Barriers to the Adoption of Electronic Health Records in Nigerian Healthcare Systems: Analysing Infrastructure, Training and Policy Challenges

Abstract

Electronic Health Records (EHRs) have transformed healthcare by digitising patient data, improving efficiency, and reducing costs. While 90% of U.S. physicians use EHRs, adoption in Nigeria remains as low as 18%, despite evidence that EHRs reduce medical errors and enhance care coordination. Nigeria’s doctor-to-patient ratio of roughly 1:9,000, combined with a high disease burden, makes limited EHR adoption especially likely to worsen healthcare disparities. This perspective article examines key barriers to EHR adoption in Nigeria, focusing on infrastructure limitations, workforce training deficits, and policy gaps. Infrastructure challenges include unreliable electricity (60.5% access) and limited internet penetration (40%), making digital systems difficult to sustain. In addition, digital literacy among healthcare professionals is uneven, with some regions reporting only 26.7% of workers possessing basic computer proficiency. The lack of structured EHR training contributes to resistance, as providers struggle with workflow disruptions when transitioning from paper-based systems. Policy and regulatory weaknesses further hinder adoption. Fragmented guidelines, weak data privacy laws, and limited political commitment undermine trust and scalability. Financial constraints are another major barrier, as annual EHR costs exceed $10,000 per practice, making implementation unaffordable for many facilities. To overcome these challenges, Nigeria must invest in alternative energy sources, offline-capable EHR systems, and sustainable funding models through public-private partnerships. Integrating EHR training into medical curricula and professional development programmes can help ease resistance. In addition, standardised policies, financial incentives, and robust data protection laws are crucial for long-term adoption. Countries such as Rwanda and Kenya offer scalable models – Rwanda successfully integrated EHRs into its human immunodeficiency virus and cancer programmes, while Kenya upgraded hospital IT systems through collaborative initiatives. By following these examples and prioritising strong government leadership, Nigeria can enhance EHR adoption and improve healthcare efficiency.

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