“Virtual nurses”: Can AI fill the gaps in Nigeria’s primary healthcare?

AI-powered “virtual nurses” are stepping in to provide first-line care, offering advice through familiar platforms like WhatsApp—but challenges abound.

Nigeria’s primary healthcare system is riddled with structural deficiencies. Official figures show that there are over 34,000 PHCs, yet only 10–25% are functional—meaning that they are staffed, equipped, supplied with drugs, and have the capacity to provide continuous everyday care.

Basic medical equipment is especially scarce. A 2023 survey estimates that only 29.9% of public primary health facilities contain core equipment like thermometers and stethoscopes. Primary drugs are available in only about 34% of PHFs. 

In response, virtual nurses have emerged to support the strained healthcare system, delivering symptom assessment and health advice, especially in underserved areas. 

AwaDoc, an AI-driven health attendant on WhatsApp recently launched in Nigeria, onboarded over 11,000 active users in its beta phase and handled over 73,000 messages from patients across various African nations. 

AISHA by Sproxil, a WhatsApp-based AI assistant, launched recently to provide responses to general health queries beyond the company’s earlier focus on drug authenticity. 

Though it is not yet state-government run, AISHA demonstrates the rising role of consumer-facing virtual health companions in Nigeria, showing how private sector innovation is expanding access to quick, low-cost health advice in familiar platforms like WhatsApp.

These platforms are supplemental and don’t replace human nurses, yet they minimise delay in clinical assistance and deliver simple advice that decreases pressure on physical clinics.

How virtual nurses can assist

Depending on the scale of the problem, virtual nurses offer several possible gains: they can operate 24/7, so when clinics are closed, they still provide advice. They are lower cost than deploying more physical infrastructure or hiring large numbers of new staff immediately. 

They reduce wait times and can help people decide if a condition is urgent or manageable at home, reducing unnecessary visits. 

“In communities where one doctor may serve more than 3000 people, AI-driven assistants can at least provide first-line support; they don’t replace doctors, but they can reduce the number of people falling through the cracks.” explained Douglas Philips, an Abuja-based physician. 

For vaccination, tools like ADVISER (an AI-driven tool for optimising vaccine intervention allocation) have been used among over 13,000 families in Oyo State, helping to increase vaccine uptake. 

Limitations

However, virtual nurses still have certain challenges. More than 70% of respondents in rural areas report patchy network access. Nigerian broadband penetration is around 47%, with many rural regions under-represented.

Language is another hurdle. Many digital health platforms are designed in English, which can exclude rural and older populations who communicate better in indigenous languages. 

Without cultural and linguistic adaptation, virtual nurses risk misdiagnosing symptoms or providing advice that feels distant and irrelevant, Douglas said.

“Most of my patients struggle with English medical terms, so bringing an AI nurse that responds in Pidgin or Hausa could make health advice less intimidating and more relatable.” 

Still, many users favour face-to-face consultation in lieu of automated consultation.

What needs to be done

For virtual nurses to be effective in Nigeria’s healthcare system, solutions must be locally grounded and realistic.

First, AI health assistants should be grounded in local context, reflecting disease patterns, drug availability and the common language used to describe symptoms.

Part of the early success of AwaDoc was that it interfaced easily via WhatsApp, requiring little setup and reaching people where they were already present.

A hybrid approach is also needed. Virtual nurses can provide triage and first-line guidance, but there must be a clear pathway to human backup when high-risk cases are flagged. Without that safety net, patients may either delay urgent treatment or lose confidence in the technology. 

Investment in infrastructure is another essential layer. Predictable electricity supply, dependable rural wireless, and cheap data are crucial for digital health resources to reach beyond the cities. 

This should accompany regulatory policies that lay out respective roles for telemedicine, data security, and culpability upon misdiagnosis or harm. 

Lastly, both citizens and healthcare workers must be tech-savvy to exploit these tools. Publicity campaigns may help establish a trusted base by outlining clearly what’s within the competence of the virtual nurses and what should remain with human doctors. 

An evolving trend

Virtual nurses—AI-driven avatars, chatbots, or WhatsApp assistants—are an innovative tool that has already gained measurable traction in Nigeria.

Given that only about a quarter of PHCs are completely functional, and many LGAs lack qualified medical officers, such tools may alleviate essential gaps of accessibility, delays in medical assistance, and overloaded human clinicians. 

But success is dependent on infrastructure, regulation, trust, and integration with existing health systems. When a tool such as a virtual one is introduced judiciously, with human supervision, it can offer far more than an emergency stopgap. 

They can become a regular companion at the frontline of healthcare, especially where primary care is weakest.