For three days in April 2020, l was unable to sleep, eat or do my work. Why? I was waiting for the results of a COVID-19 test which l had taken to eliminate the possibility that l had contracted the virus after someone close to me had tested positive for the disease.
Mustering the courage to go for the test was not an easy thing to do. And then the waiting started. I was told the results would only be available after three days.
My anxiety levels were very high. l had difficulty concentrating and even making simple decisions was a problem. I had difficulty sleeping and when l did fall asleep, l had nightmares.
Unable to cope with these feelings of fear, worry, numbness and frustration, l reached out to a psychologist who explained that what l was going through was ‘normal’.
She explained the psychological stress presented by the possibility of having contracted the virus and talked me through my fears. My results came back, and I was able to sleep peacefully at night and able to focus on my work.
I am lucky because the majority of the people in Nigerians cannot access the kind of psychosocial support health services that l was able to access in real-time to help me deal with the anxiety and fears brought on by the pandemic due to last of digital tools and literacy.
More than a year into the pandemic, the constant worry, the fear, the anxiety and the frustrations surrounding access to the COVID-19 vaccine has added to the pressures that ordinary citizens and health professionals are going through.
The cost of access to health services is beyond the reach of many, connecting to the right health service was a major challenge as there was lockdown, health personnel and services are inadequate and have been largely ignored even as the government focuses more on preventing the spread of the virus and managing those who have contracted the disease.
Attention to training health professional on the use of digital tools , even prior to the pandemic, has been woefully inadequate.
A National Digital Health Strategy 2018–2023 document indicates that less than 25% of health facilities in Nigeria have adopted electronic health record systems, while over 80% still rely on paper-based processes due to poor digital literacy among health workers and inadequate access to digital health tools to cater for a population of more than 200 million Nigerians.
A National Health ICT Strategic Framework 2015- 2020 document indicates that less than 25% of health facilities in Nigeria have adopted electronic health record systems, while over 80% still rely on paper-based processes due to poor digital literacy among health workers and inadequate access to digital health tools to cater for a population of more than 200 million Nigerians.
Stress level of people has risen as many have lost jobs, have seen their businesses collapse and have been denied the traditional social support they would usually access due to stringent measures introduced by the government to reduce the spread of the disease.
Relatives who have lost loved ones to the virus haven’t had the opportunity to bid them a befitting farewell as the bodies are not released to them. All they have are memories of these persons to last them their lifetime.
A National Bureau of Statistics (NBS) report revealed that the incomes of over 79% of Nigerians representing more than 150 million people out of the country’s estimated 200 million population have reduced since March 2020, when the COVID-19 pandemic hit Nigeria.
An estimated 70 million Nigerians faced disruptions to their work activities during the COVID-19 pandemic due to lockdowns and safety restrictions. The situation disoriented many, as income sources were cut off and businesses struggled to adapt to digital alternatives.
Beyond the economic impact, the crisis exposed Nigeria’s limited digital readiness in the health sector, where inadequate infrastructure, poor digital literacy, and lack of access to online health services widened inequality in healthcare delivery.
“In the best of times, Nigeria’s health system struggles with digital adoption. Even more neglected are the preventative and public health aspects of technology integration. An effective response to the digital challenges exposed by COVID-19 requires the whole of society with a focus on digital literacy, infrastructure, and coordination across sectors,” said Dr. Chikwe Ihekweazu, former Director-General of the Nigeria Centre for Disease Control (NCDC).
The main public health institutions, including the Federal Ministry of Health and the NCDC, relied on limited digital reporting systems during the pandemic. Data collection and contact tracing were often done manually or through fragmented digital platforms. Despite the National Health ICT Strategic Framework (2015-2020) outlining plans for eHealth adoption, implementation has been slow due to insufficient funding, unreliable internet, and poor capacity-building among health workers.
