Justina Asishana takes a look at how Niger State is revolutionising its healthcare system, tackling fragmented medical records, delayed care and sleaze within the system, through the implementation of Digital Public Infrastructure DPI technology.
Gone are the days of lost files,” declares Niger State’s Commissioner for Communications, Technology, and Digital Economy. Suleiman Isah This is a bold statement that marks the beginning of a technological revolution in the state’s healthcare system. Through the implementation of Digital Public Infrastructure, Niger State intends to tackle decades-old challenges of fragmented medical records, delayed care, and exploitative practices that have plagued its health sector.
Hadiza Abdullahi had spent N400 to visit the hospital only to be told that her paper‐based medical file, where all her health treatment and diagnosis history were stored, was missing.
She is thus being compelled to undergo a new folder preparatory process in order to see the doctor. That would cost her time and money.
“It pained me so much. The distance where I have to go and buy the file from the hospital is very far. The stress would have been too much for us. That is why I just decided to go home and come back the following week. I spent N800 to and fro that day over nothing”, Hadiza lamented.
With her medical records gone missing, Hadiza had to explain her diabetic condition over again to the doctor on her next visit.
Many health facilities in the Niger State are still running paper records. Manual record-keeping and fragmented systems have led to lost files, duplicated costs, and delayed care to patients.
Health professionals aren’t able to digitally share data of patients and exchange information to provide care to patients. Making referrals means patients would have to carry their files along.
Chime Azuka was referred from the General Hospital in Gulu to the IBB Specialist Hospital in Minna due to his kidney condition. He told The Nation that they had to wait for the doctor for some time to sign the referral letter to enable him to be admitted into the IBB Specialist Hospital.
Ongoing DPI reforms
There have been calls for reforms and leveraging Digital Public Infrastructure at health facilities in Niger State. Some of the health facilities are now rolling out the transition from manual to digital health management systems.
The key is the integration of a national identification-linked health card designed to replace paper files and siloed hospital records. The card, tied to patients’ national ID numbers, creates a lifelong digital health profile accessible across all state facilities.
“Gone are the days of lost files,” declared Suleiman Isah, Niger State’s Commissioner for Communications, Technology and Digital Economy. “With this card, your medical history —diagnoses, treatments, lab results—follows you anywhere.
“We are currently working on automating the health records of the general hospitals across the state. We have started with Jummai Babangida General Hospital and General Hospital Minna. We are done with M.I. Wushishi General Hospital and Talba Housing Estate General Hospital. By next month, we will move to Suleja and New Bussa general hospitals.
M.I Wushishi General Hospital and Talba Housing Estate General Hospital are showing signs of transformation with the latest adoption of such digital management systems.
“What we are doing is that we are scanning all the active files in the hospitals to make the health sector fully digital. We are introducing a unified hospital card. With that one hospital card, you can go to any of the 23 secondary health facilities in the state to access health services.
For patients like Chime Azuka, who faced delays in securing a referral letter for kidney treatment, the system will eliminate bureaucratic hurdles. “Doctors at IBB Specialist Hospital can now instantly access records from General Hospital Gulu,” Isah explained.
The initiative aligns with global DPI frameworks, using digital identity to anchor patient data securely. Over 10,000 active files have already been digitised across four hospitals, with full statewide coverage expected by mid-2025.
“If you are in Suleja and you are involved in an accident, with your medical card in your wallet or bag, the doctor there can see every treatment that you have been taking in Minna. You don’t have to buy another card and you don’t need a referral letter.”
Digital Payments: Curbing Exploitation, Ensuring Transparency
Alongside identity, the card embeds a digital payment wallet. Patients fund the wallet via bank transfers or receive contributions from family, with spending restricted to medical services.
“So, instead of using POS or cash in the hospital as it is being used now, the patient finds the wallet. It is more like your health account but it is a wallet. People can also contribute to the wallet if they want to assist someone who has a medical issue financially. The person cannot spend this money in the wallet unless in any of the hospitals,” the Commissioner said.
“The hospital card will ensure proper tracking of drugs sold and the amount of injections given. There will be proper accountability. The patients will also receive alerts of every service they receive or drugs they buy. This wallet is a safeguard,” Isah emphasised.
“If you go to the laboratory for a medical test and it is N1,500 but the person attending to you says N5,000; when you use your card, the amount charged for that service is already in the system and that is what the system would deduct from your wallet. So you are not aiding any extortion practice and no more inflated charges.”
For Hadiza, who faced arbitrary fee hikes for replacement cards, the transparency is transformative. “No more begging for fair prices,” she said.
The infrastructure also enables real-time accountability. Patients receive SMS alerts for every transaction, while hospitals track drug inventories and service usage digitally. “Fraudulent billing by staff drops when payments are automated,” Isah noted.
Data Exchange: Breaking down silos
Critical to the DPI framework is interoperable data exchange, enabling hospitals to securely share patient records. Previously, referrals required physical letters, risking delays. Now, health workers at Talba Housing Estate Hospital can instantly retrieve a patient’s X-rays or medical records from Suleja General Hospital.
Emergency responders, for instance, can access allergy histories or chronic conditions during crises, even if the patient is unconscious.
While the system is still rolling out, patients like Zainab Mustapha are optimistic, “Seriously, those laboratory attendants can really exploit people. Even the cost of buying cards is becoming something else, from N200 to N500 and now N1,000. The hospital card will help us a lot because many of us have seen hell at the hands of these healthcare workers”, Zainab Mustapha said.
Hadiza agrees, saying, “If this means no more lost files or begging for referrals, I’ll embrace it fully.”
For Niger State, the initiative marks a leap toward equitable healthcare. By anchoring services in DPI—digital identity, payments, and data networks—the state is not only solving today’s inefficiencies but building a resilient system for tomorrow’s challenges.
As Isah put it: “This is how healthcare should work: seamless, transparent, and centred on the patient.”
This report is produced under the DPI Africa Journalism Fellowship Programme of the Media Foundation for West Africa and Co-Develop.
