Telemedicine: How Nigeria Can Improve Healthcare Delivery, Economy Through Its Fast Growing Internet Penetration
Telemedicine is on its way to becoming the new opium of the Nigerian masses. Frustrated, distressed, sometimes angered by the slow response of hospitals, Nigerians can receive just as great healthcare from the comfort of their rooms with this not-so-new arrangement. What is telemedicine and what promise does it have in Nigeria?
Telemedicine is the practice of offering medical services remotely, without a physical meeting between the patient and the healthcare provider. While many countries have latched on to its huge potentials, Nigeria has not keyed into its beauty. This system of offering medical services is in synergy with the modern trend of telecommunications. It not only promises a massive growth and real time medical operations, it in extension offers greater growth to the information and communication sector in Nigeria. Currently, Nigeria has 185,742,016 phone subscribers according to the National Communications Commission (NCC). Of these, 40 million are users of smartphones, and have at least two sim cards with internet access.
Since 2015, Nigeria’s internet penetration has grown at a good rate. In 2015, just 23.7% of phone subscribers had access to the internet. In 2016, the figure rose to 27.7%, while it was 32.2% and 36.9% in 2017 and 2018 respectively. In 2019, it rose to 41.8% while the NCC has reported it to be at 46.6% in 2020. This figure is expected to rise to 65.3% by the year 2025. In a system that is bureaucratically restraining, better access to the internet and medical care for the populace can be achieved through telemedicine. It does not just save time, it saves the stress of sitting in hospitals waiting to be attended to.
The Bureau of Public Service Reform, led by its Director General at the time, Dr. Joe Abah conducted a study in twelve public hospitals in four states: Kano, Lagos, Abuja and Enugu. The study was to check the average time spent by a patient in Nigerian public hospitals. The findings noted that patients claimed to have spent more time than necessary at the hospitals in these states. The average time recorded to have been spent by each patient according to the research was six hours, twelve minutes.
It further revealed that on average, about three hours, 50 minutes was spent on pre-documentation, 32 minutes on nursing care and one hour, 50 minutes to get doctors consultation. All these can be significantly reduced with telemedicine and its real time service provision. Telemedicine can also ease the documentation of patient information, further helping hospitals and other healthcare providers to keep a better patient dtatbase.
According to the Internet World Stats, only 200,000 people could access the internet as at December 31st 2000. In the same period in 2019, the number has risen to 126.07m, suggesting a growth rate of over 62,000%. In internet penetration, the figures also revealed that Nigeria has grown by 61.2% in the last 20 years. While there have been ongoing researches on the real impact of telemedicine on the populace, many more privately owned telemedicine companies are rising and making an entrance into the system. It may take a while for Nigerians to accept the possibility of seeing their doctors from a distance, but with result-driven convictions, the future promises much more.
Clemens et al. 2018 reported that telemedicine saves an average of two hours travel time and US$70 per visit. An orthopaedic study conducted showed a total savings of US$5,538,120 for 921 patients living in remote areas over 5.5 years. If this is possible in the United States where the system of transportation is far more seamless and less stressful than Nigeria’s, a lot of time will be saved should telemedicine be adopted locally. In Nigeria, there is also a huge default in the number of medical personnel available to attend to patients. For every doctor in the country, there are 2500 patients waiting to be attended to. This suggests the fury and frustrations seen in hospital waiting rooms round the country as patients often have to queue to get medical access. For patients enrolled under the National Health Insurance Scheme, it’s worse as they are not treated as priorities.
Such patients, when schooled on how to access their doctors just by being honest from their homes, we will be cutting a lot of costs, promoting internet connectivity and interconnection and also helping to create more jobs for the current internet savvy generation of doctors. Nigeria currently has the 7th highest number of mobile phone users in the world, however the quality of internet access is still a far cry from what’s needed to grow the telemedicine industry. These are some of the challenges that have to be solved to have a better telemedicine experience. In the mobile internet speed index, Nigeria ranks 112th with less than 50% of mobile internet users having access to 3G & 4G technology.
The internet penetration seen in Nigeria has 50% of it being accounted for by 10 states. Majority of these states have stronger internet connections than others and have easier access to the telecommunication companies in the country. If more states are brought on board in internet access, there is a lot more to be achieved. This is going to happen through making the process as locally penetrating as possible. Lagos, Ogun, Kano, Oyo, FCT, Kaduna, Rivers, Delta, Edo and Niger States were all in the top 10. This means Nigeria has a higher chance of achieving internet penetration in these states.
Already, local telemedicine outlets are being set up in Lagos State while Oyo State is also looking to use its fast growing internet savvy population to achieve this. There has never been a better time to go in full throttle in Nigeria as the times and current conditions suggest people need to do a lot more from their zones. This, by no means eliminates the importance of the hospital as surgical interventions cannot be done over the phone. For easier synergy in telemedicine, pharmaceutical companies should also provide online services for as many customers who stay faraway from the locations of the store or company.
Telemedicine companies may also incorporate pharmaceutical services into their setup, to drive better engagement and a more total approach. Telemedicine might have grown during the lockdown enforced by the COVID-19 pandemic, as the telecommunication sector grew 18.1% during the second quarter despite the sharp decline seen in the overall Gross Domestic Product (GDP).
In the Q1 2020, the telecommunication sector grew by 9.71%. As a result of the enforced halts seen in many sectors, the overall GDP fell by -6.1% in the second quarter of 2020 in comparison to the growth experienced in the first quarter of the same year. Generally, the Services GDP contracted sharply due to the lockdown, and the health sector was also adversely affected. If telemedicine had become a critical part of Nigeria’s approach to medical service delivery, there would have been a win-win situation, as services will be rendered to people in their homes while the telemedicine sector will grow in proportion to the telecommunications sector.
Nigeria has to join the new trend of greatness rising from telemedicine. Its global market is expected to be worth $53.1 billion by 2026 with a compound annual growth rate of 14.19% from 2019 to 2026, according to researchers. This means there is the promise of a good return on investment as our rising internet penetration will make this a possibility, and an achievable target in the years to come.