Introduction: In recent years, there has been significant progress in the application of digital technology across various sectors, including health, and research on health technology has become a focal point for many researchers. Nigeria, in particular, has seen a substantial number of studies in this area. This scoping review aims to describe the advancements and current trends in digital health technology (DHT) research in Nigeria.

Methodology: The scoping review followed the Arksey and O’Malley methodology and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist. Using preset key terms related to DHT, literature was identified through searches of PubMed/MEDLINE, Google Scholar, Directory of Open Access Journals (DOAJ), and African Journals Online (AJOL) databases. The literature was screened based on inclusion and exclusion criteria to select relevant studies. Data from the included literature was extracted into Excel, and descriptive statistics were conducted using IBM SPSS 27.1 and Python 3.12.4.

Results: A total of 1840 studies were initially identified through electronic database searches and gray literature. After screening, 230 studies were included in the scoping review. The distribution of publication years increased dramatically from 2010 to 2024, with the lowest in 2012 (0.9%) and the highest in 2022 (15.2%). Most studies were cross-sectional (36.5%), followed by reviews (27.8%), qualitative studies (13.0%), interventional studies (7.8%), and mixed-method studies (4.3%). The main categories of health technology discussed included general DHT (25.7%), mobile health (mHealth) (23.9%), eHealth (12.2%), digital devices/tools (10.4%), telemedicine (7.4%), and health information systems (HISs) (6.5%).

Conclusion: Since 2010, Nigeria’s health technology research has expanded significantly in different areas. Despite this growth, practical application remains limited. To fully digitize the healthcare system, collaboration among the government, private sector, and stakeholders is essential to fund projects and train leaders for effective integration of health tech solutions in the Nigerian healthcare system.

Summary

In recent years, digital technology has made substantial progress across various sectors, including healthcare, and this has become a key area of research in many countries, including Nigeria. This scoping review aims to summarize advancements and current trends of digital health technology (DHT) research in Nigeria. By analyzing data from 230 studies conducted between 2010 and 2024, the review reveals a significant increase in research on digital health in Nigeria, particularly in areas like mobile health (mHealth), eHealth, and telemedicine. Despite this growth, the practical application of these technologies remains limited. The review underscores the need for collaboration among the government, private sector, and stakeholders to fully integrate digital solutions into the Nigerian healthcare system.

1. Introduction

Over recent decades, the rapid advancement of digital technology has instigated significant changes across nearly every aspect of human activity, including the health sector [1]. Digital health has emerged as a comprehensive term that includes electronically captured data, along with the associated technical and communication infrastructures and applications within the healthcare ecosystem. Groundbreaking advances in digital health are reshaping health, medicine, and biomedical science, redefining and reengineering the tools necessary for creating a healthier future [2]. Innovations such as cloud computing, artificial intelligence (AI), machine learning (ML), blockchain, digitally mediated diagnostics and treatment, telehealth, telehealth, mobile health (mhealth), eHealth, algorithmic medicine, and consumer-facing mhealth applications are now commonly employed in self-management, healthcare, and biomedical science. These developments hold the promise of facilitating earlier diagnoses and interventions, enhancing outcomes, and fostering more engaged patients [3].

The evolution of health technology has been a dynamic journey influenced by historical events, technological progress, and evolving healthcare practices. From the early use of telegraphy in healthcare in the 1700s [4] to the introduction of innovative mechanical thrombectomy devices for treating cerebrovascular disease in the mid-1990s [5], this journey has been marked by significant milestones. Over the centuries, advancements such as the stethoscope, X-ray, artificial kidney, and respirators have revolutionized patient care while also presenting new challenges for healthcare professionals and policymakers [6]. The recent surge in electronic systems and AI in medical care, driven by the COVID-19 crisis, underscores the ongoing tension between traditional medical practices and modernization efforts [7].

