ASSESSING THE CHALLENGES AND BENEFITS OF TELEHEALTH SERVICES IN NIGERIA

CHAPTER ONE

INTRODUCTION

Background of the Study

Globally, the healthcare system has been over-stretched in the face of epidemics and pandemics as a result, exacerbated the dearth of health workers, signaling the need for innovative means such as telemedicine as an essential tool for reducing the negative effects of shortages in medical practitioners. Steve and Iren (2021) emphasized that the COVID-19 pandemic accelerated the use of technology in healthcare sector and uncovered its opportunities in providing prompt clinical care, education, and healthcare, at a low cost and extensive coverage.  Couple with the fact that physical clinical consultations were restricted, and the higher risk of occupational exposure for medical practitioners when providing patient care. This necessity gave rise to the adoption of telemedicine, a concept coined in the 1970s and defined by Orimoko (2022) as "healing at a distance."

Owen and Onyeama (2020) noted that telemedicine gained broader acceptance in Nigeria during the Covid-19 pandemic, as it allowed Nigerians to seek healthcare remotely, reducing the risk of disease transmission during hospital visits or transit. Bhaskar (2020) defined telemedicine more broadly as the remote provision of healthcare services using digital communication technologies, emphasizing its potential to bridge healthcare gaps in  Africa. Musbahu & Tahil (2022) averred that telemedicine uses technology tools, including messaging platforms, emails, phones, tablets, wireless monitors, teleconferencing, video conferencing, and other telecommunication technologies and the effectiveness of telemedicine services lies on their patient-centered nature, and ability to shield patients, doctors, and the general public from communicable diseases. By leveraging telecommunications, telemedicine supports medical consultations, diagnostics, and training for healthcare professionals, thereby eliminating the need for extensive travel (Haleem 2021). Manasseh and Jakes (2021) highlighted that telemedicine ranges from simple telephone consultations between healthcare professionals to complex real-time interactions using satellite technology and videoconferencing across different countries. This transformative approach holds promise in overcoming geographical barriers, enhancing healthcare delivery, and improving the overall health outcomes of urban and rural areas.

Notably, in some developed and developing nations, telemedicine is a practical growing component of health information systems. However, most sub-Saharan African countries, including Nigeria, lack evidence on proper telemedicine use in healthcare delivery. According to Eze & Onwujekwe, 2021), the healthcare system in Nigeria is characterized by disparities between urban and rural areas. While urban centers may have access to better healthcare facilities and more specialized medical personnel, rural areas often suffer from a severe lack of resources. On the other hand, Adeolu (2023) argued that rural areas in Nigeria is often characterized with poor population who hardly get access to basic amenities burdened with poverty and low standard of living. The geographic isolation, the scarcity of physicians and hospitals, and difficulties of travel to larger cities where such care is available are among the factors limiting this access.  Consequently, Governments at federal, state, and local levels, have been making healthcare in these remote rural areas their focal point over the years to enable citizens in both rural and urban areas to have equal right to medical services and clinical healthcare regardless of the geographic isolation barriers but this effort has only been partly successful. 

Statement of the Problem

Medical services encounter numerous obstacles and bottlenecks, including a shortage of skilled and experienced staff, inadequately equipped facilities, and limited utilisation of advanced technologies in healthcare delivery (Moahi, 2019). Many governments, particularly those from developing economies, are seeking more cost-effective methods of providing healthcare to their citizens. The emergence of Information and Communications Technology (ICT) has introduced innovative approaches to delivering healthcare that are affordable and have a greater likelihood of reaching a larger population, particularly in remote areas (Adewale, 2004). However, these efforts have only achieved partial success. Thus, implementing a healthcare system that enables doctors to reach patients in far locales is essential and highly beneficial in accomplishing the government's objective of providing valuable treatment to these remote rural and impoverished communities. 

