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The current fragmentation and limitations within Nigeria’s emergency and healthcare communication systems. The need for a robust, interoperable digital infrastructure that connects call centers, emergency responders, hospitals, and health authorities. A full audit of failed and successful models across Nigeria and similar African contexts to identify what has worked, what hasn’t, and why. Clear guidance on internal system design priorities and external integration pathways. A market and stakeholder assessment to identify where opportunities for innovation and adoption exist.
Disjointed Systems: Emergency phone lines (e.g., 112), ambulance dispatchers, and hospitals rarely share real-time information. This results in delayed response times, poor triage, and preventable loss of life. Lack of Interoperability Standards: No enforceable national standard currently exists for how different health systems should exchange emergency data, track patients, or share incident information. Institutional Hoarding of Data: Health institutions and emergency services operate in silos, often withholding or duplicating data, which severely impedes coordinated care. Infrastructure Gaps: Even when solutions exist (e.g., DHIS2, SORMAS), they are often limited to surveillance or reporting—not real-time, event-based emergency coordination. Low System Resilience: Most past emergency tech pilots were donor-funded and fell apart after the initial phase due to lack of ownership, poor technical integration, or weak policy backing.
Nigeria is on the cusp of implementing a centralized Electronic Medical Records (EMR) initiative, spearheaded by the Federal Ministry of Health and supported by agencies like NITDA and the Nigerian Digital Health Council. States like Lagos, Edo, and Kaduna are actively digitizing aspects of primary healthcare and emergency services, offering fresh opportunities for system-wide integration.
Africa’s digital health sector attracted over $450 million in funding between 2021 and 2023, signaling strong investor confidence in healthtech innovation. New accelerators, grant programs (e.g., Mastercard Foundation, Gates Foundation), and venture studios are focused on health systems strengthening through tech—especially post-COVID.
Rising urban populations, road traffic accidents, epidemics (Lassa, COVID, cholera), and natural disasters are increasing the burden on emergency services. The current lack of systemized response networks makes countries like Nigeria more vulnerable to mass casualty events and poor post-crisis care.
African regional bodies (e.g., AU, IGAD, WAHO) are pushing for cross-border health data interoperability—particularly for emergencies and disease surveillance. Any emergency response platform designed today must anticipate continental standards and integration protocols for future scale.
With no dominant solution yet in the emergency health space, and with national and international stakeholders actively seeking interoperable systems, ERA is strategically positioned to lead in building a foundational emergency health infrastructure that can scale across Nigeria and beyond.
The demand is extremely high, but coordination is almost non-existent.
Existing platforms cover isolated segments, not the full chain from call → dispatch → hospital → follow-up.
Policy direction is shifting toward national EMR integration and interoperability.
ERA has a first-mover advantage if it can align with upcoming digital health standards while creating strong internal interoperability across its ecosystem.
To digitize ambulance dispatch across Lagos and integrate it with the existing 112 emergency call system. The Lagos State Ambulance Services (LASAMBUS) partnered with a private vendor to deploy GPS-enabled tracking devices on government-owned ambulances. The system included a real-time dashboard and routing features to coordinate faster response.
Poor technical maintenance: The GPS devices frequently malfunctioned, and there was no long-term service contract in place. Unclear institutional ownership: LASAMBUS lacked direct control over the platform and data governance, leading to operational friction.No integration with hospitals: There was no formal data exchange with hospitals to anticipate admissions or automate patient records. Limited training and uptake: Emergency call center agents and responders were not consistently trained on the platform.
To establish a nationwide EMS structure that connects call centers, primary health centers (PHCs), and ambulance networks under a unified framework. Coordinated by the Federal Ministry of Health (FMoH) with support from WHO and NGOs, the NEMS pilot launched in select states with emergency hotlines, trained call handlers, and linkages to PHCs and ambulance services.
Lack of sustained funding: Donor support ended after the pilot phase, and the government failed to allocate follow-up budgets. No political continuity: Changes in leadership at the FMoH and state ministries stalled momentum. Fragmented state buy-in: States were not adequately consulted or aligned in implementation, leading to uneven adoption. Missing digital infrastructure: The scheme lacked the software backbone to support real-time coordination, analytics, or interoperability.
