Integration of digital health into pharmacy education in Nigeria: Challenges and recommendations for national adoption

Abstract

Digital health offers pharmacists the opportunities to enhance patient outcomes and transform healthcare services. Thus, its integration into the pharmacy curriculum and training programmes is highly essential for the dynamic role of pharmacists, in addition to the technical components learnt from their pharmacy institutions. Pharmacy education in Nigeria has evolved significantly over the decades, however, several barriers still challenge the integration of digital health. These challenges include insufficient infrastructure, rigid curricula, weak collaboration with digital health stakeholders, and inadequate technology adoption, among others. In this commentary, we highlight the significance of digital technologies in pharmacy practice and existing challenges to their integration in Nigeria's pharmacy education. We further propose a practical and strategic approach involving multiple relevant stakeholders to ensure pharmacy graduates in Nigeria are well-equipped for pharmacy practice in the current digital era.

Digital health, a term that describes the intersection of health and information and communication technology (ICT), is gradually becoming an integrated part of healthcare practice. ¹ It includes concepts such as mobile health (mHealth), Electronic Health Records, and telehealth. ¹ Digital health holds considerable potential, which can be fully realised only if future healthcare workforces are trained to be comfortable and competent in its use. ² Digital health-integrated education strengthens training systems across health professions, and also prepares graduates to practice in a digital era with a technologically advanced global patient population.^3,4

Technological advancements have continued to revolutionise the healthcare sector by providing enhanced medical services access, widened healthcare scope, cost-effective treatments and improved patient engagement. ⁵ However, just as the healthcare sector is advancing technologically, healthcare professionals, especially pharmacists, must evolve their practices to gain a deeper understanding of digital health. As medication experts and one of the most accessible health care providers, pharmacists can leverage digital health to improve healthcare outcomes such as medication adherence, patient engagement and therapy optimisation.^4,6,7 It can also be leveraged to support long-term patient management and engage patients to be enlightened, active participants in their care. ⁸

The incorporation of digital health into the pharmacy curriculum is highly essential for the dynamic role of pharmacists. As such, pharmacy students need to be taught how to incorporate digital health tools like dispensing software, remote monitoring tools, and other emerging innovations into pharmaceutical care in addition to the technical components learnt from their pharmacy institutions.^9,10 Educational delivery can be synchronous (such as live teleconsultations), asynchronous (such as recorded modules), or hybrid. Ultimately, equipping students with these trainings ensures they can integrate appropriate digital tools into pharmaceutical care and adapt to evolving practice needs.

The use of the internet and gamification, ⁶ in addition to telehealth, ⁷ has been established in both undergraduate and postgraduate teaching for health professions, such as pharmacists, for a long time. ¹¹ Additionally, digital technologies have become increasingly used in pharmacy education, particularly following the coronavirus disease 2019 (COVID-19) pandemic. ¹² This is evident as many pharmacy courses, like those at the Department of Pharmacy at the University of Malta, shifted to a remote style (online and without in-person interactions) or boosted their use of technology because of the pandemic's health restrictions. ¹³

Pharmacy education in Nigeria has also evolved significantly over the decades, aligning with global trends to produce competent pharmacists capable of delivering pharmaceutical care and contributing to healthcare systems.^14,15 The Pharmacy Council of Nigeria (PCN) regulates the accreditation of pharmacy programmes and determines the standard of knowledge and skills of pharmacists-in-training. ¹⁵ However, unlike other nations, there is currently no evidence of the formal integration of digital health in pharmacy education in Nigeria. Without reforms to address this gap, Nigerian pharmacy graduates risk being unprepared to meet the digital healthcare revolution affecting global medical practice. ¹⁶ Therefore, there is an immediate necessity to integrate digital health training into the Nigerian pharmacy education system.

This necessity is supported by studies that reveal the potential of digital health integration to improve educational outcomes and better practice readiness in both high- and low-resource contexts.^17,18 Digital health integration also ensures compliance with international quality standards, such as the International Pharmaceutical Federation's Development Goal 20, which supports digital competency in pharmacy personnel. ¹⁶ The full benefits of digital health in Nigeria are yet to be realised due to challenges in the sector, some of which include inadequate resource and infrastructure investments, high cost of scaling-up, and weak coordination. ¹ These challenges also translate to hinder the integration of digital health in pharmacy education. Insufficient infrastructure, limited faculty expertise, rigid curricula, weak collaboration with digital health stakeholders, inadequate technology adoption, regulatory misalignment and insufficient funding are all institutional challenges in the pharmacy education system. ¹⁴ Educational disparities also persist, with some universities lacking modern laboratory equipment and essential pharmaceuticals for hands-on training. ¹⁵

However, despite current barriers to digital health integration, there are emerging examples from Nigeria and other African contexts that demonstrate feasibility and potential. For example, studies have reported both online and blended learning in Nigerian pharmacy schools during the COVID-19 pandemic. ¹⁹ Similarly, a South African study also demonstrated potential for mHealth and e-learning integration in health sciences curricula, despite structural limitations. These initiatives demonstrate the potential for a national adoption of digital health in pharmacy education in Nigeria, provided existing barriers are addressed.

To tackle the challenges, a strategic approach involving multiple stakeholders needs to be established. Regarding insufficient infrastructure, public–private partnerships or donor grants, such as collaboration with telecommunications companies to subsidise campus internet or partnering with global health funders to equip e-learning labs, are necessary. Pharmacy schools should also prioritise investment in robust ICT infrastructure and establish minimum IT standards linked to accreditation to incentivise infrastructure upgrades.

A national task force that brings together representatives from the PCN, faculties of pharmacy, digital health experts, and Ministries of Health and Education, and other relevant stakeholders, should be established. This task force will be responsible for establishing and implementing a standardised curriculum that includes digital health in pharmacy training. The PCN should also ensure full adoption of this curriculum by using accreditation procedures, and both the Ministries of Health and Education should offer funding support and policy backing. Pharmacy institutions should collaborate with digital health providers to ensure curriculum delivery and develop a strategy to train their staff to minimise resistance to adoption.

The proposed execution approach will include three stages. It will begin with short-term actions (0–1 year), such as curriculum development, faculty training, and infrastructure assessment. This should be followed by medium-term actions (1–3 years), which involve implementing digital health modules in selected institutions for evaluation. Finally, the long-term phase (>3 years) will focus on national digital health adoption. In addition, periodic curriculum reviews and continuous public–private funding should be pursued as long-term strategies to strengthen the inclusion of digital health in pharmacy training. This proposed model is based on logical staging and practical considerations for phased implementation.

The progress should be tracked by evaluating multiple outcomes such as the rate of curriculum implementation, faculty training completion, student digital literacy improvement, digital learning tool adoption, employer assessments of graduate readiness, infrastructure development, and policy or funding achievements. The monitoring of these indicators will both maintain accountability and provide evidence for policy adjustments while enabling the expansion of the programme. The systematic implementation of digital health in pharmacy education creates a bridge from theoretical knowledge to practical skills, leading to better-trained graduates who provide improved health services in digital healthcare environments.

Integrating digital health into Nigerian pharmacy education is an urgent necessity. Pharmacy graduates must be equipped to practice in a digital era where technology is at the focus of patient care, health systems, and global collaboration. This will also position Nigeria in consistent strides with global calls for digital transformations in health education and practice. The collective efforts of all relevant stakeholders are needed to achieve the full integration of digital health into pharmacy education in Nigeria. This requires embedding digital competencies into curricula, investing in faculty development, and aligning regulatory standards with technological innovation.