Even though the adoption of digital health technology (DHT) has been challenging in low- and middle-income countries, Nigeria has made notable progress in DHT, demonstrating potential for transformative innovations to improve healthcare delivery [8]. The country has leveraged mobile technology-based telemedicine to address gaps in healthcare services, particularly in underserved areas, using Nigeria’s communication satellite system for virtual telemedicine connections [9]. Efforts have also focused on implementing health information systems (HISs) to electronically store patient records, aiming to enhance system quality dimensions and improve healthcare delivery efficiency [10]. Additionally, there is a growing trend of using information technology systems in Nigeria, with a significant percentage of Internet users seeking health information online, highlighting a viable path for disseminating health information and improving healthcare services [11]. Moreover, the deployment of digital health insurance management systems has shown promise in expanding health insurance coverage, especially among vulnerable populations, underscoring the role of technology in achieving Universal Health Coverage in Nigeria and similar settings [12].

Various studies have explored individual aspects of DHT in Nigeria, such as telehealth, mHealth, eHealth, algorithmic medicine, mobile applications, cloud computing, AI, ML, blockchain, medical devices, and digitally mediated diagnostics and treatment. However, these studies often focus on isolated technologies, lacking an integrated approach that examines their combined impact, interplay, and potential synergies in addressing Nigeria’s healthcare challenges. This gap underscores the need for a broader perspective to evaluate the collective progress and identify holistic solutions. This scoping review aims to address this gap by describing the advancements and current trends in DHT research in Nigeria, providing a comprehensive analysis, and offering insightful recommendations for future directions to optimize healthcare delivery and outcomes.

This study is particularly important as it will shed light on Nigeria’s experience with digital health adoption, offering lessons for other similar low- and middle-income countries facing resource constraints. Understanding how DHT is being implemented in Nigeria will provide valuable insights into the successes and barriers that can inform regional and global strategies for scaling digital health initiatives. Focusing on Nigeria is key because it represents a dynamic and rapidly growing healthcare landscape within Africa, where DHTs have the potential to address longstanding healthcare challenges, including access, quality, and equity. With one of the largest populations on the continent, Nigeria serves as a vital case study to understand how digital health innovations can be leveraged to transform healthcare in resource-limited settings. By analyzing Nigeria’s progress, this review contributes to identifying scalable models and actionable solutions applicable to other low- and middle-income countries.

2. Methodology

2.1. Methods and Reporting

The current scoping review was conducted following the Arksey and O’Malley [13] scoping review methodology, which includes five essential steps: (1) defining research questions, (2) identifying relevant literature, (3) selecting publications, (4) data extraction, and (5) data analysis, summary, and reporting of results. The reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) checklist [14].

2.1.1. Research Questions

The main research question was, “What are current trends and advancements of digital health technology in Nigeria?” From the central question, the following subquestions were asked:

1.
How many and what types of studies/literature on DHT in Nigeria?
2.
What types of digital technology are being applied in the health sector in Nigeria?

2.1.2. Literature Identification

A thorough search was conducted using PubMed/MEDLINE, Google Scholar, Directory of Open Access Journals (DOAJ), and African Journals Online (AJOL) to identify studies related to DHT in Nigeria. The searches were conducted utilizing preset key terms: “health technology,” “digital health technology,” “digital health,” “mHealth,” “eHealth,” “mobile health,” “telemedicine,” “health informatics,” “health information systems,” “artificial intelligence,” “machine learning,” “health mobile apps,” “digital devices,” and “Nigeria.” Manual Google searches were also performed to uncover additional relevant literature. Furthermore, organizational and institutional documents on the subject were reviewed to ensure a comprehensive collection of sources. The literature search was restricted to publications from 2010 onward to ensure the inclusion of more recent and updated trends in DHT research in Nigeria.

2.2. Literature Selection

The collected literature was imported into Rayyan software for duplication removal and screened based on preset inclusion and exclusion criteria (Table 1). Two reviewers conducted the screening, and any disagreements were resolved through discussion. If the issue could not be resolved, a third party was consulted for further resolution.

Table 1. Inclusion and exclusion criteria.

Criterion	Included	Excluded
Study/literature design	All	None
Year of publication	2010–2024	Before 2010
Outcome of interest	Digital health technology	Other things out of the scope of digital health technology
Accessibility	Abstract and full text assessable	Abstract and full text are inaccessible Abstract accessible, full text inaccessible
Language	English	Other languages besides English
Country	Nigeria	Other countries/regions besides Nigeria

2.3. Data Extraction

An Excel spreadsheet was used to extract relevant data from the included literature. The extracted information included various details such as the title, author ID, year of publication, study design or type of literature, specific area of DHT, and the health sector involved in order to facilitate the organization and analysis of the data, allowing for a comprehensive overview of the advancements and trends in DHT as presented in the reviewed studies.