To build a tech-first emergency response solution that connects citizens to verified responders via mobile devices.
A private healthtech company developed an app featuring mobile GPS, incident reporting, ambulance dispatch alerts, and real-time tracking. It aimed to serve as a civilian-facing emergency coordination layer in Abuja.
No institutional partnership: The app was not integrated with the 112 system or government-owned ambulances. Low trust and adoption: Citizens were unfamiliar with the app, and emergency operators did not endorse or use it. Couldn’t scale beyond Abuja: Without backing from national agencies or telecoms, expansion to other states proved too resource intensive. No monetization or sustainability model: The company relied on user growth rather than B2B or government partnerships, limiting revenue.
Description: No single platform links emergency calls, ambulance response, hospital readiness, and post-incident follow-up. Impact: Delays in dispatch, duplication of records, and lack of oversight into the emergency response chain.
Interoperability Research
Research Report for ERA's Interoperability in Nigeria & Africa
Prepared for:
[ERA's Tech Team]
Prepared by:
ISRAEL AYODELE, Head of Products
Date: 07 June 2025
Executive Summary
This report presents a comprehensive overview of the current state, failures, and untapped opportunities within Nigeria’s and Africa’s emergency response and digital health interoperability landscape. Despite billions in donor and government investments, no system currently exists in Nigeria that successfully links emergency calls, dispatch centers, ambulances, hospitals, and post-incident follow-ups into a single, interoperable workflow.
The top five industry problems are persistent: institutional silos, fragmented data systems, voice-only emergency routing (112), unsustainable pilots, and the absence of a legally enforced interoperability policy. Past attempts, including Lagos’ LASAMBUS digitization and the federal NEMS initiative, have failed due to governance issues, lack of adoption, and poor technical integration.
Real-world models like Tanzania’s TZ-HIE and Kenya’s FHIR-based EHR efforts prove that scalable, standards-based health integration is possible across Africa — but Nigeria is behind. While systems like DHIS2, SORMAS, and the National Data Repository exist, they operate in isolation or serve limited use cases like HIV or epidemiology, not emergency care.
The Nigerian healthcare technology market is projected to reach $161.7M by 2027, with larger African digital health markets exceeding $3.8B. There is strong government and private sector momentum, with over $3 billion committed in the last two years for health reforms and infrastructure upgrades. However, the emergency response layer remains neglected.
This report identifies a clear, high-impact niche: building a lightweight, API-first Emergency Response Interoperability Layer (ERIL) that connects emergency call centers, dispatchers, ambulances, and hospitals using global standards (e.g. FHIR, OpenHIE). The solution can be whitelabeled, licensed, or embedded into state and federal systems, and integrated with existing digital tools already in use (e.g. SORMAS, DHIS2).
A trust-based rollout model, combined with strategic partnerships (e.g., OEMs, MoH, ambulance vendors), positions this as a commercially viable and system-transforming innovation — one that solves a high-frequency, high-severity problem with a clear ROI for both public and private health systems.
2. Introduction
Objective of This Report
This report aims to provide a comprehensive, evidence-based understanding of the state of emergency response interoperability in Nigeria and Africa, with the goal of informing the strategic planning and technical roadmap for the development of ERA (Emergency Response Application).
Specifically, it addresses:
Ultimately, this document serves as a foundational piece for both internal alignment and external engagement — providing the necessary insights to build a scalable, future-proof, and policy-aligned ERA ecosystem.
Context: The Problem with Emergency Response and Interoperability in Nigeria/Africa
Emergency healthcare systems across Nigeria — and much of Sub-Saharan Africa — remain severely fragmented, under-coordinated, and technologically siloed.
Key contextual issues include:
This failure to integrate emergency response systems across the healthcare value chain—from the first distress call to the hospital handover—creates enormous gaps in care, data loss, and inefficiencies that cost lives.
