Digital Health for Non-Communicable Diseases in Nigeria

To achieve good health outcomes in Nigeria, the PHC system needs innovative leadership and consistent diffusion of digital health technologies—especially in treatment, control and prevention of non-communicable ailments (Zeadally et al., 2020). But the challenges to digital health implementation vary among the 36 states. Conceptually, Nigeria is disproportionately affected by premature mortalities arising from non-communicable diseases (NCDs) and other communicable diseases. This underscores the need to establish an infrastructure base that provides easy and long-term access to affordable interventions in the areas of diagnosing, treating and preventing disease—as well as rehabilitating patients (Mitchell & Kan., 2019).

However, evidence-based research indicates that behavioural risk factors for non-communicable diseases (such as unhealthy diets, physical inactivity, tobacco use and excessive intake of alcohol) are increasing in Nigeria. Consequently, there is dire need to introduce alcohol/tobacco control interventions, provide more funds and technical support for vaccination and cancer screening, as well as implement programs that promote healthy diets and physical activities. Although these approaches can help reverse the rising trend of non-communicable diseases in Nigeria, some of the identified systemic challenges to the interventions include:

• Barriers to regular medical consultations and diagnostics (such as unavailability of medical professionals and DH technologies)
• Poor access to health promotion programs and pharmacotherapy experienced mainly by patients residing in inaccessible rural communities

Stakeholders in Nigeria’s DH ecosystem can address these challenges by maximizing the increasing penetration of mobile phone and internet in Nigeria to launch a new era of digital health services. But the optimal use of DH technologies requires human training, and this highlights the importance of funding and partnership among public/private companies, foreign agencies, NGOs, government agencies, the federal/state governments among other stakeholders. Evidence from both developed and developing countries show that investing in human capacity development is one of the result-oriented strategies that empower health personnel to leverage DH technologies in the diagnosis, treatment and prevention of non-communicable diseases. “Be Mobile Be Healthy” is a mobile technology initiative developed by WHO and ITU in 2015 to improve health outcomes for specific NCDs in Nigeria. Some examples of such DH tools used for specific cases across Africa are: (a) mDiabetes developed in Senegal (b) mTobaccoCessation in New Zealand, and (c) mCervical Cancer in Zambia.

DH across the world relies on multiple applications to solve various health problems, including health systems’ challenges. DH tools are there considered a catalyst that optimises health interventions (Srivastava et al., 2015). In Nigeria, different DH models are currently utilized to address health systems’ challenges related to NCDs as well as Reproductive and Maternal Child Health—and these DH interventions may be combined to optimize health outcomes. Research participants agreed that capacity building at the state government level is imperative to successfully manage digital health solutions. In addition, stakeholders in the DH ecosystem should ensure that expenditure and revenues are properly computed to determine Return on Investment (ROI) for digital health. This financial evaluation should also extend to the federal government and local government levels in order to justify investments in digital health. Thus, stakeholders should operationalize DH interventions with continuous technical support and guidance from WHO and FMoH, including private-sector organizations and ICT companies. Building in-country capacity is central to the success of health innovation in every country. On this premise, health administrators among the research participants agreed that local ICT companies need to be attracted to provide sustainable digital health solutions based on robust business models (Rolfe., 2019). Consequently, doing so will encourage healthy competition among foreign investors, innovators and private-sector organizations. DH roles in achieving UHC includes but not limited to reminding patients on medical refills, follow-up appointments, and routine yearly observations among others.