According to the World Health Organization (WHO), the COVID-19 pandemic disrupted health service delivery in over 90% of countries, including Nigeria, where many hospitals lacked the tools for telemedicine or digital patient record management.
Unlike many other countries that could pivot rapidly to digital healthcare solutions, Nigeria’s response was constrained by low investment in innovation. The government provided limited digital support for remote consultation, data integration, and training for frontline workers.
The impact of these gaps has not yet been fully measured by the Federal Ministry of Health, but anecdotal evidence and research from the WHO and Nigeria Digital Health Readiness Assessment (2021) indicate that citizens in rural areas, women, and small clinics faced significant digital exclusion during the pandemic making it harder to access health information, virtual care, or vaccination updates.
The policy brief by the United Nations (2020) had warned that digital exclusion could deepen inequality in developing nations like Nigeria, urging governments to invest in technology infrastructure and capacity development to strengthen health system resilience.
While countries like Kenya and South Africa scaled telemedicine platforms rapidly, Nigeria lagged behind. The National Health ICT Framework revealed that fewer than 25% of health facilities had any form of electronic health record (EHR) system by 2020, and over 80% still relied on paper-based processes.
Access to digital health tools remains uneven. Many hospitals lack ICT equipment, and health professionals often have minimal digital training.
According to the Federal Ministry of Health, Nigeria has fewer than 10,000 digitally trained health professionals serving a population of over 200 million a ratio far below what is needed to deliver efficient, technology-enabled healthcare.
Despite government initiatives like the NCDC’s digital surveillance systems and the Nigeria eHealth Blueprint, awareness and use of digital health services remain low. The absence of sustained funding and the high cost of digital tools discourage adoption, while poor connectivity in rural regions isolates millions from critical health innovations.
“COVID-19 was a wake-up call for Nigeria. We saw that technology isn’t a luxury it’s essential to protecting lives,” said Dr. Oyebanji Filani, Commissioner for Health, Ekiti State, at a 2022 health technology forum.
Yet, few citizens are aware of available digital tools, and limited digital literacy means many cannot use them effectively when needed. As Nigeria moves toward implementing the National Digital Economy Policy and Strategy, experts emphasize that investing in digital literacy, affordable internet access, and eHealth systems is crucial to building a more resilient and equitable health sector
Technology to the Rescue?
Prior to the COVID-19 pandemic, patients seeking healthcare services in Nigeria were required to visit hospitals physically and book appointments at the clinics if they needed them.
But the pandemic forced health service providers to rethink how to reach patients and enable them to keep their appointments.
Even though in-person consultations are still happening, attention has shifted to expanding access using digital health tools and telemedicine platforms, as it is now easier and quicker to book a virtual session than pursue in-person visits.
As part of efforts to promote digital access to healthcare during the pandemic, several hospitals and health organizations in Nigeria introduced free call-in and online consultation services, allowing citizens to speak directly with medical professionals, access verified information, and receive guidance without leaving their homes.
Why can’t it be sustained?
I put this question to Dr. Chikwe Ihekweazu, then Director-General of the Nigeria Centre for Disease Control (NCDC).
He says that “almost everything we’re doing right now, from logistics to managing the outbreak itself, is being migrated into different technological platforms,” noting that automating processes would help authorities handle increased testing
The theme for that year’s World Health Day was “Building a Fairer, Healthier World,” a message that resonates deeply in Nigeria, where the digital divide continues to shape health outcomes and access to care.
The national digital health call-in service, launched during the pandemic, is one way the government and private sector are trying to bridge the gap in access to reliable health information and support.
According to the World Health Organization (WHO), in most low- and middle-income countries like Nigeria, the digital health access gap is estimated between 70–90%, meaning that millions of people still cannot benefit from telemedicine, electronic health records, or online health consultations.
In Nigeria, this figure is believed to be even higher due to poor infrastructure, low internet penetration, and limited digital literacy among health professionals.