2.3.1. Data Analysis, Summarizing, and Reporting

Descriptive statistics were used to outline the current trends and developments in DHT research in Nigeria, and they were conducted using IBM SPSS version 27.1 and Python 3.12.4. In addition, scholarly publications were categorized and discussed under key themes, including general DHT, mHealth, eHealth, digital devices/tools, telemedicine, HISs, mobile apps, AI, ML, assisted reproductive technology (ART), and other relevant topics. The included literature was independently coded and categorized into main themes by two individuals, with any disagreements resolved through discussion, while unresolved issues were referred to a third party for adjudication.

3. Results

3.1. Overview of Study Selection

A total of 1840 studies were initially identified through electronic database searches and gray literature. After removing duplicates, 1511 studies remained for screening. Based on the titles and abstracts, 1162 studies were excluded due to lack of relevance, leaving 349 studies for full-text assessment. Of these, 119 studies were further excluded: 68 did not address the outcome of interest, 24 were focused on health technology not in Nigeria, 12 were published before 2010, and 15 were excluded for other reasons. Ultimately, 230 studies were included in the current scoping review (Figure 1).

Details are in the caption following the image — **Figure 1**
Open in figure viewer PowerPoint

PIRSMA flowchart diagram of the study selection. PIRSMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

3.2. Advancements and Current Trends of Digital Heath Technology in Nigeria

3.2.1. Year of Publication

Among the 230 literature sources included, the distribution of publication years is as follows: 23 (10.0%) were published in 2024, 30 (13.0%) in 2023, and 35 (15.2%) in 2022. Publications from 2021 and 2020 comprised 20 (8.7%) and 31 (13.5%), respectively. The number of studies decreased for earlier years, with 11 (4.8%) published in 2019, 15 (6.5%) in 2018, and 12 (5.2%) in 2017. Further, 11 (4.8%) were published in 2016, 16 (7.0%) in 2015, 8 (3.5%) each in 2014 and 2013, 2 (0.9%) in 2012, 5 (2.2%) in 2011, and 3 (1.3%) in 2010 (Figure 2). This distribution indicates a significant increase in recent publications, reflecting a rising focus and advancements in the research area.

3.2.2. Types and Categories Included Studies

The current scoping review included different types of studies/literature. 84 (36.5%) were cross-sectional studies, and 64 (27.8%) were reviewed. Qualitative studies accounted for 30 (13.0%), while interventional studies made up 18 (7.8%). Table 2 shows all types of designs of literature included in this scoping review. Regarding the categories of DHTs discussed, 59 (25.7%) focused on general DHT and 55 (23.9%) on mHealth. eHealth was discussed in 28 (12.2%) studies, while 24 (10.4%) examined digital devices/tools in healthcare. Telemedicine was the subject of 17 (7.4%) studies, and HISs were discussed in 15 (6.5%) studies (Table 3).

Table 2. Designs of studies/literature included in the scoping review.

Study design	Frequency	Percent	Valid percent	Cumulative percent
Cross-sectional study	84	36.5	36.5	36.5
Qualitative study	30	13.0	13.0	49.6
Quantitative study	1	0.4	0.4	50.0
RCT	6	2.6	2.6	52.6
Review	64	27.8	27.8	80.4
Interventional study	18	7.8	7.8	88.3
Retrospective study	2	0.9	0.9	89.1
Prospective study	4	1.7	1.7	90.9
Modeling study	4	1.7	1.7	92.6
Spatial analysis	1	0.4	0.4	93.0
Mixed methodology	10	4.3	4.3	97.4
ISF	1	0.4	0.4	97.8
Letter to the editor	1	0.4	0.4	98.3
Report	4	1.7	1.7	100.0
Total	230	100.0	100.0	—

Table 3. Categories of digital health technology discussed in the included literature.

