Barriers and facilitators of provision of telemedicine in Nigeria: A systematic review.

Healthcare access remains a challenge in developing countries and could be a drawback to the attainment of Objective 3 of the Sustainable Development Goals. Digital interventions such as telemedicine have been identified as an effective tool to improve healthcare access. However, evidence suggests that the impact of telemedicine is not uniform globally due to variances in barriers and facilitators. Thus, we conducted a systematic review to identify the barriers and facilitators of telemedicine in Nigeria. The systematic review was pre-registered on PROSPERO (Identification Number: CRD42024609405). Search was conducted on PubMed, Scopus, and the Cumulative Index of Nursing and Allied Health Literature databases. We included studies that reported on the estimates of barriers and facilitators of telemedicine in Nigeria as well as the factors associated with telemedicine implementation, provision, or operation in Nigeria. The outcome was the reportage of barriers and facilitators of telemedicine in Nigeria. A total of 384 studies were identified from the search. After the application of eligibility criteria and deletion of duplicates, 29 studies were included in the review. The most reported barriers were technical and institutional-related while the most reported facilitators were human-resource-related. Technical barriers frequently reported were power outages, poor internet connectivity, and paucity of health professionals with technical expertise while institutional barriers were lack of regulation and poor organizational policies. Formal telemedicine training and education were the most reported human resource facilitators while the use of low-tech educational networks and internet accessibility were the most reported technical facilitators. Findings from this review suggest that technical barriers are a challenge to adopting telemedicine in Nigeria. Evidence shows that education and training are critical in addressing these technical challenges. Thus, this review provides a background for interventions towards the effective implementation of telemedicine in Nigeria.