“This means that a large portion of Nigerians are still unable to access essential digital health services,” says Dr. Oyebanji Filani, Commissioner for Health in Ekiti State. “We must see digital health not as a luxury but as a necessity a tool for inclusion, not exclusion.”
The Head of Public Health Communications at the Nigeria Centre for Disease Control (NCDC), Dr. Chinwe Ochu, says the expansion of digital and phone-based health services during the pandemic was a direct response to the surge in public distress and health-related inquiries.
“Before COVID-19, we only had a few hotlines for disease surveillance and emergency response,” she explains. “But during the pandemic, there was a massive increase in the number of calls from people experiencing anxiety, fear, or confusion about the virus. We had to strengthen our helpline system and train responders to provide both health information and psychosocial support.”
Since its expansion, the NCDC Connect Centre has handled hundreds of thousands of calls, providing verified information, emotional support, and referrals to nearby facilities. The helpline operates 24 hours a day, connecting citizens to healthcare professionals across the country.
While this has been an important step in improving access to timely health information, experts say more needs to be done to publicize these helplines, especially in communities with low digital literacy or limited internet access.
Health communication specialists have urged the Federal Ministry of Health (FMoH) and the National Orientation Agency (NOA) to collaborate with media houses, telecom operators, and faith-based organizations to ensure that helpline numbers are widely shared through radio, TV, and SMS campaigns.
“Many Nigerians who need help don’t have the time or resources to go online looking for numbers,” says Dr. Amina Abubakar, a public health expert based in Abuja. “The numbers should be visible everywhere from public transport stations to market walls and community radio broadcasts.” Just as the national emergency line 112 can instantly connect callers to the ambulance, fire service, or police, Nigeria’s health authorities are being urged to establish a single USSD short code that allows citizens to reach verified health and mental health support lines directly, without requiring internet access.
In Nigeria, misinformation surrounding COVID-19 created widespread anxiety, fear, and confusion among citizens.
To address this, Oluwafunke Kofoworade and her team launched Digital Health Global a digital response system built to provide verified health information and bridge the gap in access to care.
“We realised that many Nigerians were relying on rumours and social media for medical advice,” she explains. “So we developed simple tools that anyone could use, even without internet access.” Through a WhatsApp chatbot, Telegram chatbot and a toll-free USSD short code (*698*79#), users could access reliable COVID-19 updates, safety tips, and emergency contacts from any mobile phone.
For those without smartphones, the USSD feature ensured access to information and support in real time. Suggestions have since been made to expand government helplines such as the NCDC Connect Centre to deliver digital counselling and brief psychological interventions to the public. However, challenges remain in standardising online health and therapy practices for web-based consultations.
Health and distress hotlines in Nigeria have also been providing callers with medical guidance, psychological support, and basic digital first aid, with many referred to nearby hospitals or community health centres for specialized care. Providing consultations through online platforms and phone-based systems has had varying degrees of success.
The following are some of the helplines that people can call to get assistance.
Community-based self-help groups have also become an important way of providing health and psychosocial support to Nigerians, especially those in rural areas. In northern states such as Kano, Kaduna, and Borno, where access to health services is limited and stigma persists, these groups have been providing mutual care and awareness during and after the pandemic.
Many of these groups, supported through the Community Health Influencers, Promoters and Services (CHIPS) programme, each have dozens of members who organize advocacy campaigns to reduce stigma and promote access to healthcare and digital health tools.
But even these kinds of community-based support activities have been affected, as in-person meetings have reduced due to fear of infection and limited connectivity in rural areas. The stigma surrounding mental health also means few people seek help even when services are available.
“The government must prioritize community health and digital inclusion,” says Dr. Peter Adebayo, Director of Primary Health Systems Strengthening at the Federal Ministry of Health. “Our well-being depends on systems that empower communities with the tools and support they need.”
[This article was produced by the Africa Health Journalism Project (AHJP) in collaboration with the International Center for Journalists (ICFJ) and the ONE Campaign].