Category	Frequency	Percent	Valid percent	Cumulative percent
General DHT	59	25.7	25.7	25.7
mHealth	55	23.9	23.9	49.6
eHealth	28	12.2	12.2	61.7
Telemedicine	17	7.4	7.4	69.1
Robotics	1	0.4	0.4	69.6
Digital devices/tools	24	10.4	10.4	80.0
Health information system	15	6.5	6.5	86.5
Mobile app	6	2.6	2.6	89.1
ART	5	2.2	2.2	91.3
Blockchain	2	0.9	0.9	92.2
Cloud computing	1	0.4	0.4	92.6
AI and ML	6	2.6	2.6	95.2
IoT	4	1.7	1.7	97.0
Health informatics	7	3.0	3.0	100.0
Total	230	100.0	100.0	—

Abbreviations: AI, artificial intelligence; ART, assisted reproductive technology; DHT, digital health technology; IoT, Internet of things; mHealth, mobile health; ML, machine learning.

4. Discussion

From 2010 to 2024, Nigeria’s research in DHT has surged, highlighting significant engagement with the Internet of all things (IoAT). These research studies focused on general DHTs, mHealth, and eHealth, health digital devices, and telemedicine. Additionally, Innovations in information systems, health informatics, and mobile applications are prominent, alongside the integration of AI and ML to enhance healthcare delivery. Such advancements in health technology research make Nigeria a key player in the global digital health arena, leveraging IoAT to improve healthcare access and quality (i–x).

