ASSESSMENT ON THE IMPACT OF TELEMEDICINE IN RURAL COMMUNITIES IN NIGERIA

CHAPTER ONE

INTRODUCTION

Background of the study

Information and Communications Technology (ICT) has emerged as a significant catalyst for the development of many nations across various sectors. In Nigeria, where there is a notable shortage of healthcare professionals relative to its over 150 million population, as highlighted by the Nigerian Medical Association (NMA 2020), there is a pressing need for innovative healthcare delivery methods. 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." Telemedicine utilizes digital devices such as mobile phones and computers to facilitate remote access to healthcare services, enabling patients to consult with doctors via video and voice calls. 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 rural Africa. 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 rural communities.

In Nigeria, telemedicine initiatives have been aimed at bridging the gap between urban and rural healthcare services. These initiatives utilize mobile phones, internet services, and other digital technologies to offer medical consultations, diagnoses, and treatment plans to patients in remote areas. This approach not only improves access to healthcare but also reduces the need for patients to travel long distances to urban centers for medical attention (Akinwumi et al., 2021).  According Adeolu (2023), 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. 

1.2 Statement of Problem

Healthcare in rural Nigeria faces substantial challenges, marked by geographical remoteness, insufficient infrastructure, and limited access to medical services. Okunade (2023) assert that rural areas in Nigeria grapples with a myriad of healthcare problems  that stem from its unique geographical and socioeconomic conditions. Vast distances, coupled with inadequate transportation infrastructure, often result in the isolation of many communities from essential healthcare facilities (Youngson et al., 2021). This geographical remoteness exacerbates the difficulty of delivering timely and effective medical services, leading to disparities in healthcare access between urban and rural areas (Keeves et al., 2021). Additionally, limited resources and a shortage of skilled healthcare professionals further compound the challenges faced by rural communities, creating an urgent need for innovative solutions. In a report by Amri and Sihotang (2023), the struggle to provide adequate healthcare to these underserved regions has prompted innovative solutions, with telemedicine emerging as a promising avenue for transforming the healthcare landscape. 

In recent years, telemedicine has emerged as a transformative solution in global healthcare, breaking down geographical barriers and providing medical services remotely (Mbunge et al., 2021).  Developing  a system of healthcare that could allow doctors to gain access to patients in remote locations became essential and most helpful in achieving the government's aims of bringing useful healthcare to these remote rural and poorer areas. This among other things promised to improve the quality of healthcare in rural and outlying areas, lower costs of delivering healthcare and allow remotely placed physicians to consult over any patient's case. Moreover, in a study by Adebayo & Adedoyin (2020), telemedicine in Nigeria has shown promising results in managing chronic diseases, providing maternal and child health services, and offering specialist consultations that would otherwise be inaccessible to rural populations. For instance, telemedicine has been used to facilitate remote consultations with specialists for conditions such as diabetes, hypertension, and mental health issues, thereby ensuring continuity of care and timely medical interventions. Although prior studies by Okunade  (2023) and George (2023) has examine the impact of ICT in healthcare delivery, little or no attention has been to the area of telemedicines, its operation and the level of impact it has on raising the health status of  Nigeria especially with regards to the rural populace. Against this backdrop, the study conducts assessment on the impact of telemedicine in rural communities in Nigeria with reference to Konshisha Local Government in Benue State.

1.3 Objectives of the Study

The objectives of this study is focused on the impact of telemedicine in rural communities in Nigeria with reference to Konshisha Local Government in Benue State. Specifically, the study seeks:

To assess the extent to which telemedicine services are accessible to rural populations in Nigeria.

To identify the key factors that influence usage of telemedicine services among rural communities in Konshisha

To examine the impact  of telemedicine on healthcare delivery and patient outcomes in rural Nigeria.

1.4 Research Questions

What is the extent to which telemedicine services are accessible to rural populations in Nigeria.

What are the key factors that influence usage of telemedicine services among rural communities in Konshisha

What is the  impact of telemedicine on healthcare delivery and patient outcomes in rural Nigeria.

1.5 Research hypotheses

Ho: There is no significant impact of telemedicine on healthcare delivery and patient outcomes in rural Nigeria

Hi: : There is no significant impact of telemedicine on healthcare delivery and patient outcomes in rural Nigeria

1.6 Significance of the study

The practical significance of this study lies in its potential to improve healthcare delivery in rural Nigeria by identifying effective strategies and technologies that can enhance the accessibility and quality of medical services through telemedicine. By highlighting the barriers and facilitators to telemedicine adoption, the study provides actionable insights for policymakers, healthcare providers, and technology developers to design and implement more efficient telemedicine systems, ultimately reducing healthcare disparities between urban and rural areas. Theoretically, the study contributes to the academic understanding of telemedicine's role in healthcare systems, particularly in low-resource settings. It enriches the existing body of literature by offering empirical evidence on the impact of telemedicine on healthcare outcomes and service delivery in rural Nigeria, thus informing future research and theoretical frameworks on digital health interventions and their applicability in similar contexts globally.

1.7 Scope of the Study

The study will focus on investigating the impact of telemedicine specifically within rural communities in Nigeria, with a geographical scope centered on Konshisha Local Government in Benue State. The objectives are structured to achieve a comprehensive understanding of telemedicine accessibility, usage factors, and healthcare outcomes in this specific rural context. It aims to assess the accessibility of telemedicine services to rural populations, particularly in Konshisha, identifying factors that influence their utilization. Additionally, the study seeks to examine how telemedicine affects healthcare delivery and patient outcomes in rural Nigeria, contributing valuable insights into the practical implications and effectiveness of telemedicine interventions in improving healthcare access and outcomes in underserved rural areas like Konshisha.

1.8 Limitations of the study

Several limitations could affect the findings and generalizability of this study on telemedicine in rural communities in Konshisha Local Government, Benue State, Nigeria. Firstly, the study's geographical scope is limited to a specific locality, which may not fully represent the diverse healthcare challenges and telemedicine adoption patterns across all rural areas in Nigeria. Secondly, the study's reliance on self-reported data from healthcare providers and users may introduce response bias and inaccuracies in assessing telemedicine accessibility, usage factors, and healthcare outcomes. Thirdly, the study's timeframe and resources may constrain the depth and breadth of data collection and analysis, potentially limiting the comprehensiveness of findings.

1.9 Definition of Key terms

Telemedicine: The use of telecommunications technology to provide healthcare services remotely, facilitating medical consultations, diagnoses, and treatment plans without the need for in-person visits.

Rural Area: A rural area refers to a geographic region that is typically characterized by a low population density and is located outside urban centers or cities. Rural areas often have agricultural or natural landscapes, limited infrastructure compared to urban areas, and may face challenges in accessing essential services such as healthcare, education, and transportation.

Healthcare Outcomes: The results or effects of healthcare interventions on patients' health status and well-being, including measures of improvement or decline in health conditions, quality of life, and mortality rates.