Nigeria Digital Health Strategy

Problem

Nigeria's digital health landscape is characterized by a proliferation of pilots that never scale. Remote consultation platforms, electronic patient records, community health worker apps — many demonstrate genuine local benefit, then stall. The same obstacles recur: connectivity gaps, inconsistent digital literacy among end users, regulatory uncertainty, and systems built for one context that can't communicate with anything adjacent to them.

This is partly a technology problem and partly a coordination problem. But more fundamentally, it reflects an approach to digital health that optimizes for getting a pilot launched rather than for building something the system can absorb and sustain. Without interoperability baked in from the start, every successful pilot becomes an island — and the cumulative effect is a health information environment that generates data no one can use.

Approach

Advisory engagements follow a structured sequence: assess the current state of a client’s digital infrastructure, identify the specific gaps between their setup and interoperable standards, and build a roadmap that is technically grounded and politically achievable. The work spans four phases:

• System evaluation — mapping existing digital tools, data flows, connectivity infrastructure, and workforce capacity; identifying misalignments with national frameworks such as the NDHI National Enterprise Architecture
• Standards alignment — translating system requirements into FHIR-based data models and integration specifications; aligning clinical terminology with international standards while preserving context-specific adaptations
• Implementation roadmap — sequencing technical work against institutional readiness, with interoperability requirements embedded at each phase rather than retrofitted at the end
• Deployment support — working with regional technology partners, supporting workforce training, and establishing governance structures that can sustain the system beyond the initial engagement

A recurring reference point has been the NPHCDA Immunization FHIR Implementation Guide — a concrete example of interoperability principles applied to a Nigerian public health context. It demonstrates what standards-based design looks like in practice: standardized patient profiles, structured immunization event documentation, and integration pathways with national databases and civil registration systems. It is also a template for how similar guides could be built for maternal health, chronic disease management, and other priority areas.

What the Work Produces

Engagements vary in scope, but the outputs typically fall into a few categories:

Lessons

Nigeria has a structural advantage that developed health systems do not: it is not locked into decades of legacy infrastructure. The cost of that advantage is that the institutions doing the building are younger, less resourced, and operating under more political pressure. That combination — clean technical slate, constrained institutional capacity — means the path to sustainable digital health runs through standards adoption and governance design, not through building better apps.

The FHIR Implementation Guide model is useful precisely because it forces that discipline early. When you have to write down exactly how a vaccination event should be structured for interoperability, you also have to answer harder questions: who owns the patient identifier, how is consent handled, what happens when a child moves across state lines? Getting those questions answered in a technical specification is a proxy for getting them answered in policy — and the technical work often surfaces governance gaps that would otherwise stay invisible until they become crises.