Why This Research is Urgent
The urgency of this research stems from a convergence of health sector reforms, digital transformation efforts, and regional priorities:
1. Federal and State-Level Health Reforms
2. Boom in Digital Health Investments
3. Increasing Demand for Emergency Infrastructure
4. Cross-Border and Regional Health Priorities
5. Strategic Timing for ERA
This research therefore serves as a critical first step in designing not just a digital product, but an interoperable, scalable ecosystem that addresses one of the most pressing gaps in African healthcare today. The timing, demand, and structural failures of past systems all point to a clear need—and window of opportunity—for bold, evidence-backed innovation.
Let me know if you want this structured as a slide deck section or turned into bullet points for executive briefings.
3. Industry Deep-Dive
The emergency response and healthtech interoperability space in Nigeria—and across Africa—is characterized by significant fragmentation, repeated failures to scale, and a lack of unified technical and governance standards. This section explores the most critical, recurring industry-wide challenges and maps the major stakeholders involved in shaping or inhibiting progress in emergency response innovation.
Review Table
Rank
Problem
Details
Rank
Problem
Details
1
Lack of real-time, integrated emergency response coordination
Emergency calls (112), ambulance dispatch, hospital admission, and incident tracking operate as separate verticals. There is no unified, live data system connecting them. As a result, response times are delayed, patient handovers are chaotic, and outcomes are poor.
2
Data silos between agencies and hospitals
Hospitals, private ambulance firms, government agencies (NCDC, FRSC), and state call centers all maintain isolated data systems. There are no shared identifiers, case IDs, or protocols for automatic record exchange. Each actor sees only a fragment of the emergency chain.
3
Fragmented systems and lack of interoperability infrastructure
Most legacy systems (hospital software, dispatch tools, incident logs) lack APIs, standard data formats, or cloud-native design. This makes real-time integration costly and complex. In some cases, tools used by one state (e.g. Lagos LASEMA) are completely incompatible with federal or private tools.
4
Low sustainability of donor-funded or pilot systems
Multiple emergency health pilots—especially those deployed during COVID or other epidemics—shut down after donor funding ended. These include command and control dashboards, mobile contact tracing apps, or emergency surveillance tools. They were never institutionalized within government systems.
5
Absence of legal, regulatory, and operational frameworks for interoperability
There is no clear legal mandate or standardized technical documentation (e.g. HL7, FHIR) that requires actors to build interoperable systems. Data-sharing agreements between hospitals and agencies are rare, and where they exist, they're often informal. This results in inconsistent compliance, poor data quality, and limited policy follow-through.
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3.1 Top 5 Industry Problems (Ranked by Severity and Frequency)
3.2 Stakeholder Map
A comprehensive look at the actors shaping emergency response, interoperability, and system adoption in Nigeria and the broader African context.
A. Government and Regulatory Bodies
Column 1
Column 2
Column 1
Column 2
Entity
Role
Federal Ministry of Health
Oversees national health policy; coordinating new centralized EMR efforts.
NCDC (Nigeria Centre for Disease Control)
Manages disease surveillance and public health emergencies; operates SORMAS.
NITDA (National Information Technology Development Agency)
Sets digital infrastructure policy and compliance requirements for data protection and IT standards.
NPHCDA (National Primary Health Care Development Agency)
Operates PHC networks; relevant for integrating with rural care and first responders.
NGF (Nigeria Governors’ Forum)
Influences state-level health tech adoption and budget allocations.
Federal and State Ministries of Health
Local implementation of emergency care systems and public health surveillance.
Emergency Call Centers (e.g., 112, LASEMA, FRSC)
First point of public contact; operate in isolation without connected dispatch or hospital intake links.
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B. Private Sector Actors
Column 1
Column 2
Column 1
Column 2
Entity Type
Examples / Description
HMOs
Reliance HMO, AXA Mansard, Hygeia; manage patient care financing, but typically not integrated with emergency or hospital systems.
Telehealth and Healthtech Startups
Helium Health, LifeBank, Healthtracka; some are building APIs or health data infrastructure, but emergency coordination remains untouched.
Ambulance and Emergency Services
Private ambulance providers, Red Cross; most lack shared tracking systems or digital dispatch platforms.
OEMs / Health IT Vendors
Providers of hospital software or diagnostics tools. Most systems are standalone and not designed for shared case management.
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C. International Development and Technical Partners
Column 1
Column 2
Column 1
Column 2
Partner
Involvement
WHO Nigeria & Africa Region
Supports digital health strategy, emergency coordination, and data standardization projects.