Implementing telemedicine would enhance the standard of healthcare in rural and distant regions, reduce healthcare delivery expenses, and enable physicians located far away to provide consultations for any patient's condition. On the other hand, the adoption of telehealth services in Nigeria is also accompanied by many obstacles. Oyeleye et al. (2021) and  Iloh et al. (2020) asserts that primary obstacles such as inadequate internet connectivity in remote regions, deficient legislative frameworks, apprehensions regarding data protection and security, and the necessity for healthcare personnel to acclimatise to novel technology. These obstacles impede the extensive implementation and efficacy of telehealth services nationwide. Notwithstanding these challenges, telemedicine presents a multitude of advantages to Nigeria's healthcare system. It improves the availability of healthcare services, especially in distant and neglected regions, by overcoming geographical obstacles (Owoyemi, 2020). Similarly, teleconsultations and remote monitoring allow healthcare providers to deliver prompt interventions and ongoing care management, leading to enhanced patient outcomes and decreased healthcare expenses related to avoidable hospital visits (Oyeleye et al., 2021).Furthermore, telehealth improves healthcare efficiency by decreasing waiting periods, fostering collaboration among healthcare providers, and enabling medical education and training via virtual platforms (Iloh et al., 2020). 

Whereas studies have found willingness to adopt telemedicine in countries like Nigeria with resource-poor settings and hard-to-reach populations. However, using telemedicine in Nigeria is still nascent, possibly due to some critical factors. Hence, it is in the light of these that the study seeks to assess the challenges and benefits of telehealth services in Nigeria.

 1.3  Objectives of the Study

The main purpose of this study is to assess the challenges and benefits of telehealth services in Nigeria. Specifically, the study will;

Assess the extent of telehealth utilization among healthcare workers in

Assess the challenges faced by patients and healthcare providers in utilizing telehealth services.

Analyze the impact of telehealth on patient engagement and adherence to treatment plans.

Evaluate the benefits of telehealth services in Nigeria.

1.4  Research Questions

The following questions have been prepared for the study:

To what extent is telehealth utilized among healthcare workers in Nigeria?

What are the challenges faced by patients and healthcare providers in utilizing telehealth services?

What are the benefits of telehealth services in Nigeria?

1.5 Research Hypotheses

H0: There are no significant challenges faced by patients and healthcare providers in utilizing telehealth services.

Ha: There are significant challenges faced by patients and healthcare providers in utilizing telehealth services.

1.6 Significance of the Study

The study findings will reveal the importance of integrating  telehealth training into nursing education to equip students with the necessary skills and knowledge. It will inform policymakers and educators about the barriers to  telehealth  adoption, thereby guiding the development of targeted interventions to promote telehealth in the Nigerian healthcare system. However, subsequent researchers will use it as a literature review. Build on the findings to explore further aspects of the challenges and benefits of telehealth services in Nigeria contributing to the academic body of knowledge.

1.7 Scope of the study   

The scope of this study is boarded on the  challenges and benefit of telemedicine in Nigeria. Empirically, this study will aassess the extent of telehealth utilization among healthcare workers, the challenges faced by patients and healthcare providers in utilizing telehealth services, and evaluate the benefits of telehealth services in Nigeria.

Geographically, the study will be delimited to health workers in Lagos State.

1.8 Limitation of the study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. In addition, there was the element of researcher bias. Here, the researcher possessed some biases that may have been reflected in the way the data was collected, the type of people interviewed or sampled, and how the data gathered was interpreted thereafter. The potential for all this to influence the findings and conclusions could not be downplayed. More so, the findings of this study are limited to the sample population in the study area, hence they may not be suitable for use in comparison to other schools, local governments, states, and other countries in the world.

 1.9 Definition of Terms

Health: refers to a state of physical, mental, and social well-being in which an individual is free from illness and injury.

Telehealth: involves the use of digital information and communication technologies, such as computers and mobile devices, to access and manage health care services remotely.

Telemedicine: refers to the delivery of healthcare services and clinical information using telecommunications technology. This includes remote consultations, diagnoses, and treatments via phone, video conferencing, email, or other digital communication tools.