Digital Health Equity in Nigeria: A Scoping Review of How Equity Is Conceptualized, Operationalized, and Measured

This research project, “Digital Health Equity in Nigeria: A Scoping Review of How Equity Is Conceptualized, Operationalized, and Measured,” aims to provide the first comprehensive synthesis of evidence on digital health equity within Nigeria’s evolving digital health ecosystem. As Nigeria expands its investment in digital health through the National Digital Health Strategy, electronic medical records, telemedicine platforms, mobile health applications, artificial intelligence-enabled tools, and donor-supported digital health programmes, there is growing recognition that these innovations may not benefit all populations equally. While digital technologies have the potential to improve healthcare access, quality, and efficiency, they may also unintentionally reinforce existing social and health inequities if barriers such as poor internet connectivity, limited device ownership, low digital literacy, disability, geographic isolation, poverty, gender disparities, and language differences are not adequately addressed. The purpose of this study is to examine how the concept of digital health equity is understood, applied, and assessed across research studies, policies, programmes, and implementation initiatives in Nigeria. Although equity is increasingly referenced in digital health discussions, there is currently no widely accepted framework or consistent approach for defining and measuring digital health equity in the Nigerian context. As a result, it remains difficult to compare findings across studies, evaluate whether digital health interventions are reaching underserved populations, or determine whether current investments are reducing or widening inequities in healthcare access and outcomes. To address this gap, the project will conduct a rigorous scoping review using internationally recognized methodologies, including the Joanna Briggs Institute (JBI) framework and the PRISMA-ScR reporting guidelines. The review will systematically identify and analyze evidence published between 2006 and 2026 from peer-reviewed literature, policy documents, government reports, programme evaluations, conference proceedings, and other relevant grey literature. Sources will be collected from databases such as PubMed, African Journals Online (AJOL), and Google Scholar, as well as from key national and international organizations involved in digital health in Nigeria. The review will focus on four key questions: 1. How digital health equity is conceptualized in Nigerian research, policy, and practice. 2. How digital health equity is operationalized through the design, implementation, and governance of digital health interventions. 3. How digital health equity is measured, including the indicators, frameworks, methodologies, and equity dimensions used to assess equitable access, adoption, utilization, and outcomes. 4. What evidence gaps remain regarding underserved populations, geographic disparities, and underexplored dimensions of equity. The study will examine a broad range of equity dimensions, including socioeconomic status, gender, age, disability, education, language, digital literacy, geographic location, internet connectivity, electricity access, and digital device ownership. It will also explore whether existing initiatives use established frameworks such as the Digital Divide Framework, Digital Inclusion Frameworks, Digital Determinants of Health, or PROGRESS-Plus to guide equity-related activities and evaluations. Data extracted from included studies will be analyzed using both descriptive and qualitative approaches. The review will identify recurring definitions, conceptual models, implementation strategies, and measurement approaches while also documenting the populations and settings that receive the greatest or least attention in existing research and programmes. Particular emphasis will be placed on understanding how equity considerations are incorporated into digital health interventions through strategies such as local language adaptation, accessibility features, community health worker support, low-bandwidth functionality, and other context-specific approaches designed to improve inclusion. The expected outcomes of this research are significant for both policy and practice. First, the review will generate a comprehensive evidence map of digital health equity in Nigeria, bringing together fragmented information from multiple sectors and disciplines. Second, it will identify strengths, limitations, and evidence gaps in current approaches to promoting and assessing equity in digital health. Third, the findings will provide a foundation for developing context-specific frameworks, indicators, and measurement tools that can be used to assess digital health equity more consistently across future research and programmes. Finally, the study will support evidence-informed policymaking by providing practical insights for government agencies, development partners, researchers, healthcare providers, and digital health implementers seeking to ensure that digital health investments benefit all Nigerians, particularly underserved and marginalized populations. Ultimately, this project seeks to contribute to a more equitable digital health future in Nigeria by strengthening the evidence base needed to design, implement, evaluate, and govern digital health interventions in ways that promote inclusion, reduce disparities, and advance universal health coverage.