especially in low-income communities, to access essential healthcare services without financial strain. WellaHealth’s services extend to common conditions like malaria, typhoid, and even chronic diseases like hypertension and diabetes. For more severe cases, WellaHealth collaborates with labs and hospitals to ensure patients receive comprehensive care.

Dr. Orioke (MobiHealth): MobiHealth’s telemedicine services are designed to be affordable, with consultation fees significantly lower than traditional private hospital visits. Flexible subscription models and partnerships with health insurance providers ensure affordability. Our basic subscription goes for N5,000 for a family of 6 per annum. To support low-income families we collaborate with NGOs and government programs to provide free or discounted care.

Are there specific conditions or illnesses that it focuses on through its telemedicine services, such as chronic disease management or preventive care? Why is that?

Dr. Neto (WellaHealth): So for specific conditions, on our telemedicine service, we have doctors in-house that can actually give you advice on anything—from chronic diseases like diabetes and hypertension to if you’re feeling unwell with a fever, malaria, etc. For our telemedicine service, we can give you consultations for any condition at all. We’re not restricted. Where we start to have some restrictions, where we are very focused, is if you now want to get a test and drugs. We have varying plans. Our cheapest plan would cover tests for malaria and drugs for malaria, and then our higher plans cover tests and drugs for lots of other conditions, including, say, diabetes and hypertension. But our key focus is really on those day-to-day illnesses like malaria, typhoid, you know, coughs, colds, and flu that really limit people from reaching their full potential when they are sick. So we’re able to provide the consultation, of course, but then also testing and treatment within a network of community pharmacies, a number over 2000 across Nigeria.

And then for diagnostics. So again, the pharmacy network really gives us a lot of value in that you can go in there, in person, over 2000 across the country, do rapid diagnostic tests and get further input from the pharmacist around what your diagnosis can be. We also have a network of labs we work with. One of our partners is Beacon Diagnostics. They’re in over 26 states across Nigeria, so if you need further testing, we can refer you to them. Depending on your results there, we can also refer you on to a physical examination with a doctor. So we’re able to provide the full gamut of care, starting from telemedicine to in-pharmacy care, labs, and even into a hospital. We have plans that can give you coverage at any point in that value chain.

Dr. Orioke (MobiHealth): We focus on conditions like maternal and child health (e.g., virtual antenatal care, postnatal care), chronic disease management (e.g., hypertension, diabetes), and preventive care (e.g., routine screenings, immunisations, health education, mental health services). These areas are prioritised due to the high prevalence of chronic diseases and the need to reduce preventable deaths in Nigeria.

Diagnosis via telemedicine relies on patient history, reported symptoms, and video-based assessments. MobiHealth doctors use patient-provided data and AI-powered wear-on devices (e.g., ultrasound, stethoscope) to make preliminary diagnoses. For lab tests or imaging, MobiHealth partners with diagnostic centres where patients can be referred. Results are integrated into the platform for continuity of care. For complex cases requiring physical examination, we are big on partnerships with already existing healthcare providers. Patients are referred to partner hospitals and laboratories if beyond telehealth. Safety measures ensure the timely identification of cases requiring escalation.

The success of telemedicine is best seen in the lives it touches. Take, for instance, the story of a son in the UK who used WellaHealth’s HealthSend service to secure timely care for his mother in Nigeria. Through its HealthSend service, a telemedicine consultation identified her condition, a nurse was dispatched, and her health improved. The son received updates throughout; this displays how telemedicine can bridge not just healthcare gaps but geographical ones.

MobiHealth has similar success stories. It was able to provide virtual care to the participants in different states across the country during the just concluded project 10m National Health Check. Know your number; control your number.

In one instance, a patient in Bichi, Kano State, experiencing chest pain, used a telehealth cabin to connect with a doctor. The doctor diagnosed early signs of a heart attack and coordinated stabilizing care until the patient could reach a hospital.

As Dr Great Oyita, a former medical lead at MobiHealth, shared, “A patient in Bichi experienced sudden chest pain but had no immediate access to a hospital. However, the patient was brought to the healthcare centre, which housed one of MobiHealth’s telehealth cabins.

“Through the Mobihealth platform, the patient was able to connect with a doctor who identified the early signs of a heart attack and advised the patient on stabilising measures. The doctor also coordinated with the primary healthcare centre, where we had the telemedicine cabin installed to ensure the patient received the necessary medications until an in-person transfer to a hospital was possible. This quick intervention prevented a life-threatening escalation of the condition.”

“ For expecting mothers in rural areas, Mobihealth’s telemedicine platforms have proven particularly valuable. In one instance, a woman at risk of serious pregnancy-related complications in Epe was identified by a virtual doctor who advised the local health worker at the primary healthcare centre on how to manage the situation until they could get her to a nearby facility equipped to handle such. Telemedicine enabled the immediate response and guidance needed to save both the mother’s and the baby’s lives, preventing further complications that could have arisen from delayed access to expertise.”

These stories remind us that, even in a broken system, telemedicine may not be the silver bullet that solves everything, but it is a step in the right direction in terms of providing access to healthcare for people who would not otherwise have it—particularly those in rural areas or who cannot afford the long trips to crowded urban hospitals.

“I firmly believe telemedicine is a powerful solution for many of Nigeria’s healthcare challenges. The country is plagued with infrastructural and human resource gaps. My experience with Mobihealth International, where I saw firsthand how telemedicine can bridge these gaps, has convinced me of its potential.” Dr. Oyita said.

Nurse Mercy Jimoh from Government Hospital Ibusa in Delta State also agrees, adding, “Yes, telemedicine could relieve some of the pressures in overcrowded hospitals such that the number of people visiting the hospital and clinics physically in Nigeria will be reduced, as they can easily access medical care online….While Nigeria’s healthcare system is at a crossroads, telemedicine may not be able to fix everything, but it’s a powerful tool in bringing healthcare closer to those who need it most.”

Looking ahead, Oyita predicts a rise in “Afrocentric telemedicine solutions that cater specifically to Nigeria’s unique healthcare needs. Platforms may integrate local languages, culturally relevant health advice, and services focused on endemic diseases like malaria, sickle cell anaemia, and typhoid.”

He also sees telemedicine as a way to empower Nigerian healthcare workers by reducing burnout and enabling them to consult across locations.

“ Specialists can offer their expertise nationwide without needing to relocate. Brain drain could be partially mitigated as Nigerian doctors abroad offer teleconsultations back home, leveraging their expertise while remaining in the diaspora.”