i.
General DHT
DHT research in Nigeria is diverse, and researchers have focused on its adoption, utilization, and impacts across healthcare settings. The main areas include using health technology to enhance health worker’s performance [15], implementation of information and communication technology (ICT) in the country’s healthcare system [16–18], investigating ICT knowledge and use among healthcare providers, and how it can be used as digital interventions to fight depression in youth [19]. Other areas include smart healthcare delivery systems, capacity-building among digital health leaders, applying digital technology in extending maternal health services to rural areas and enhancing immunization with innovative technology [20].
ii.
mHealth
mHealth has also been a key focus area for health technology researchers in Nigeria. Studies on mHealth have focused on exploring the balance between the Nigerian health system and mHealth, proposing frameworks for mhealth management [21], integration of mHealth into routine immunization services [22], and understanding gender dynamics in mHealth for enhancing maternal healthcare in rural areas [23]. Other studies have focused on identifying factors affecting mHealth adoption among healthcare workers and their perceptions on adopting mHealth in public health facilities [24, 25] role of mHealth interventions in adolescent sexual and reproductive health [26], knowledge and use of mHealth among doctors, nurses, and pregnant women [27], and privacy protection regarding the use of mHealth in healthcare delivery in Nigeria [28]. Collectively, health technology researchers in Nigeria have sought to underscore mHealth’s potential and how it can be applied to enhance the healthcare sector in Nigeria.
iii.
eHealth
Studies on eHealth in Nigeria have been grounded on achieving sustainable eHealth with ICTs, especially in rural communities [29, 30]. The COVID-19 pandemic has also increased the interest of researchers to understand the demand of and how electronic health services can be used to provide healthcare services remotely [31]. Other studies on eHealth have investigated the knowledge, perception, and utilization of eHealth among health workers in Nigeria [32] and cost analysis of innovative eHealth programs to understand the economic benefits and the necessity to address infrastructural gaps for successful implementation of eHealth in the country [33].
iv.
Telemedicine
In telemedicine, studies emphasized the current status, challenges, and future prospects of telemedicine, highlighting the evolving landscape of this technology in the country [34]. On the other hand, other studies explored factors influencing the adoption of telemedicine in Nigerian healthcare [35], specifically the use of toll-free mobile phone calls to monitor adverse drug reactions, illustrating the potential of telecommunication in pharmacovigilance [36] and using mobile telephone support for managing depression [37], while other scholars emphasized the legal side of the use of telemedicine in Nigeria [38]. These studies collectively indicate growing research on the integration of telemedicine into Nigeria’s healthcare system to enhance access to healthcare and improve patient outcomes despite ongoing challenges.
v.
Health digital devices/tools
Recent studies highlight a significant trend in Nigeria toward integrating digital devices and tools into healthcare. Studies on innovations such as a smart malaria diagnostic device and mhealth tools for COVID-19 surveillance and next pandemic preparedness are the same illustrations [39, 40]. Portable digital X-ray machines for the diagnosis of tuberculosis are other examples of health digital devices studied for enhancing diagnostic capabilities, especially in rural areas [41]. Additionally, digital tools for contraceptive use and optimizing data collection for mass health campaigns have also been studied [42, 43]. These advancements reflect a broader effort to leverage digital health devices to enhance healthcare delivery and address public health challenges in Nigeria.
vi.
HISs and health informatics
Several studies have discussed significant advancements in HISs and health informatics in Nigeria. For instance, Afolaranmi et al. [44] and Adedeji et al. [45] studied on the adoption and implementation of electronic medical records (EMRs) in Nigerian primary care, while others examined the importance of mobile and web-based HISs for smooth healthcare delivery [46–48]. Other studies on the same area explored the impact of training healthcare workers on effective data management practices, emphasizing the need for comprehensive training to optimize HIS utilization [49] and the role of digital health insurance systems in expanding healthcare coverage in Nigeria [12]. These efforts underscore the evolving landscape of HISs and health informatics research in Nigeria to achieve efficient and sustainable healthcare delivery.
vii.
Mobile apps
Mobile apps and diverse aspects of their use and impact in healthcare have also been considerably studied in Nigeria. For example, Otu et al. [50] focused on combating COVID-19 using the InStrat COVID-19 tutorial app, as well as training health workers to use the app, while others explored the primary healthcare workers’ initial perceptions regarding the IMPACT app [51], the potential of mobile phone apps use in managing diabetes [52], the challenges and prospects of mhealth apps for personal healthcare, as well as the knowledge and attitude towards their usage [53, 54].
viii.
AI and ML
AI and ML research are trending in Nigeria. Some studies on the topic include Artificial Neural Network Prediction Model for Maternal Health Services Quality in Nigeria [55], the use of satellite imagery technology in public health to analyze site catchment areas for assessing poliovirus circulation in Nigeria [56], and predictive analytics using ML to identify ART clients at high risk of treatment interruption in Nigeria [57]. Other studies explored the knowledge and perception of healthcare workers toward adopting AI in healthcare service delivery in Nigeria [58, 59], while others navigated the legal and ethical aspects of AI to enhance patient safety in Nigeria [60].
ix.
ART
According to the CDC, ART refers to all fertility treatments involving the manipulation of eggs or embryos. Generally, ART procedures consist of surgically extracting eggs from a woman’s ovaries, fertilizing them with sperm in a lab, and then placing them back into the woman’s body or donating them to another woman. These procedures do not encompass treatments that involve only sperm handling, such as intrauterine (artificial) insemination, or treatments where a woman takes medication merely to stimulate egg production without the intention of retrieving the eggs [61].
This technology has been studied by different researchers in Nigeria in recent years. For instance, Fabamwo and Akinola [62] explored the understanding and acceptability of ART among infertile women in urban Lagos, Nigeria, where only 51.8% were aware of ART, while most having poor knowledge. Other studies on ART include a 10-year cross-sectional review of ART at the Institute of Fertility Medicine, Lagos State University Teaching Hospital [63], examining female clients’ experiences with ART [64], ethical issues in ART practice [65], and the perception of key ethical concerns by providers and clients in Nigeria [66].
x.
Others
Besides the main topics on health technology research in Nigeria, as discussed above, other areas where few studies have been conducted include robotics, cloud computing, blockchain, and the Internet of things (IoT). For example, Akogun studied on the use of robotic health assistants in managing fevers among nomadic populations [67], while Desmennu, Ikhu-Omoregbe, and Ayo [68] examined the use of cloud computing for enhancing data management in Nigerian teaching hospitals. Olukayode et al. [69] and Wazhi et al. [70] studied the blockchain technology’s potential for record-keeping, emphasizing its role in strengthening the healthcare system. Furthermore, studies on IoT include the use of IoT-embedded technologies for tracking biomedical equipment, integration of the IoT and big data analytics for revolutionizing healthcare, and use of the Internet of healthcare things (IoHT) in predictive surveillance of infectious diseases in Nigeria [71–73].

