AN EVALUATION OF THE AFFORDABILITY OF TELEHEALTH SERVICES IN NIGERIA

CHAPTER ONE

INTRODUCTION

Background of the Study

Telehealth facilitates and encourages remote healthcare, and these advancements can decrease regular physical contact and hospitalization while greatly improving the provision of excellent healthcare services (Mbunge, Muchemwa & Batani, 2022). The COVID-19 pandemic has led to a rapid increase in the use of telehealth, with healthcare automation becoming more prevalent. Telehealth is an increasingly important part of health information systems in both developed and developing countries (APA, 2020). Nevertheless, the majority of sub-Saharan African nations, including Nigeria, have insufficient evidence about the appropriate use of telehealth in healthcare provision (APA, 2020).

Research has discovered that countries such as Nigeria, which have little resources and populations that are difficult to access, show a readiness to embrace telehealth. Nevertheless, the utilization of telehealth in Nigeria is still in its early stages, potentially as a result of several crucial aspects. Additionally, the cost of internet connectivity and telecommunications services is a significant determinant of the affordability of telehealth in Nigeria. Although mobile phone adoption and internet access have improved significantly, data costs continue to be expensive for many Nigerians, especially those residing in rural and low-income regions (ITU, 2021). 

The exorbitant expense associated with data serves as a major obstacle to receiving telehealth services, as these services frequently necessitate ample bandwidth for video consultations and other online interactions. However, the economic dilemma highlights the necessity of implementing measures that decreases data expenses and enhance the affordability of internet services.

According to Omoleke & Taleatu (2021), telehealth affordability is not just determined by data prices, but also by the pricing structures implemented by telehealth service providers. Several telehealth platforms impose charges for consultations and remote monitoring services, which may provide a barrier for those with poor financial means (Baron, Hirani & Newman, 2017). Furthermore, the absence of standardised pricing mechanisms and limited insurance coverage for telehealth services worsen this problem, creating barriers for many Nigerians to receive these services without incurring substantial out-of-pocket costs (NHIS, 2020).

The socio-economic conditions of Nigeria significantly influence the affordability of telehealth services (Exner-Pirot, 2018). Due to income inequality and widespread poverty, a considerable segment of the population may face difficulties in affording essential healthcare, let alone telehealth services that may entail supplementary expenses (World Bank, 2021). Moreover, the COVID-19 epidemic has had a detrimental effect on household earnings, resulting in increased anxiety around affordability (UNDP, 2022).

Moreover, there is an increasing acknowledgment of the necessity for focused measures that might improve the affordability of telehealth services. Implementing subsidies and financial incentives for telehealth providers, establishing government-supported programmes to reduce data costs, and integrating telehealth services into national health insurance schemes are potential initiatives that could enhance affordability (WHO, 2020). Furthermore, the involvement of public-private partnerships might be crucial in reducing expenses and broadening the availability of telehealth services nationwide (GSMA, 2020). Therefore, a survey will be conducted in order to evaluate the affordability of telehealth services in Nigeria.

Statement of the Problem

Telehealth has demonstrated high levels of efficiency and success. A significant driver behind the expansion of telehealth programmes is the increasing ubiquity of mobile phones and internet connectivity nationwide, which acts as a crucial foundation. The advancement of technology has not only facilitated simpler communication, but it has also allowed telehealth platforms to extend their services to remote and disadvantaged populations. 

However, despite these technological advancements, there are still barriers that impede the widespread acceptance and application. A crucial factor is the unequal distribution of healthcare facilities and resources, namely between urban and rural areas (Oyeleye et al., 2021). While urban areas in Nigeria generally have better access to healthcare and technical resources compared to rural areas, the absence of infrastructure in rural parts hinders the implementation of telehealth services (NPC, 2020). 

Socio-economic considerations in Nigeria have a substantial impact on the adoption of telehealth, shaping its patterns. Furthermore, the availability of telehealth services to various socio-economic groups is affected by disparities in income and the cost-effectiveness of telecommunication services (Afolabi & Eze, 2021). Moreover, the cultural norms and principles associated with the act of seeking medical care and the preference for in-person appointments can impact the degree of acceptance and utilisation of telehealth services (WHO, 2019). Hence, it is in the light of these that the study seeks to evaluate the affordability of telehealth services in Nigeria.

 1.3  Objectives of the Study

The main purpose of this study is to evaluate the affordability of telehealth services in Nigeria. Specifically, the study will;

Determine whether there are cost differences between traditional in-person healthcare services and telehealth services in Nigeria. 

Analyze the economic factors that influence the affordability of telehealth services. 

Investigate the impact of telehealth service costs on patient access and utilization rates.

1.4  Research Questions

The following questions have been prepared for the study:

Are there cost differences between traditional in-person healthcare services and telehealth services in Nigeria?

Do economic factors influence the affordability of telehealth services in Nigeria?

Does the cost of telehealth services impact patient access and utilization rates in Nigeria?

1.5 Research Hypotheses

H0: Economic factors does not significantly influence the affordability of telehealth services in Nigeria.

Ha: Economic factors significantly influences the affordability of telehealth services in Nigeria.

1.6 Significance of the Study

The study results will help healthcare providers integrate telehealth into their services more effectively, ensuring they can offer cost-effective care to a broader patient base.Additionally, the Federal Ministry of Health (FMOH) will use the information to inform policy decisions, create regulations, and design programs that enhance healthcare accessibility. Nevertheless, subsequent researchers will use it as a literature review. This means that other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regard to the affordability of telehealth services in Nigeria.

1.7 Scope of the study   

The scope of this study is boarded on the affordability of telehealth services in Nigeria. Empirically, this study will determine the cost differences between traditional in-person healthcare services and telehealth services, analyze the economic factors that influence the affordability of telehealth services and investigate the impact of telehealth service costs on patient access and utilization rates.

Geographically, the study will be delimited to healthcare workers.

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

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