Across Africa, digital health has become a cornerstone of health system strengthening. Governments, development partners, researchers, and technology innovators have invested heavily in digital solutions ranging from electronic medical records and artificial intelligence (AI)-powered clinical decision-support systems to telemedicine platforms, digital referral systems, mobile health applications, and remote patient monitoring technologies. Together, these innovations promise to improve service delivery, strengthen health information systems, expand access to healthcare, and enhance the quality, efficiency, and responsiveness of health services.[1]
Yet one question remains difficult to answer. If digital innovation is accelerating, why are health outcomes improving so slowly?
Nigeria offers a compelling case study. With over 180 million active mobile subscriptions, the country holds enormous potential to leverage mobile technologies for health service delivery and health system strengthening.[2] The Federal Ministry of Health has reinforced this direction through its National Digital Health Strategy (2019–2024), which prioritises governance, interoperability, and stronger health information systems as the foundation for digital transformation.[3] Despite these investments, improvements in maternal and newborn health outcomes have not kept pace.
Nigeria continues to bear one of the highest maternal and newborn mortality burdens in sub-Saharan Africa. The maternal mortality ratio remains high at over 1,000 deaths per 100,000 live births, with a lifetime risk of maternal death of approximately 1 in 19 women, compared with about 1 in 4,900 women in high-income countries.[4] Newborn outcomes tell a similarly sobering story. Neonatal mortality remains approximately 41 deaths per 1,000 live births, meaning that roughly one in every 25 Nigerian infants does not survive the first 28 days of life, a rate 10 times higher than in high-income countries such as Canada and Austria.[5]
Perhaps the answer does not lie in building the next digital innovation, but in scaling the ones we already have.
A Landscape Rich in Innovation
To better understand Nigeria’s digital maternal and newborn health ecosystem, ACE Strategy & Consults conducted a national landscape analysis of digital interventions implemented between 2012 and 2025.
The review identified 21 digital maternal and newborn health interventions, ranging from SMS reminder systems and mobile applications to electronic medical records, emergency referral platforms, digital clinical decision-support tools, and remote monitoring technologies. Together, they represent more than a decade of innovation and investment aimed at improving maternal and newborn health across the country.[6]
Our findings, however, revealed a striking paradox.
Of the ten interventions with sufficient documentation to assess scalability, none had achieved sustained scale, highlighting the persistent gap between digital health innovation and system-wide implementation in maternal and newborn health. This was not because the interventions failed. On the contrary, our review found that they were effective, adopted by health workers, and accepted by communities. Many were intentionally designed for low-resource settings, incorporating offline functionality, SMS, voice messaging, and other features tailored to Nigeria’s realities.5
The challenge was never the technology. It was creating the systems needed to sustain, integrate, and scale it.
Most platforms operated independently, with limited interoperability with national systems such as DHIS2. Nearly all relied heavily on donor financing, with few documented pathways into government budgets or long-term financing mechanisms. Institutional ownership remained weak, and successful pilots frequently struggled to transition into routine health service delivery.6 Collectively, these findings point to a clear conclusion: Nigeria has not suffered from a shortage of digital innovations, but from fragmented implementation.
That same conclusion emerged at the 6th African Digital Health Summit (ADHS 2026) in Abuja. Under the theme “From Pilots to Scale: Growing Africa’s Digital Health Innovation Ecosystem,” speakers repeatedly challenged Africa’s dependence on disconnected digital health projects. In his opening keynote, Dr Ahmed Ogwell, Chief Executive Officer of VillageReach, argued that the continent’s greatest digital health challenge is no longer innovation but implementation, citing fragmented financing, weak governance, and poor interoperability as the principal barriers to scale.
Together, the evidence points to a broader conclusion: Africa’s digital health challenge is no longer generating new innovations, but integrating, institutionalising, and scaling those that already exist.
The Next Breakthrough Is Connecting Systems
The evidence points in a different direction. For years, digital health conversations have centred on discovering the next breakthrough technology. Perhaps we have been asking the wrong question.
Instead of asking, “What should we build next?” perhaps the more important question is, “How do we scale what already works? How do we ensure digital innovations reach the mothers and newborns who need them most?”
Interoperability is often treated as a technical feature. In reality, it is the foundation for scale. It determines whether health workers enter patient information once or several times, whether policymakers rely on complete or fragmented data, and whether governments own their digital systems or remain dependent on disconnected donor-funded projects. Ultimately, it determines whether innovations become embedded within the health system or remain isolated pilots.
Scaling Maternal and Newborn Health Digital Innovations Starts with Interoperability
If Nigeria is to realise the full potential of digital technologies for maternal and newborn survival, future investments must be designed for scale not simply for innovation.
Success should no longer be measured by the number of new platforms launched, but by how many proven innovations become institutionalised within government systems. This requires:
- Embedding interoperability from the outset
- Planning for domestic financing rather than perpetual donor support
- Involving government from programme design
- Strengthening implementation research to generate evidence on sustainability, cost, and system integration
The future of digital health will not be written by the next pilot project. It will be written by countries that build systems capable of connecting innovation, financing, governance, and people into one resilient digital ecosystem.