5. Strategic Implications of Adoption of Digital Health in Nigeria

The current review underscores Nigeria’s remarkable progress in digital health research and its adoption of innovative technologies across various healthcare domains. The gained insights reveal significant implications for public health and future research priorities. First, the widespread adoption of mHealth, telemedicine, and digital health devices has the potential to address critical gaps in healthcare access, particularly in underserved rural areas. For example, mHealth solutions can bridge geographic barriers and improve maternal and child health outcomes, while digital health tools such as portable diagnostic devices could transform healthcare delivery in resource-limited settings. The consistent focus on AI and ML highlights the country’s growing ambition to use predictive analytics and automation to improve patient care and system efficiency. These advancements demonstrate the pivotal role digital health can play in achieving universal health coverage and reducing health disparities in Nigeria.

Despite these promising developments, the findings highlight persistent challenges, including limited infrastructure, gaps in healthcare worker training, and barriers to scaling up digital health solutions nationwide. Addressing these issues should be a public health priority, with emphasis on improving broadband connectivity, investing in workforce capacity-building, and fostering public–private partnerships to scale innovative solutions. Future research should explore the impact of these tools on health outcomes and cost-effectiveness in diverse contexts while addressing ethical and legal considerations, particularly in AI and telemedicine. These priorities are essential to ensure that digital health tools not only enhance healthcare delivery but also contribute meaningfully to sustainable and equitable health systems in Nigeria.

6. Recommendations and Way Forward

The current scoping review indicates that health technology research in Nigeria has evolved significantly, with publications in this area increasing dramatically since 2010. However, most studies on various categories of health technology in Nigeria are cross-sectional, primarily assessing the knowledge, attitudes, and perceptions of different segments of the Nigerian population, including the general public and medical personnel. In addition to cross-sectional studies, there are reviews discussing the theoretical frameworks for applying health technology to advance healthcare service delivery in the country. Interventional studies and clinical trials that practically evaluate the benefits of health technology in Nigerian healthcare are scarce, highlighting the need for a shift from theoretical to practical paradigms.

To achieve practical application of health technology in Nigerian healthcare, the country must design and implement health technology interventions that can effectively transform the healthcare system. This requires a collective effort from the government, private sector, and stakeholders to fund DHT research and projects. Additionally, it is crucial to train health tech leaders, including bioinformaticians, developers, and other specialists, to oversee the development and integration of various health tech solutions within the country’s healthcare sector.

7. Study Limitation

Although this scoping review clearly illustrates the trend of health technology research in Nigeria since 2010, it is not without limitations. First, the search was limited to PubMed/MEDLINE, Google Scholar, DOAJ, and AJOL databases, potentially omitting relevant studies from other databases not accessed. Second, the quality assessment of the included studies was not explicitly detailed, which may have led to the inclusion of lower-quality papers. Despite these limitations, the current scoping review serves as a valuable resource for understanding recent achievements and trends in health technology research in Nigeria, providing insight into the evolving landscape and highlighting areas for future investigation and development.

8. Conclusion

Since 2010, Nigeria has witnessed an increase in health technology research across various fields, including general DHTs, mHealth, eHealth, digital health devices, telemedicine, HISs, health informatics, mobile applications, AI, and the IoAT to improve healthcare access and quality. Despite this increase, a significant proportion of these studies focus on theoretical frameworks that need to be applied and implemented to digitize Nigeria’s healthcare system. Achieving this necessitates a collaborative effort from the government, private sector, and stakeholders to finance DHT research and projects, as well as to train health tech leaders to manage the development and integration of diverse health tech solutions within the country’s healthcare sector.

Nomenclature

DOAJ:: Directory of Open Access Journals
AJOL:: African Journals Online
eHealth:: The delivery of healthcare services and information through electronic means, including internet-based tools and digital systems
mHealth:: The use of mobile devices and applications to support medical and public health practices
Telemedicine:: The remote diagnosis and treatment of patients using telecommunications technology
ART:: Assisted reproductive technology
AI:: Artificial intelligence
ML:: Machine learning
IoAT:: Internet of all things
DHT:: Digital health technology.

Ethics Statement

No ethical approval was needed since there was no direct involvement of human or animal subjects.

Conflicts of Interest

The authors declare no conflicts of interest.

Funding

No funding was received for this manuscript.

Acknowledgments

The authors have nothing to report.

Open Research

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Adoption of Digital Health Technology in Nigeria: A Scoping Review of Current Trends and Future Directions

Abstract

1. Introduction