Development of an IoT-Based Remote Patient Monitoring System for Chronic Disease Management in Rural Health Posts in Nigeria

Chronic disease management for hypertension and diabetes in rural Nigerian communities is challenged by low frequency of health facility contact and absence of structured between-visit monitoring, and internet-of-things-based remote patient monitoring offers a scalable solution whose technical performance under Nigerian rural conditions requires empirical development. This study develops and evaluates an IoT-based remote patient monitoring system for chronic disease management at rural health posts in Nigeria, with field deployment in Cross River and Plateau states. The system comprises a patient home unit integrating an automated blood pressure cuff, a glucometer with digital output, a pulse oximeter, and an ESP32 microcontroller transmitting measurements via GSM to a cloud MQTT broker, and a clinician dashboard web application visualizing patient measurement trends and flagging alert values. A health worker tablet application enables health post-based data entry and patient communication. System architecture was designed to function under intermittent connectivity using store-and-forward messaging to prevent data loss during connectivity gaps. A twelve-week field evaluation at five rural health posts involving forty-five hypertensive and diabetic patients assessed data transmission completeness, measurement frequency compliance, clinical alert response rates, and patient and health worker usability. Data transmission completeness was 89 percent across the field period. Patient compliance with twice-weekly measurement schedules was 74 percent. Clinical alerts generated fourteen clinical responses including three medication adjustments and two urgent referrals, demonstrating clinical value. Usability ratings were high among both patients and health workers. The study recommends larger-scale clinical effectiveness evaluation. Keywords: IoT, remote patient monitoring, chronic disease management, rural health posts, Nigeria.