CDC Africa / Nigeria
Technical partner on disease surveillance and lab networks; backs SORMAS.
World Bank / Gavi / Global Fund
Fund national health infrastructure projects; typically demand systems alignment and long-term sustainability.
UNDP / UNICEF
Often fund state-level emergency preparedness pilots; some co-design health logistics systems.
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D. Local Actors and End Users
Column 1
Column 2
Column 1
Column 2
Stakeholder
Role
Hospitals & Clinics
Provide emergency care but often lack digital admission/alert systems.
PHCs (Primary Health Centres)
Handle rural emergencies and outbreak cases, but are rarely equipped for digital intake or referrals.
LGAs (Local Government Areas)
Control PHC-level infrastructure and staffing. Key gatekeepers for rural coverage.
State Emergency Call Centers
Such as Lagos LASEMA, operate in silos, not integrated with national or private hospital systems.
There are no rows in this table
What This Means for ERA
ERA is entering a market where:
The path forward for ERA must include not just product development—but policy engagement, technical adaptability, and ecosystem collaboration with both public and private actors.
4. Historical & Contemporary Innovation Audit
The emergency response and digital health space in Nigeria has seen multiple attempts at transformation—many well-intentioned but short-lived. These efforts, led by both government and private actors, often struggle to move from pilot phases to institutionalized systems due to weak coordination, unclear mandates, and funding or policy gaps. Below is an audit of three representative case studies that offer critical lessons for ERA's approach.
Example 1: LASAMBUS Digitization Pilot (Lagos State)
Goal:
Approach:
Why It Failed:
Example 2: National Emergency Medical Service (NEMS) Scheme
Goal:
Approach:
Why It Failed:
Example 3: G-Emergency Project (Abuja-based Private Initiative)
Goal:
Approach:
Why It Failed:
What We Learn from These Failures
Column 1
Column 2
Column 1
Column 2
Failure Category
Lessons for ERA
Technical fragility
ERA must ensure 24/7 platform reliability, support, and maintenance. This includes GPS, call routing, and dashboards.
No system-wide integration
Every module ERA builds should plug into hospitals, emergency centers, and health databases via APIs.
Poor governance
Institutional ownership and MOU-backed partnerships must be secured early in any deployment.
Lack of funding continuity
A sustainable business model—e.g., licensing, SaaS, or public-private financing—should be central to ERA’s scale plan.
Adoption barriers
ERA must include onboarding, training, and value demonstration to all stakeholders—end users, operators, and decision-makers.
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5. Gap Analysis & Innovation Threshold
This section evaluates the limits of innovation among key stakeholders in Nigeria’s emergency and health systems. It then identifies five major innovation loopholes — points of failure or absence in the current ecosystem — where meaningful and scalable transformation can occur.
5.1 Innovation Limits by Key Stakeholders
Table 13
Column 1
Column 2
Column 3
Column 1
Column 2
Column 3
Stakeholder
Innovation Limits
Reason
Federal Government
Policy-level innovation only
The federal government provides top-level strategies (e.g., NHMIS, EMR policy drafts), but implementation is decentralized, often requiring buy-in from individual states, which leads to slow or inconsistent rollouts.
State Governments
Fragmented systems
States have varying levels of digital readiness. Some use pen-and-paper systems, others have siloed digital tools. There’s no national mandate for standard emergency tools or platforms.
Hospitals
Legacy and siloed software
Many hospitals use outdated or proprietary record systems. Integration with external APIs or real-time coordination tools is either not supported or extremely limited.
Emergency Dispatch
No integration layer
The 112 call centers are voice-only systems. There is no underlying tech stack to track ambulance dispatch, sync with hospitals, or handle real-time incident data.
Donor-Funded Projects
Pilot-only scale
NGOs and global health funders launch pilots, but these projects often end after funding runs out. There's rarely government absorption or long-term sustainability planning.
There are no rows in this table
5.2 Five Innovation Loopholes
These gaps highlight where critical innovation is either missing or extremely underdeveloped — areas where ERA can lead or partner for strategic advantage.
1. No Universal Emergency Response Coordination Layer
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