Nigeria has already demonstrated that it can innovate. The next challenge is institutionalisation. As echoed during ADHS 2026, Nigeria’s Honourable Minister of State for Health and Social Welfare Dr Iziaq Adekunle Salako, called for greater investment in integrated, government-owned digital health infrastructure capable of supporting sustainable service delivery.
ACE Strategy & Consults remains committed to advancing this agenda through research, implementation support, and partnerships that strengthen health systems across Nigeria.
Ultimately, the true measure of digital transformation in maternal and newborn health is not the number of technologies a country develops, it is whether every woman, every newborn, and every community regardless of where they live can benefit from those innovations through equitable, routine, high-quality healthcare.
Author Bio
Aishat Kadir is a Research Assistant at ACE Strategy and Consult Ltd, where she supports evidence generation and research across maternal and newborn health programmes in Nigeria.
References
- Egwudo AE, Jegede AO, Oyeniyi TA, Ezekwelu NJ, Abdu-Aguye SN, Okwuraiwe AP, Onyeaghala CA, Ozoude TO, Suleiman MO, Aziken GO, Okeke OP, Abodunrin OR, Eleje GU, Akinsolu FT, Sobande OO. Integrating digital health technologies into the healthcare system: Challenges and opportunities in Nigeria. PLOS Digit Health. 2025 Jul 24;4(7):e0000928. doi: 10.1371/journal.pdig.0000928. PMID: 40705785; PMCID: PMC12289021.
- Nigerian Communications Commission. (n.d.). Subscriber statistics. Retrieved July 18, 2026, from https://ncc.gov.ng/market-data-reports/subscriber-statistics
- Federal Ministry of Health and Social Welfare. National Enterprise Architecture for Digital Health. Abuja (Nigeria): Federal Ministry of Health and Social Welfare; 2024. Available from: https://771a986e-0804-495e-808e-d67ed0887f9f.filesusr.com/ugd/83cfc4_4794d1290542477c9ee9ed19350b292f.pdf
- EQUAL. (2023). Nigeria: Maternal and Newborn Health Country Profile. Healthy Newborn Network. Updated March 2024. https://healthynewbornnetwork.org/hnn-content/uploads/nigeria-country-profile_March-2023-2.pdf
- Federal Ministry of Health and Social Welfare, National Population Commission (NPC), & ICF. (2024). Nigeria Demographic and Health Survey 2023–24: Key indicators report. https://dhsprogram.com/pubs/pdf/PR157/PR157.pdf
- Ekpin V, Ibrahim A, Precious C, Kadir A, Umar H, Junaidu R, Idedia G, Olanrewaju R, Alao U, Akpan P, West B, Ukeje D, Ikeoluwa A, Adegoke Z, Adewole T, Okagbue HI, Atobatele S, Olajire A. Landscape Analysis of Digital Health Interventions for Maternal and Newborn Health in Nigeria: Evidence to Inform Scalable Implementation. Manuscript under review at Pan African Medical Journal; 2026.
[1] Egwudo AE, Jegede AO, Oyeniyi TA, Ezekwelu NJ, Abdu-Aguye SN, Okwuraiwe AP, Onyeaghala CA, Ozoude TO, Suleiman MO, Aziken GO, Okeke OP, Abodunrin OR, Eleje GU, Akinsolu FT, Sobande OO. Integrating digital health technologies into the healthcare system: Challenges and opportunities in Nigeria. PLOS Digit Health. 2025 Jul 24;4(7):e0000928. doi: 10.1371/journal.pdig.0000928. PMID: 40705785; PMCID: PMC12289021.
[2] Nigerian Communications Commission. (n.d.). Subscriber statistics. Retrieved July 18, 2026, from https://ncc.gov.ng/market-data-reports/subscriber-statistics
[3] Federal Ministry of Health and Social Welfare. National Enterprise Architecture for Digital Health. Abuja (Nigeria): Federal Ministry of Health and Social Welfare; 2024. Available from: https://771a986e-0804-495e-808e-d67ed0887f9f.filesusr.com/ugd/83cfc4_4794d1290542477c9ee9ed19350b292f.pdf
[4] EQUAL. (2023). Nigeria: Maternal and Newborn Health Country Profile. Healthy Newborn Network. Updated March 2024. https://healthynewbornnetwork.org/hnn-content/uploads/nigeria-country-profile_March-2023-2.pdf
[5] Federal Ministry of Health and Social Welfare, National Population Commission (NPC), & ICF. (2024). Nigeria Demographic and Health Survey 2023–24: Key indicators report. https://dhsprogram.com/pubs/pdf/PR157/PR157.pdf
[6] Ekpin V, Ibrahim A, Precious C, Kadir A, Umar H, Junaidu R, Idedia G, Olanrewaju R, Alao U, Akpan P, West B, Ukeje D, Ikeoluwa A, Adegoke Z, Adewole T, Okagbue HI, Atobatele S, Olajire A. Landscape Analysis of Digital Health Interventions for Maternal and Newborn Health in Nigeria: Evidence to Inform Scalable Implementation. Manuscript under review at Pan African Medical Journal; 2026.